The Irish promotion of the survey was led by the Health Service Executive (HSE) website Drugs.ie and their affiliated social media channels. Sampling focused on populations accessible through online platforms. People who use drugs but who do not present to addiction services were of particular interest to the survey designers. This group includes a nightlife cohort that is underrepresented in official reports. The survey sought to engage with this population to ascertain if their drug use was continuing outside of the nightlife arena. A series of advertisements were issued with subcultural dance magazines to reach the target audience. Advertisements were place in these magazines and on Facebook and Instagram channels.2
The survey did not attempt to estimate prevalence or the extent of particular drug-using behaviours in Europe. Nevertheless, it provides a useful snapshot of patterns of drug use during Covid-19 restrictions in Ireland among a small cohort of people using drugs at that time and who chose to respond to the survey.
Study demographics
Almost three-quarters (71.2%) of participants were male; 27% were female; 1% identified as non-binary; and 0.9% selected ‘prefer not to say’. Age ranged from 18 to 67 years, with a median age of 26 years. Over one-half (54.1%) lived in a city, 30.9% in a town, and 15.1% in a village.
Drug usage
Respondents were asked about their frequency of drug use in the last year and in the last month for the following substances: cannabis, ecstasy, cocaine, amphetamines, heroin, LSD, synthetic cannabinoids, other synthetic stimulants
(e.g. cathinones), and other opioids without medical prescription (e.g. methadone, buprenorphine, fentanyl, or others) (see Table 1). Last-month use coincided with a period of Covid-19 restrictions. Cannabis was the most commonly used drug, with 85.2% and 64% reporting last-year and last-month use, respectively. While last-year use of both cocaine (71%) and ecstasy (62.6%) was high, last-month use of both substances was much lower (cocaine 29.2%, ecstasy 11.2%).
Impact of Covid-19 restrictions on drug use
Last-year users of each drug were asked if their use of that drug had changed since the introduction of Covid-19 restrictions. Eleven options were provided and respondents could select more than one option (see Table 2). Due to low numbers, the following options are not presented here: started using; used psychoactive medicines instead (e.g. benzodiazepines); used a new psychoactive substance instead; used a different form (e.g. pills, powder, capsule); used by a different route (e.g. changed from injecting to smoking or vice versa); and used other illicit drugs instead.
Table 1: Last-year and last-month drug use by drug type
* Data were only included for respondents who answered both last-month and last-year questions; respondents with contradictory responses, e.g. those reporting last-month use of a drug but reporting never use in the last year, were excluded.
Cannabis users were more likely than cocaine or ecstasy users to use more frequently (32.6%) and in greater quantities (12.5%) since the introduction of the Covid-19 restrictions. Those who used cannabis daily or almost daily were most likely to use more frequently (43.9%) compared with 16.9% of those who used cannabis less than monthly. Just 11.9% of cannabis users stopped using cannabis compared with 39.9% and 46% who reported stopping use of cocaine and ecstasy, respectively.
Changes in illicit drug use since introduction of Covid-19 restrictions
Respondents were asked ‘in general, would you say you have used more or less illicit drugs, since the start of the Covid-19 epidemic in your country?’ Of the 655 valid responses, 36.2% used less, 22.6% used more, 15.4% used the same amount, 23.5% had not used illicit drugs, and 2.3% did not know. The main reasons reported for using less illicit drugs were fewer opportunities to use drugs (65.4%) and reduced availability of drugs to buy (49%) (see Table 3).
Table 2: Changes in cannabis, ecstasy, and cocaine use since introduction of Covid-19 restrictions
* All last-year ecstasy users are presented together, as most respondents (82%) reported less than monthly use.
Table 3: Reasons for decreased and increased drug usage since Covid-19 outbreak
Note: Respondents could select more than one option.
Changes in how illicit drugs were obtained since Covid-19 outbreak
Less than two-thirds (63.2%) of respondents had obtained or attempted to obtain illicit drugs since the Covid-19 outbreak. Of these, 22.6% reported no difficulties accessing illicit drugs; 60.3% reported accessing drugs to be somewhat or moderately difficult; and 17.1% reported extreme difficulty. Those who had obtained illicit drugs reported a number of changes in the way in which they obtained illicit drugs (see Table 4). One-third (33.9%) of respondents who had obtained illicit drugs obtained larger quantities of drugs compared with pre-Covid times, while 28.4% used a different dealer. Of those who had obtained drugs since the Covid-19 outbreak, 22.3% reported that the purity of drugs was lower, while 5.6% reported higher purity; 3.3% reported that the cost of drugs was lower, while 39.9% reported higher costs.
Intention to access treatment and harm reduction professional supports
Regarding professional support, 6.6% reported an increase in their intention to seek professional support to reduce or abstain from illicit drugs since the Covid-19 restrictions, while 11.9% reported an increase in their use of online or remote professional support services to seek support for reducing drug-related risk behaviours and/or drug use.
Table 4: Changes in how illicit drugs were obtained during Covid-19 restrictions
Note:Respondents could select more than one option.
Conclusion
There have been changes in the patterns of illicit drug use since Covid-19 restrictions were implemented in Ireland. Cannabis users were least likely to change their pattern of use, although daily/almost daily users reported using cannabis more frequently. Those who used cocaine and ecstasy prior to the Covid-19 outbreak were more likely to stop using those drugs altogether. The main reason for reduced use of illicit drugs was fewer opportunities available to use drugs, while boredom was the main reason cited for increased use of illicit drugs.
Deirdre Mongan
2 The Health Research Board would like to acknowledge the role of Nicki Killeen (HSE Social Inclusion) in promoting this survey among the target group.
