While most drug poisoning deaths across Europe involve opioids, benzodiazepines are implicated in many deaths and are frequently present in deaths involving opioids.¹

The benzodiazepines involved in these deaths are not always prescribable benzodiazepines; indeed, one driver behind an increase in drug poisoning deaths, particularly in Scotland, is the emergence of benzodiazepine-type new psychoactive substances (NPS) such as etizolam.² Scotland’s experience with etizolam, and the implications for Irish drug poisoning deaths, were addressed in a letter published in the Irish Journal of Psychological Medicine in 2024.³

The non-medical use of prescription drugs has become a global health concern. Non-medical usage is defined as the taking of prescription drugs, whether obtained by prescription or otherwise, except in the manner or for the reasons or time period prescribed, or by a person for whom the drug was not prescribed.¹

A Trendspotter study undertaken between May and September 2019 by Ana Liffey Drug Project and the European Union Drugs Agency (EUDA) Irish National Focal Point identified converging signals of the non-medical use of pharmaceuticals in Ireland.² The user groups identified included high-risk opioid users, prison populations, people with complex and multiple needs, and young people. Among these groups, the motivations for using street tablets were for their intoxicating effects, to enhance desired effects from illicit substances, to help withdrawal symptoms, to improve sleep, and to reduce stress.

A new report from Trinity College Dublin presents a decade-long exploration of non-fatal opioid overdoses (NFODs) in Ireland.¹ Authored by Professor Jo-Hanna Ivers and Neil Dunne, the study combines clinical data, systematic review findings, and policy analysis to shine a light on the evolving nature of opioid-related harm, especially within Dublin’s inner city.

The study found that between 2011 and 2021, over 2,500 NFOD cases were recorded in Ireland’s acute hospitals. Dublin’s inner city, despite accounting for just a fraction of the national population, was disproportionately affected. Heroin was the most implicated opioid until 2020, when methadone, a drug used in opioid agonist treatment, surpassed it in prevalence. Outside the city, other opioids, including prescription and synthetic drugs, emerged as primary contributors to overdose, pointing to different risk environments across urban and rural contexts.