Treatment for cocaine use surged last year, with more than 15,442 cases, report shows

The report said crack cocaine cases were recorded in all counties, bar Leitrim, Monaghan and Mayo.

Treatment for cocaine surged to new heights last year, with an emerging trend of increased use of synthetic drugs and ketamine.

The Health Research Board (HRB) said social disadvantage remained a “persistent feature” of treatment cases, with six out of 10 people unemployed and almost one in eight homeless.

The HRB 2025 Drug Treatment Demand report reveals powder cocaine cases were recorded from every county in Ireland.

Most cocaine cases (44%) were in Co Dublin, followed by Cork (7%) and Limerick (5%).

The report says there was a total of 15,442 treatment cases in 2025, compared to 13,295 in 2024 (+16%).

Of these cases:

• Cocaine accounted for 6,535 cases — previously treated and new cases — a jump of 24% on 2024;
• Cocaine accounted for 42% of all treatment cases, the greatest number, followed by opioids (mainly heroin) at 25%, and cannabis (15%);
• Cannabis was the most common problem drug for those aged under 19;
• Cocaine accounted for 51% of new treatment cases, seen as a more accurate reflection of current trends.

The report said crack cocaine cases were recorded in all counties, bar Leitrim, Monaghan and Mayo. Three in four crack cases were in Co Dublin, followed by Limerick (12%).

While numbers are still small, there are emerging trends in other drugs:

• New psychoactive substances, including synthetic cannabis, jumped by 51%, from 170 cases in 2024 to 256 cases in 2025;
• New cases for ketamine more than doubled, from 57 in 2024 to 130 cases in 2025; 
• There were 249 cases last year where people vaped their drug, compared to 100 vaping cases in 2024. In more than half of the vaping cases, the majority were taking HHC, a semi-synthetic form of cannabis;
• There were 66 new treatment cases of problem use of nitrous oxide, or laughing gas, in 2025. More than half of those cases involved people aged 17 or younger.

The report said there had been a 340% increase in treatment for cocaine as the main problem drug since 2017 (280% rise in cocaine powder and a 900% rise in crack cocaine).

For new cocaine treatment, people in 40% of cases were in paid employment, compared to just 5% of crack cases.

The proportion of female cases increased from 19% in 2017 to 29% in 2025, increasing almost 575% in numbers over the period, from 284 cases in 2017 to 1,912 cases in 2025.

The number of women over 50 who were treated for cocaine almost doubled, from 76 in 2024 to 142 cases in 2025.

Women accounted for a quarter of powder cocaine cases, but 45% of crack cases.