Alcohol a 'foundational driver' to use other drugs, especially cocaine

DRINKING ALCOHOL IS one of the main drivers to use other drugs, the independent advocacy group has found.

New research by Alcohol Action Ireland (AAI) drew on national data alongside international evidence to examine the co-use of alcohol and other drugs including cocaine, cannabis, opioids, ketamine and MDMA.

Sheila Gilheany, the chief executive of AAI, said people drink alcohol 10 times more than they use drugs, but they shouldn’t be treated as separate concerns.

“This framing is not only inaccurate but actively unhelpful because it obscures the substance most consistently implicated in polydrug harm – alcohol,” she said.

Figures show that 85% of lifetime cocaine users in Ireland also used alcohol the first time they had it.

AAI says this is particularly concerning as youth (ages 15 to 24) drinking levels have surged from 66% in 2016 to 78% in 2025 – a rate not seen since the early 2000s, which was considered a crisis.

The number of cases treated for problem alcohol use last year was 8,798. Of those cases, almost a third reported problem use of more than one substance, with cocaine being the most common (72.1%), followed by cannabis (50.4%), benzodiazepines (17.5%) and opioids (9.8%).

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Cocaine was the main drug reported alongside alcohol use among those aged 20–49 years, while in other age groups it was cannabis.

Meanwhile, 61.8% of cases of treatment for illegal drug use reported problem use of more than one drug. Alcohol was the additional problem drug for 35.2% of these.

Gilheany said combining substances with alcohol “intensifies harm”, but that its damage is often overlooked.

She noted that the terms of reference of the recent Citizens Assembly on Drugs specifically excluded consideration of alcohol.

“In contrast, many of the agencies providing treatment services or working in the areas of education and prevention do so for both alcohol and illegal drugs,” she said.

“What is clear is that efforts to reduce illegal drug use will not succeed without concurrent actions to address Ireland’s alcohol consumption.”

She said the evidence shows that interventions on affordability, advertising and availability are the most effective ways for a government to offset the harm caused by alcohol.

AAI is calling on the government to raise excise duties on alcohol in the upcoming budget.