The drug market keeps changing. Harm reduction is how we keep up |
I HAVE WORKED with people who use drugs for more than 30 years, and I have seen drug trends change many times.
In the late 1990s, working at The Passage day centre in London, I saw crack cocaine take hold among the people we worked with. At the end of the 2000s, head shops spread across Ireland selling new psychoactive drugs legally, until they were shut down in 2010.
Through the 2010s, street tablets became a bigger part of the mix in Ireland. These are just some examples. There are many more.
Each time, the people hit hardest were those already on the margins. And each time, harm reduction services were among the first to see the changes.
That frontline perspective matters today. Eddie Mullins, chief executive of Merchants Quay Ireland, recently spoke about the deteriorating health of people using crack cocaine.
Eddie’s concerns are reflected in the data. Cases treated for crack as the main problem drug rose from 173 in 2017 to 1,741 in 2025, according to the Health Research Board.
A makeshift crack pipe on a Dublin street. Tony Duffin Tony Duffin
The shift towards crack is also reflected in demand for harm reduction equipment. Michael Considine, CEO of One-Use Harm Reduction Products, which supplies services across Ireland, recently described how smoking equipment now accounts for four in five items supplied to........