There has been a massive increase in people who have already developed a severe drinking problem by the time they seek help, new figures show.
Publishing their 2018 report on alcohol treatment, the Health Research Board says this makes treatment more difficult.
The HRB says those in treatment report drinking significantly more on a typical day than should be consumed per week for low-risk drinking.
The agency also reports a significant rise in the number of drinkers who are also using cocaine, particularly among men.
There has also been a jump in cases involving homeless people, particularly men.
In more positive trends, the HRB reports notes a drop in the number of new treatment cases, involving people never before in treatment, and a significant fall in cases involving people under the age of 18.
Headline figures from the report show:
These latter figures show a significant trend in terms of the level of alcohol abuse by people by the time they reach out for help.
“Two in three cases were already dependent on alcohol when they presented to treatment for the first time,” said Dr Anne Marie Carew, research officer at HRB.
“This means that more people are presenting when the problem is already severe which makes treatment more complex and recovery more difficult.”
She said that on average both men and women presenting for treatment were drinking more in a typical day than would be advised by the HSE in one week for low-risk drinking.
She said the women were consuming typically 15 standard drinks per day, when the low-risk guideline for women over a full week was 11 standard drinks.
A standard drink is a half pint of regular beer, 100 mls of wine (a small glass) or a pub measure (35mls) of spirits.
That translates to around a bottle and a half of wine or five and a half pints.
The men in treatment were typically consuming 20 standard drinks a day, compared to the weekly threshold of 17.
That low risk guideline translates to around two and a third bottles of wine or eight and a half pints per week.
Preferred drinks for women were spirts (36%) and wine (35%), followed by beer (20%).
For men, it was beer (45%), spirits (38%) and wine (9%).
There has been a slight increase in polydrug use (alcohol and at least one other drug), from 19% of cases in 2012 to 22% in 2018.
Cannabis is still the main second drug, but the proportion of cases has dropped, while cases involving cocaine have jumped by 70%, from 453 to 772.
Cocaine as an additional drug was far more common among men (one in two cases) than women (two in five cases).
“Cocaine continues to increase as an additional drug,” said HRB chief executive Darrin Morrissey.
Other figures show that around half of cases involved people who were unemployed, while the proportion of cases involving homeless people doubled to one in ten of all cases, including 12% of men.
Almost a quarter of all cases were people who had left education before the age of 16.
In relation to new cases, those under 18 have dropped dramatically, from 213 in 2012 to 87 in 2018.