Inspire’s Insights and Information Manager, Kiara Moore, shares her insights from the Public Health Agency’s latest briefing event.
Last week, colleagues from across the substance use, health and social care sectors came together for the Public Health Agency’s ‘Emerging Drug Trends’ briefing event, during which they explored the latest evidence of challenges related to drug use and drug-related harm in Northern Ireland.
The gathering was particularly relevant to the research I am currently undertaking for my PhD thesis, Exploring Conflict-Related Trauma and Problematic Substance Use within Post-Conflict Northern Ireland.
This was a valuable opportunity to reflect on current drug trends, while also considering these factors within the wider social, historical and post-conflict context of Northern Ireland.
Furthermore, the event afforded us the chance to consider current statistics, what they tell us about changing patterns of substance use and the effect of those patterns on people, families, communities and services.
⭕️ Drug-related deaths remain a significant concern
According to the Northern Ireland Statistics and Research Agency, 251 drug-related deaths were registered in 2024. Of these, 219 met the definition of drug misuse.
Men accounted for more than two-thirds of drug-related deaths, while people aged 35 to 44 had the highest drug-related mortality rates.
The figures conveyed the significant impact of deprivation. Between 2020 and 2024, the most deprived areas accounted for 43.7% of all drug-related deaths, compared with 7.4% in the least deprived locales.
These figures are more than statistics. Behind every number is a person, a family and a community affected by substance use and its consequences.
⭕️ Increasingly complex patterns of substance use
A key theme of the day was the ever more complex profile of drug use in Northern Ireland.
Opioids were mentioned in 52.2% of drug-related deaths in 2024; benzodiazepines were referenced in 51%. Pregabalin was the individual drug cited most frequently, appearing in 40.2% of drug-related deaths.
There has also been a considerable increase in deaths involving multiple substances. The proportion of deaths involving five or more drugs increased from 12.7% in 2014 to 21.9% in 2024.
This underlines the importance of understanding substance use in its wider context and recognising the risks associated with multiple substances, rather than considering individual drugs in isolation.
A particularly concerning issue discussed by representatives from the PSNI and partner agencies was the predominance of synthetic opioids. Intelligence presented during the discussions suggested that they are becoming ubiquitous, posing major risks due to their potency and association with overdose-related harm. Oxycodone was highlighted as a growing concern across the island of Ireland, which reflects wider changes within opioid markets and consumption habits.
The misuse of prescription and pharmacy medicines was identified as another looming problem. Experts expressed concern around the expanding misuse of codeine-containing medications, including over-the-counter preparations classified as Schedule 5 controlled drugs. While codeine can be effective for the short-term management of acute pain, it is highly addictive and can cause harm when misused. Presenters emphasised concerns that codeine is increasingly being used beyond its intended purpose, raising crucial public health considerations despite the regulatory controls surrounding its supply.
The burgeoning availability of high-strength vaping products containing tetrahydrocannabinol and synthetic cannabinoids, often referred to as Spice, was another topic of conversation. These products were reported to be associated with acute adverse reactions — including collapse — and serious health consequences. Their strength, unpredictable contents and ease of access continue to present substantial problems for health, treatment and enforcement services.
Even with the appearance of new substances, cannabis remains the most commonly used illicit drug in Northern Ireland. That said, the drug market continues to evolve, with new products, novel psychoactive substances and increasingly potent forms of existing drugs contributing to greater levels of risk.
Elsewhere, cocaine continues to constitute an important concern. In 2024, it was the most prominent drug in deaths involving only one substance, accounting for 40.7% of single-drug deaths.
When the agenda moved on to the subject of drug driving offences, presenters pointed out that cannabis had historically been most commonly detected in drug driving cases. Cocaine, however, became most prevalent substance associated with drug driving in 2022 that that this is still the case today. This shift stressed the wider societal impacts associated with substance use beyond treatment settings. In addition, methylmethcathinone is, more and more, a feature of drug driving casework. Although often receiving less public attention than cocaine or cannabis, its pervasiveness demonstrates how rapidly drug markets can change and reinforces the need for continued monitoring and public awareness.
Taken together, these findings illustrate a substance-use landscape that is diverse, complex and unpredictable. Services, policymakers and communities must continue to adapt to emerging trends while ensuring that interventions remain grounded in evidence and responsive to changing needs.
⭕️ What does this mean for services?
The shifting nature of drug use means that treatment and support services must develop in sync with that change.
A person experiencing problematic substance use may often have complex and overlapping needs, from mental and physical health conditions to trauma, housing, relationships and poverty.
For me, this was particularly striking when considered alongside my own research interests. Understanding substance use in Northern Ireland requires us to look beyond individual behaviours and consider the broader contexts of people’s lives. Experiences of trauma, adverse life events, deprivation, social exclusion and inequality all play important roles in shaping substance use and recovery journeys.
Effective support, therefore, needs to be accessible, person-centred and non-judgemental. Early intervention can make a real difference. People do not have to wait until they have reached crisis point before seeking help.
👉🏻 Steps to Change is here to help
If you, or someone you care about, is struggling with alcohol or drug use, support is available through Steps to Change.
Steps to Change provides support to adults and families across Northern Ireland who are affected by alcohol or drug use. You can self-refer and access support at a pace that works for you.
If you live within the Belfast Health and Social Care Trust or Southeastern Health and Social Care Trust areas, please feel free to contact Inspire Addiction Services using the details below:
📞 0800 987 4117
📧 addictionservices@inspirewellbeing.org
🌐 www.inspirewellbeing.org
If alcohol or drug use is affecting you, your health, your relationships or your family, please reach out to Steps to Change today.
Taking that first step can be difficult, but support is available. You do not have to face it alone.
If you live in any of Northern Ireland’s other health and social care trust areas across, you can be connected to the most appropriate local service through Inspire’s Right Support Right Time programme.
📞 0808 189 0036
📧 hello@inspirewellbeing.org
Live chat is available via www.inspirewellbeing.org