Trends in cocaine use and cocaine-related harms in Ireland: a retrospective, multi-source database study (2025)

Background: Increased cocaine supply has coincided with increased global cocaine use. In 2019 Ireland had one of the highest last-year rates of cocaine use in Europe. However, there is a lack of data on the health-related impacts of cocaine use in European countries over time.
Methods: This retrospective, multi-source database study utilised data from national databases to evaluate the following time trends: (1) prevalence of cocaine use; (2) number of cocaine-related hospital discharges; (3) number of cocaine-related psychiatric hospital admissions; (4) treatment demand for problem cocaine use; and (5) cocaine-related deaths. Joinpoint regression was used to examine change points over time and average annual percentage changes (AAPCs).
Results: Last-year cocaine use among 15-64-year-olds increased from 1.1% in 2002/03 to 2.4% in 2022/23. The number of cocaine-related acute hospital discharges per 100,000 population increased from 1.4 in 2000 to 24.3 in 2023 (AAPC: 13.0%; 95% CI: 11.95, 14.84), and psychiatric hospitalisations increased from 0.2 in 2000 to 2.4 in 2022 (AAPC: 11.1%; 95% CI: 9.41, 15.48). Treatment entrants reporting cocaine as a main problem drug increased from 1.5 per 100,000 population in 2000 to 93.2 in 2023 (AAPC: 17.6%; 95% CI: 15.89, 20.74), while cocaine-related deaths increased from 0.3 in 2000 to 5.6 in 2020 (AAPC: 16.9%; 95% CI: 14.71, 21.70). In general, rates of harm increased from 2000 to 2007, decreased until 2011-2013, and since 2013 have increased significantly and consistently.
Conclusions: Multiple databases show significant increases in cocaine-related harm since 2000. Responding to cocaine-related health problems and prevention efforts focused on cocaine constitute a public health priority. [Author's abstract]