Ireland Country Drug Report 2018

Drug harms

Drug-related infectious diseases

Notification data from the Health Protection Surveillance Centre indicate that the numbers of new cases of human immunodeficiency virus (HIV) infection have shown an increasing trend in the last five years, which may be partly explained by changes in reporting procedures in some areas of Ireland. In 2016, a total of 512 people were newly diagnosed with HIV infection, of whom 21 were people who inject drugs (PWID). This compares with 50 notifications reported in 2015, which was the highest number of PWID among HIV notifications reported since 2008 and was linked to an outbreak of HIV among homeless drug users in Dublin.

In 2016, more than one third of hepatitis C virus (HCV) cases were attributed to injecting drug use; however, a risk factor was reported for fewer than half of all reported cases of HCV infection. Old age (older than 34 years), gender (male) and place of residence (living in Dublin or the surrounding counties) were noticeable characteristics of PWID among HCV notifications in Ireland.

With regard to hepatitis B virus (HBV) infections, a downward trend in the number of notifications was observed between 2008 and 2014; however, recent data suggest that numbers of cases diagnosed and notified are stabilising. Risk factor data were available for 81 % of the acute cases notified and of these almost two thirds were likely to have been sexually acquired.

 

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Drug-related emergencies

In Ireland, data on drug-related acute emergencies refer to all admissions to acute general hospitals with non-fatal overdoses and are extracted from the Hospital In-Patient Enquiry scheme. The long-term trend shows a decrease in overdose cases in the last decade (5 012 cases in 2005 and 3 956 cases in 2015). In 2015, one third of the cases were younger than 25 years and more than half of those admitted to hospital were female. More than one third of the non-fatal hospital drug-related emergencies were linked to non-opioid analgesics (mainly paracetamol), while psychotropic substances were present in one quarter of cases and benzodiazepines in less than one fifth. Alcohol was present in about 1 out of 10 cases.

Opioids were the most common illicit substances in non-fatal intoxications involving narcotics or hallucinogens (13 % of cases), followed by cocaine and cannabis.

Emergency departments in two Irish hospitals, in Dublin and Drogheda, participate in the European Drug Emergencies Network (Euro-DEN Plus) project, which was established in 2013 to monitor acute drug toxicity in sentinel centres across Europe.

 

Drug-induced deaths and mortality

Drug-induced deaths are deaths directly attributable to the use of illicit drugs (i.e. poisonings and overdoses).

In 2015, the number of drug-induced deaths reported from a special register maintained by the Health Research Board remained stable at 224, compared with 223 deaths reported in 2014. Most those who died were male and were in their late 30s. The mean age of victims in 2015 was 39 years, the highest ever recorded, mainly due to the increase in deaths in those aged 55 years or older compared with 2014. The reason for this increase is not yet known, although more than half of deaths among those aged 55 years or older were among women.

Opioids were by far the drugs most commonly associated with drug-induced deaths, although they were frequently found together with other psychoactive substances, such as alcohol and prescription medicines.

No information regarding overall mortality among cohorts of drug users is reported.

The drug-induced mortality rate among adults (aged 15-64 years) was 70 deaths per million in 2015, which is more than three times the most recent European average of 21.8 deaths per million.

 

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