2014 NATIONAL REPORT (2013 Data) TO THE EMCDDA by the Reitox National Focal Point IRELAND New Developments, Trends REITOX Acknowledgements Addiction service managers, drug treatment facilities and general practitioners Central Statistics Office Central Treatment List Coroner Service Customs Drugs Law Enforcement of the Revenue Commissioners Department of Education and Skills Department of Health Department of Justice and Equality Department of Social Protection Forensic Science Laboratory Garda National Drugs Unit General Mortality Register Health Protection Surveillance Centre Health Service Executive Hospital In-Patient Enquiry scheme Irish Prison Service National Advisory Committee on Drugs and Alcohol National Documentation Centre on Drug Use The Garda Síochána Office for the Minister for Children and Youth Affairs Voluntary and community groups and academic researchers We would specially like to thank the following: Dr Joe Barry, Ms Elaine Butler, Dr Des Corrigan, Ms Caroline Comar, Professor Catherine Comiskey, Mr John Craven, Mr Niall Cullen, Ms Gretta Crowley, Ms Aileen Dooley, Mr Joe Doyle, Dr Brian Farrell, Mr Liam Hughes, Dr Pierce Kavanagh, Dr Eamon Keenan, Dr Alan Kelly, Mr John Moloney, Ms Niamh Murphy, Dr Kate O’Donnell, Dr Dan O’Driscoll, Ms Dairearca Ní Néill, Mr Brendan Ryan, Ms Susan Scally, Dr Bobby Smyth, Dr Lelia Thornton and Professor Miriam Wiley. Finally, we would like to express our sincere thanks to our Health Research Board colleagues working in the area of alcohol and drug related research Fiona Bannon, Anne Marie Carew, Ita Condron, Mary Dunne, Ena Lyn, Vivion McGuire, Deirdre Mongan, Joan Moore, Mairea Nelson and Simone Walsh who provided access to literature, analysed data from reporting systems or summarised literature for Drugnet Ireland. Brian Galvin Head of the Irish Focal Point This report was written by: Johnny Connolly Suzi Lyons Margaret Curtain Brigid Pike Martin Keane This report was compiled by Mairea Nelson and Brigid Pike. Please use the following citation: Irish Focal Point (2014) 2014 National Report (2013 data) to the EMCDDA by the Reitox National Focal Point. Ireland: new developments, trends. Dublin: Health Research Board. 2 Contents Summary of each chapter ................................................................................ 6 Main points from Part A ................................................................................................... 6 Part A: New Developments and Trends ........................................................ 12 1. Drug policy: legislation, strategies and economic analysis ....................... 12 1.1 Introduction ......................................................................................................... 12 1.2 Legal framework ................................................................................................. 12 1.2.1 Laws, regulations, directives or guidelines in the field of drug issues ........... 13 1.2.2 Laws implementation .................................................................................. 14 1.3 National action plan, strategy, evaluation and co-ordination ................................. 17 1.3.1 National action plan and/or strategy ............................................................. 17 1.3.2 Implementation and evaluation of national action plan and/or strategy ......... 18 1.3.3 Other drug policy developments .................................................................. 23 1.3.4 Co-ordination arrangements ......................................................................... 26 1.4 Economic analysis ............................................................................................... 27 1.4.1 Public expenditures ..................................................................................... 27 1.4.2 Budget......................................................................................................... 29 2. Drug Use in the General Population and Specific targeted-Groups .......... 30 2.1 Introduction ......................................................................................................... 30 2.2 Drug use in the general population (based on probabilistic sample) ...................... 31 2.3 Drug use in the school and youth population (based on probabilistic sample) ....... 33 2.4 Drug use among targeted groups/settings at national and local level ..................... 34 3. Prevention ...................................................................................................... 35 3.1 Introduction ......................................................................................................... 35 3.2 Environmental prevention.................................................................................... 36 3.2.1 Alcohol and tobacco policies ............................................................................... 36 3.3 Universal prevention ........................................................................................... 36 3.3.1 School ......................................................................................................... 36 3.3.2 Family ......................................................................................................... 40 3.2.3 Community ................................................................................................. 40 3.4 Selective prevention in at-risk groups and settings ............................................... 41 3.4.1 At-risk groups ............................................................................................. 41 3.4.2 At-risk families ........................................................................................... 42 3.4.3 Recreational settings (incl. reduction of drug and alcohol related harm) ....... 43 3.5 Indicated prevention ............................................................................................ 43 3.5.1 Children at risk with individually attributable risk factors ............................ 43 3.5 National and local media campaigns .................................................................... 44 4. High Risk Drug Use (HRDU) .......................................................................... 45 4.1 Introduction ......................................................................................................... 45 4.2 Prevalence of and trends in HRDU ...................................................................... 45 4.2.1 Estimates of high risk drug use prevalence ................................................... 45 4.2.2 Other sources of information on prevalence of high risk drug use ................ 45 4.2.3 Trends in this area ....................................................................................... 48 4.3 Characteristics of high risk drug users.................................................................. 49 4.3.1 Main patterns of polydrug use among the main groups of high risk drug users49 4.3.2 Data and studies of characteristics of high risk drug users ............................ 49 5. Drug-related treatment: treatment demand and treatment availability ...... 53 5.1 Introduction ......................................................................................................... 53 5.2 General description, availability and quality assurance ......................................... 54 5.2.1 Strategy/policy ............................................................................................ 54 5.2.2 Treatment systems ....................................................................................... 55 5.2.2.1 Organisation and quality assurance .................................................................. 55 5..2.2.2 Availability and diversification of treatment ................................................... 56 3 5.3 Access to treatment ............................................................................................. 58 5.3.1 Characteristics of treated clients (TDI data included) ................................... 60 5.3.2 Trends in treated population and treatment provision (incl. numbers) ........... 63 6. Health Correlates and Consequences .......................................................... 64 6.1 Introduction ......................................................................................................... 64 6.2 Drug-related infectious diseases........................................................................... 65 6.2.1 HIV/AIDS and viral hepatitis ...................................................................... 65 6.2.2 STI’s and tuberculosis ................................................................................. 70 6.2.3 Other infectious morbidity ........................................................................... 70 6.3 Other drug-related health correlates and consequences ......................................... 70 6.3.1 Non-fatal overdoses and drug related emergencies ....................................... 70 6.3.2 Other topics of interest e.g. psychiatric and somatic co-morbidity ................ 75 6.4 Drug-related deaths and mortality of drug users ................................................... 77 6.4.1 Drug-induced deaths (overdoses/poisonings) ............................................... 77 6.4.2 Mortality and causes of deaths among drug users ......................................... 79 6.4.3 Specific causes of mortality indirectly related to drug use ............................ 79 7. Responses