Drug and Alcohol Trends Monitoring System (DATMS) 2022: Year 7

Research Objectives & Method

In 2015 we developed our DATMS in Dublin 15. The objective was to establish an evidence base for drug use in Dublin 15 and use this data to inform local service provision. The study is repeated annually to always have current information and monitor changes over time. This report documents the seventh year of our DATMS. The Year 1 reporting period began June 2014, Year 2 began June 2015, Year 3 to 7 is from 2017 to 2021. The DATMS employs a mixed-method design comprised of primary and secondary data sources. Years 1 to 5 and 7 involved a trend report, and Year 6 involved a qualitative longitudinal study that explored clients’ experiences of attending treatment and family support services.

Trend Analysis

A trend analysis from Years 1 to 7 identifies three recurring themes emerging from different data sources. These themes give us a deeper understanding of the nature and consequences of drug and alcohol use in Dublin 15. As a range of data sources has produced these themes, the validity of the research findings has been strengthened.

THEME 1: Drug use in Dublin 15 is a community wide issue that crosses all socio-economic boundaries

This theme profiles drug use in Dublin 15 as a community wide issue that crosses all socio-economic boundaries. It has been identified by the following data sources: treatment demand, untreated drug use, factors contributing to drug use, and the consequences of drug and alcohol use. The evidence is as follows:

1. Mapping treatment demand for treated drug users and family members affected by drug and alcohol use, including hidden harm (children aged under 18), has identified that clients were from every community in Dublin 15, from the affluent to the socio-economically deprived.
2. Years 1 to 7 reported treated drug users aged under 18 attended secondary schools with and without DEIS status. Since Year 3, the evidence reports that these schools were a mixture of affluent and socio-economically deprived.
3. All six years of the DATMS trend data reported untreated drug use among all socio-economic groups, ethnicities and in all areas of Dublin 15.
4. Since Year 1, drug dealing has been reported in local secondary schools. From Years 3 to 7, over 60% of secondary schools had evidence of drug dealing, with Year 5 reporting drug dealing in all local secondary schools. Since Year 3, these schools have been a mixture of affluent and socioeconomically deprived, including those with and without DEIS status.
5. All six years of the DATMS trend data reported drug use before and during school time in local secondary schools. Since Year 2, the evidence reports that these schools were a mixture of affluent and socio-economically deprived and included those with and without DEIS status. Since Year 5, participants reported drug use in all local secondary schools.
6. Since Year 1, participants reported that some secondary school students’ education was compromised due to drug use before and during school. Since Year 2, participants reported that these schools were a mixture of affluent and socio-economically deprived and included those with and without DEIS status.

THEME 2: Normalisation of drug and alcohol use in Dublin 15

In all six years of the DATMS trend data, the normalisation of drug use has featured prominently. The common perception was that alcohol and drugs were widely used, risk free and socially acceptable. The following data sources have identified this theme: treatment demand, untreated drug use, factors contributing to drug use and gaps in service provision. Alcohol was the most normalised drug in Dublin 15, followed by cannabis, cocaine powder, benzodiazepines and z drugs. Service providers and drug users reported the following consequences of normalisation:

1. Since Year 3, the normalisation of drug use was reported as a factor contributing to the increase in drug use in Dublin 15.
2. The normalisation of drug use may be a factor contributing to the reduction in the age of drug users in Dublin 15. Since Year 3, it has been reported that untreated drug users have been getting younger.
3. Since Year 3, data concerning gaps in service provision has reported the need to improve treatment programmes for under 18s and young people aged 18 to 25. Research participants reported that these programmes must proactively attract the most vulnerable and hard-to-reach as most young drug users do not perceive the need for treatment. The normalisation of drug and alcohol use may be a factor that hinders help-seeking.
4. Since Year 2, an increase in the amount of under 18s dealing drugs has been reported. Since Year 5, participants reported that drug runners were getting younger. The normalisation of drug use may influence a young person’s decision to become involved in the drug market as they may not identify the negative consequences of such behaviour.
5. All six years of the DATMS trend data reported the family context as a risk factor for the normalisation of drug and alcohol use and the development of inter-generational drug and alcohol dependence. Since Year 3, the majority of treated drug users who participated in the DATMS reported having family members who also had issues with drugs and/or alcohol.
6. Treatment demand data reports the main drugs used were those which were normalised, except for heroin:
   • Treated drug users aged under 18: From Years 1 to 7, cannabis herb was the most commonly used drug, followed by alcohol; since Year 2, an increase in the use of cannabis herb, cocaine powder and alcohol was reported
   • Treated adult drug users: From 2016 to 2021, the NDTRS reports the five main problem drugs were cocaine, alcohol, heroin, cannabis and benzodiazepines; over the reporting period, an increase in the number of cases treated for cocaine, alcohol and cannabis was reported, with cocaine becoming the most common main problem drug

THEME 3: Increase in drug and alcohol use in Dublin 15

Since Year 2, an increase in the use of drugs and alcohol has been reported by treated and untreated drug users. The data identifies how an increase in the availability of drugs and alcohol and the normalisation of drugs and alcohol contributes to this trend. The increase in drug and alcohol use has been identified by the following data sources: treated drug use, untreated drug use and factors contributing to drug use.

1. Treatment demand data reported an increase in the number of cases treated for drug and/or alcohol use, and this may be associated with an increase in drug use:
   • NDTRS data reports treated adult cases increased by 67% from 292 in 2016 to 487 in 2021
2. Since Year 2, treated and untreated drug users reported an increase in the use of the following drugs:
    

   Drug type	Treated drug users		Untreated drug users
   	Young	Adult	Young	Adult
   Alcohol	↑	↑	↑	↑
   Cannabis herb	↑	↑	↑	↑
   Cocaine powder	↑	↑	↑	↑
   Benzodiazepines, z drugs		↑
   Crack cocaine		↑
   Ketamine			↑	↑

   In addition, in Year 7, treated and untreated drug users also reported an increase in the use of the following drugs:
    

   Drug type	Treated drug users		Untreated drug users
   	Young	Adult	Young	Adult
   Benzodiazepines, z drugs			↑	↑
   Ketamine	↑
   Cannabis concentrates (oil, wax)	↑		↑	↑
   Nitrous oxide	↑		↑	↑
   Prescribed opiates		↑
   OTC codeine		↑
   Methamphetamine		↑
   Amphetamines		↑
   MDMA			↑	↑
   Cannabis edibles		↑	↑	↑
   GHB/GBL			↑	↑
   Methylphenidate			↑	↑

3. Each year the DATMS has reported an increase in the availability of drugs in Dublin 15. This increase is associated with an increase in drug and alcohol use. It identifies how demand influences the local drug market. This increase in demand has also increased the number of drug distributors. All drugs that have increased in availability are the most commonly used, except for crack cocaine:
   • Since Year 1, an increase in the availability of benzodiazepines and z drugs has been reported; since Year 4, synthetic (NPS) benzodiazepines and z drugs were reported to be more commonly available than authentic tablets
   • Since Year 3, an increase in the availability of cannabis herb, powder and crack cocaine has been reported
   • Year 7 reported an increase in the availability of MDMA, ketamine and nitrous oxide
4. The increase in drug use is also associated with an increase in the types of drugs available, which identifies new trends in drug use. The chart below reports the new drugs that have entered the local market and the year they were first reported to the DATMS. Most of these drugs are not commonly used though some are increasing in popularity.
    

   DATMS	Year Drug
   Year 1	Lean (syrup)
   Year 2	GHB/GBL
   Year 3	Cannabis concentrate (oil)
   Year 4	Cannabis concentrate (wax) Nitrous oxide
   Year 5	Cannabis edibles (sweets, chocolates) Cannabis drinks
   Year 7	Methylphenidate

   • In addition, with the use of cannabis cakes, the re-emergence of an old trend has been reported by treated and untreated drug users since Year 5
   • Since Year 5, the use of alcohol-free drinks by untreated drug users has been reported
   • Year 7 treated and untreated drug users reported the use of the prescribed stimulant drug methylphenidate (Ritalin, Concerta). The misuse of this drug has been long established, and this possibly signifies the re-emergence of an old trend
5. As reported above, since Year 3, the normalisation of drug use was reported as a factor contributing to the increase in drug use in Dublin 15.

Treated Drug & Alcohol Use

Treated drug users aged under 18

• Treated cases aged under 18 decreased by 16% from 51 in Year 1 to 43 in Year 7, though fluctuations in this trend were reported during this period
• From Years 1 to 7, the majority of cases were male, white Irish and aged from 15 years, and cannabis herb was the most commonly used drug, followed by alcohol
• Changes in the profile of treated cases:
  • From Years 1 to 7, an increase in the use of cannabis herb, cocaine powder and alcohol were reported
  • From Years 3 to 7, a change in the profile of polydrug use was reported, with a decrease in polydrug use from Years 3 to 5 and an increase from Year 6
  • From Years 3 to 7, the majority of cases were in education
  • From Years 1 to 7, there has been an increase in the number of secondary schools and training centres attended by treated cases aged under 18; some Years reported almost all secondary schools and training centres in Dublin 15 have students with drug and/or alcohol problems
  • Other changes are reported above in the trend analysis section

Treated drug users aged 18 and over

• NDTRS data reports treated cases increased by 67% from 292 in 2016 to 487 in 2021. From 2016 to 2021:
  • The majority of treated cases were Irish, male, aged 35 to 44 years
  • A third of cases were in treatment for the first time
  • The five main problem drugs were cocaine, alcohol, heroin, cannabis and benzodiazepines
  • From 2016 to 2021, the majority of cases were treated for polydrug use, with the exception of 2019 where the majority were treated for non-polydrug use
  • Other changes in the profile of drug and alcohol use are reported above in the trend analysis section
• From Years 1 to 7, treated adult drug users reported an increase in the use of cannabis herb, alcohol, powder and crack cocaine, benzodiazepines and z drugs

Untreated Drug & Alcohol Use

• All six years of the DATMS trend data reported similar profiles of untreated drug use by young people and adults:
  • Alcohol, cannabis herb, MDMA and cocaine powder were the main drugs used
  • Polydrug use was the norm and alcohol was an integral part of it
  • Changes in the profile of untreated drug use included:
    • From Years 3 to 7, untreated drug users were getting younger
    • From Years 1 to 7, untreated young and adult drug users have continued to report an increase in the use of alcohol, cannabis herb, cocaine powder and ketamine
      • Year 7 also reported an increase in the use of nitrous oxide, GHB/GBL and cannabis edibles
    • Other changes are reported above in the trend analysis section
• Prevalence rates estimated 23,711 (77%) of Dublin 15 residents aged 15 to 34 years used alcohol in the last year and 39,448 (78%) aged from 35 years; and 5,543 (18%) of Dublin 15 residents aged 15 to 34 years used illegal drugs in the last year and 2,023 (4%) aged from 35 years

Factors Contributing to Drug Use

Accessibility of Drugs and Alcohol

• Factors contributing to the ease of access to drugs included an increase in the number of people dealing drugs in Dublin 15, this includes young people aged under 18
• Other changes are reported above in the trend analysis section

Normalisation of Drug and Alcohol Use

• As reported above in the trend analysis section

Family Context

• All six years of the DATMS trend data reported the family context as a risk factor for the normalisation of drug and alcohol use and the development of inter-generational drug and alcohol dependence
• Year 7 was the first year we quantified the extent of hidden harm within the community; hidden harm relates to treated drug use and family support cases with children aged under 18. Year 7 reported 943 treated drug use and family support cases, and 41% (385) of these cases had children aged under 18
  • Prevalence rates estimate from 15% to 24% (4,907-7,852) of children were impacted by parental illicit drug use in Dublin 15, and from 14% to 37% (4,580-12,105) were impacted by parental alcohol dependency in Dublin 15
  • The number of cases (385) in 2021 accounts for between 3% and 8% of the estimates which identifies that our data underrepresents the extent of hidden harm in Dublin 15

Mental Health

• Poor mental health is a risk factor for drug use which identifies the importance of early intervention
• From Years 1 to 7, service providers reported an increase in the incidence of mental health issues among children, young people and treated adult drug users
• The negative impact of inter-generational drug use and deprivation on young people’s mental health was reported

Consequences of Drug and Alcohol Use

Health Consequences

• HIPE data from 2012 to 2021 reported the following:
  • Overall, the number of treatment episodes for mental health and behavioural disorders associated with drug and alcohol use increased by 154% from 169 in 2012 to 430 in 2021
  • Overall, the number of treatment episodes for poisonings increased by 200% from 17 in 2012 to 51 in 2021

Social Consequences

• All six years of the DATMS trend data reported the negative impact drug use has on family relationships, employment, finances, housing and education
• From 2017 to 2021, the number of family members receiving support increased by 385% from 149 in 2017 to 722 in 2021:
  • Over the reporting period, there has been a significant increase in the number of family members who attended evidence-based/informed programmes

Drug-Related Crime

• All six years of the DATMS trend data reported the existence of drug-related crime in Dublin 15
• From Years 3 to 5, drug debt intimidation was the most frequently occurring crime and Year 7 reported that anti-social behaviour had become the most common drug-related crime
• Since Year 3, participants reported an increase in most drug-related crimes
  • Year 7 participants associated this increase with an increase in the use of powder and crack cocaine

Education Prevention

• The BLDATF D15 Family Support service coordinates a limited number of educational assessments/interventions which complement the Department of Education’s provision
• The programmes primary focus is to reduce risk factors for drug and alcohol use and ensure best outcomes for primary school children and their families living in Dublin 15
• The number of children who received support for psychological issues increased by 171% from 17 in Year 5 to 46 in Year 7
  • The number of education prevention interventions increased by 432% from 43 in 2019 to 229 in 2021

Service Provision Strengths & Gaps Identified by Research Participants

Strengths of Addiction Services

• The Dublin 15 addiction services offer a continuum of care from low threshold to stabilisation, to drug free and rehabilitation programmes for young people and adults
• Treatment, rehabilitation, and family support services provide supportive and non-judgemental environments for people affected by alcohol or drug use
  • Engagement with evidence-based programmes empowers people to improve coping strategies, increase resilience and prioritise wellbeing
  • The shared experience of peer support reduces isolation, fosters a sense of belonging and improves wellbeing

Gaps in Service Provision

Education & prevention

• Improve drug prevention programmes for under 18s
• Increase knowledge of local service provision on a local and targeted basis

Treatment

• Improve treatment programmes for adolescents, young people and adults
• Improve access to detoxification programmes
• Increase access to mental health services for children, young people and adults

Rehabilitation

• Improve access to aftercare services
• Increase access to training, employment and apprenticeships
• Increase access to housing