Drug and Alcohol Trends Monitoring System (DATMS) Year 8

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 eighth year of our DATMS. The Year 1 reporting period began June 2014, Year 2 began June 2015, Year 3 to 8 is from 2017 to 2022. The DATMS employs a mixed method design comprised of primary and secondary data sources. Years 1 to 5 and 7 to 8 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 8 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 8 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 seven 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 8, 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 socio-economically deprived, including those with and without DEIS status.
5. All seven 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. From Year 3, participants reported drug use in at least 80% of local secondary schools, with Years 5 and 8 reporting drug use in all 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 socioeconomically deprived and included those with and without DEIS status.

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

In all seven 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 alcohol users in Dublin 15. Since Year 3, untreated drug users who use alcohol 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 seven 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 intergenerational 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 8, 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 2022, 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, cannabis and benzodiazepines 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:
   • Treated drug users aged under 18 increased by 31% from 51 in Year 1 to 67 in Year 8
   • NDTRS data reports treated adult cases increased by 107% from 292 in 2016 to 606 in 2022
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			↑	↑

   Year 8 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
   Cannabis concentrates (oil, wax)	↑	↑	↑	↑
   Cannabis edibles	↑	↑	↑	↑
   Nitrous oxide	↑		↑	↑
   Benzodiazepines, z drugs			↑	↑
   Ketamine	↑
   Prescribed opiates		↑
   Pregabalin (Lyrica)		↑
   OTC codeine		↑
   Methamphetamine		↑
   Amphetamines				↑
   GHB/GBL		↑
   Lean (Syrup)			↑	↑

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. The majority of the drugs that have increased in availability are the most commonly used:
   • 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 and powder cocaine has been reported
   • Year 8 reported an increase in the availability of 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. All of these drugs, except for nitrous oxide, 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
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 increased by 31% from 51 in Year 1 to 67 in Year 8, though fluctuations in this trend were reported during this period
• From Years 1 to 8, the majority of cases were male, white Irish and aged from 15 years, cannabis herb was the most commonly used drug, followed by alcohol
• Changes in the profile of treated cases:
  • From Years 1 to 8, an increase in the use of cannabis herb, cocaine powder and alcohol were reported
  • From Years 3 to 8, 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 8, the majority of cases were in education
  • Treated young drug users attend most local schools/training centres. There has been an increase in the amount of secondary schools and training centres attended by treated cases aged under 18, from 54% in Year 1 to 71% in Year 8
  • From Years 1 to 8, treated young drug users reported an increase in the use of cannabis herb, alcohol and cocaine powder

Treated drug users aged 18 and over

• NDTRS data reports treated cases increased by 107% from 292 in 2016 to 606 in 2022. From 2016 to 2022:

  • The majority of treated cases were Irish, male, aged 35 to 44 years
  • About 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 2022, the majority of cases were treated for polydrug use, with the exception of 2019
• From Years 1 to 8, 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 seven years of the DATMS trend data reported similar profiles of untreated drug use by young people and adults:
  • Alcohol, cannabis herb, MDMA, cocaine powder, benzodiazepines and z drugs 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 8, alcohol users were getting younger
    • From Years 1 to 8, untreated young and adult drug users have continued to report an increase in the use of alcohol, cannabis herb, cocaine powder and ketamine
      • Since Year 3, an increase in the use of benzodiazepines and z drugs has been reported
      • Since Year 4, an increase in the use of cannabis products has been reported including cannabis oil, wax and edibles
      • Since Year 5, an increase in the use of nitrous oxide has been reported
  • Prevalence rates estimated 24,753 (78%) of Dublin 15 residents aged 15 to 34 years used alcohol in the last year and 48,234 (78%) aged from 35 years; and 5,786 (18%) of Dublin 15 residents aged 15 to 34 years used illegal drugs in the last year and 2,474 (4%) aged from 35 years
  • Prevalence rates of cannabis and alcohol dependence among the general population and treatment demand data identify low levels of help-seeking among cannabis and alcohol dependent people in Dublin 15; 1% of people with alcohol dependence and 4% of people with cannabis disorders sought treatment in 2022

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 seven 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 intergenerational drug and alcohol dependence
• Since Year 7 we have 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. From Year 7 to 8, there has been an increase in the incidence of children affected by familial drug or alcohol use, from 41% (385) to 45% (363) of treated drug use and family support cases
  • Prevalence rates estimate from 15% to 24% (5,053-8,053) of children were impacted by parental illicit drug use in Dublin 15, and from 14% to 37% (4,698- 12,416) were impacted by parental alcohol dependency in Dublin 15
  • The number of cases (363) in 2022 accounts for between 3% and 8% of these 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 8, 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 2022 reported the following:
  • Overall, the number of treatment episodes for mental health and behavioural disorders associated with drug and alcohol use increased by 163% from 169 in 2012 to 444 in 2022
  • Overall, the number of treatment episodes for poisonings increased by 71% from 17 in 2021 to 29 in 2022

SOCIAL CONSEQUENCES

• All seven years of the DATMS trend data reported the negative impact drug use has on family relationships, employment, finances, housing and education
• From 2017 to 2022, the number of family members receiving support increased by 215% from 149 in 2017 to 470 in 2022:
• 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 seven years of the DATMS trend data reported the existence of drug-related crime in Dublin 15
• From Years 3 to 5, drug-related intimidation was the most frequently occurring crime, this changed to anti-social behaviour in Year 7 and visible drug use in Year 8
• Since Year 3, participants reported an increase in most drug-related crimes and since Year 7 this was associated 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 147% from 17 in Year 5 to 42 in Year 8

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 childcare for people attending day and residential programmes
• Increase out-of-hours service provision
• 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