EMCDDA Home
  • EN
Search

Drug treatment overview for Ireland

Map of Ireland

1. National context

In Ireland the Department of Health is responsible for developing and reviewing drug treatment policy and strategy, while the Health Service Executive (HSE), which manages Ireland’s public health sector, is responsible for implementing this treatment strategy and preparation of annual National Service Plans. The management of all addiction services falls under the remit of Primary, Community and Continuing Care, which oversees a number of national care groups. Funding for treatment is generally provided by the statutory sector through the HSE; however, in some cases individuals are obliged to contribute to the cost of drug treatment (excluding methadone maintenance treatment), usually through private medical care plans.

Treatment is provided through a network of statutory and non-statutory agencies. Medication-assisted treatment includes opioid detoxification and opioid substitution treatment (OST), mainly methadone, alcohol and benzodiazepine detoxification, psychiatric treatment and various forms of counselling and psychotherapy. Medication-free therapy uses models such as therapeutic communities and the Minnesota Model, frequently adapted to the needs of the clients.

Alternative therapies such as acupuncture are provided through both statutory and community projects. Furthermore, pregnant opioid users are entitled to immediate access to treatment. There are also specific initiatives available for drug users under the age of 18. These include psychiatric therapy, family therapy and specially adapted medication-free therapy. The total number of drug treatment services available in Ireland showed a strong increase between 1998 and 2004, with the largest expansion in the outpatient sector.

The integrated care pathways model was recently piloted in Ireland and it also forms the conceptual basis for the National Drug Rehabilitation Framework published in 2010. Detoxification is provided through various inpatient services: psychiatric hospitals, specialised detoxification units and detoxification beds within residential centres. Outpatient detoxification is supported in the community through outpatient services including clinics and general practitioners (GPs).

OST is provided by treatment centres, specialised GPs and in prisons. Methadone, introduced in 1992, is the most commonly used agent for opioid detoxification and substitution treatment. As of 31 December 2013 a total of 9 640 clients enrolled in OST had received methadone. In order to improve the quality of OST new guidelines for prescribing methadone in pregnancy were issued in 2013, while the first national clinical guidelines for opioid treatment are under revision.

In July 2009 a feasibility study began on the use of suboxone treatment as an alternative to methadone. It was conducted at several specialist addiction centres in Dublin and a number of Level II GP practices in Dublin and around the country. An independent evaluation conducted in 2010/2011 found that 139 patients were registered as having received suboxone treatment between 2006 and 2011. In 2010 the Department of Health set up an expert group to examine the regulatory framework for products containing buprenorphine/naloxone and buprenorphine only for the treatment of opioid dependence. Based on relevant documents and on the evaluation of the feasibility study for suboxone, the group defined the circumstances under which the use of the buprenorphine/naloxone combination is appropriate, while recommending the use of methadone as the drug of first choice.

top of page

2. Treatment registries and monitoring systems

At present there are two national registers recording drug treatment in Ireland. The National Drug Treatment Reporting System (NDTRS) is an epidemiological database on treated problem drug use set up in 1990 and managed by staff at the Drug Misuse Research Division of the Health Research Board. This reporting system complies with the requirements of the Treatment Demand Indicator (TDI) protocol.

The Central Treatment List is a complete register of all persons treated with methadone and is used to regulate methadone use and pay general practitioners for their services. The variables collected through this system are name, address, date of birth, place where treated, type of methadone treatment, date started this treatment episode, date exited last treatment episode and reason for exit. This list is administered by the Drug Treatment Centre Board on behalf of the Health Service Executive.

The number of treatment places for opiate dependence increased from 6,000 places by end 2001 to 7,390 places by end March 2005. Each treatment centre and general practitioner have a maximum quota of clients that they are allowed to register. The quota depends on the services provided as well as staff qualifications and mix. The number in each quota are referred to as treatment places.

top of page

3. Treatment demand

Table 1: Number of clients entering treatment in Ireland by year
Clients in treatment 2010 2011 2012 2013
Number of all clients entering treatment 8511 N.Av. 7703 8684
Number of all clients entering treatment with known primary drug 8511   7703 8684
% of which for opioid use 57.9   52 51.3
% of which for cocaine use 10.0   8 7.8
% of which for cannabis use 22.9   29 28.9
% of which for stimulants use (other than cocaine) 1.2   1 1.5
Number of new clients entering treatment 3740 N.Av 3270 3470
Number of new clients entering treatment with known primary drug 3740   3270 3470
% of which for opioid use 39.0   32 29.7
% of which for cocaine use 13.3   9 9.2
% of which for cannabis use 35.7   46 47.0
% of which for stimulants use (other than cocaine) 1.5   1 2.3
Notes:
The variation across time, in particular with regard to the absolute numbers of clients in treatment, should be interpreted with caution as coverage data may have changed over time. For further information on coverage details please refer to the relevant EMCDDA Statistical Bulletin.
For an explanation of terms used, see the definitions of terms.
Sources:

Reitox national reports 2014 and TDI tables.
EMCDDA Statistical Bulletin 2015.

top of page

4. Treatment provision

Table 2: Opioid substitution treatment provision in Ireland
Opioid substitution treatment 2010 2011 2012 2013
Number of clients in opioid substitution treatment 8727 8729 8923 9640
of which with methadone 8727 8729 8923 9640
of which with buprenorphine 0 0 0 0
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
‘N. Av.’ stands for ‘No information available’.
For an explanation of terms used, see the definitions of terms.
Sources:
Standard Tables 24 (ST24) on 'Treatment availability' submitted in 2014.
Table 3: Year of official introduction of opioid substitution treatment substances in Ireland
Applied substances in opioid substitution treatment Officially introduced in
Methadone (MMT) 1992
Buprenorphine (HDBT) 2002
Heroin assisted treatment N.App.
Slow-release morphine N.App.
Buprenorphine/naloxone combination 2007
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
‘N. App.’ stands for ‘Not applicable’.
For an explanation of terms used, see the definitions of terms.
Sources:
Reitox national reports.
Table 4: Legal framework of opioid substitution treatment in Ireland
Legal framework of opioid substitution treatment Methadone Buprenorphine
Do office-based medical doctors have the right to initiate the prescription of substitution treatment? N.App. N.App.
Do specialised medical doctors have the right to initiate the prescription of substitution treatment? Yes N.App.
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
'Specialised medical doctors' refers to specifically trained or accredited office-based medical doctors.
Notes:
For an explanation of terms used, see the definitions of terms.
Sources:
Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2014.

top of page

5. References and links

Related EMCDDA resources

External links

Please note that the EMCDDA is not responsible for the content of external sites.

Treatment inventories

top of page

About the EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU's decentralised agencies. Read more >>

Contact us

EMCDDA
Praça Europa 1, Cais do Sodré
1249-289 Lisbon
Portugal
Tel. (351) 211 21 02 00
Fax (351) 218 13 17 11

More contact options >>

Page last updated: Friday, 22 May 2015