Insights Report Opioid Agonist Treatment for People Experiencing Homelessness in Ireland
The National Social Inclusion Office (NSIO) has launched the fifth instalment of their Drug Insights Report Series – ‘Opioid Agonist Treatment for People Experiencing Homelessness in Ireland: Key Patterns and Trends 2014-2023.’
This Insights Report will provide an overview of Opioid Agonist Treatment (OAT) patterns specifically in Ireland from 2014-2023 for people experiencing homelessness.
There is a high level of mortality from opioid overdose among people experiencing homelessness in Ireland. As such, people experiencing homelessness need to be able to access Opioid Agonist Treatment (OAT) services, and these should be sufficiently resourced to meet demand.
OAT is an important element in the Health Service Executive’s (HSE) implementation of a harm reduction approach, which is advocated by the National Drug and Alcohol Strategy 'Reducing Harm, Supporting Recovery: A health-led response to drug and alcohol use in Ireland'.
The increased provision and development of OAT in Ireland, particularly for those experiencing homelessness is key in addressing, ‘the harms caused by the use and misuse of substances and promote rehabilitation and recovery,’ in line with Strategic Action 2.2.30, to ‘continue to target a reduction in drug-related deaths and non-fatal overdoses.'.
You can access the report here
Overall Findings
- In 2023 there were 1552 people experiencing homelessness receiving OAT, which represents a 38% increase compared to 2014 (1125 cases). This represents 14% of the total receiving treatment (11,442 cases). Over nine out of ten people were previously treated, with 136 new users
- There has been a 21% increase in new cases and a 39% increase in previously treated cases between 2014 and 2023.
- Almost three quarters (74%) of those treated between 2014 and 2023 are male. Two thirds (66%) are over 35 years of age, with an average age of 41 years (male = 42 years, female = 39 years).
- A larger proportion of females treated are under 35 years of age (31% compared to 20%), while a larger proportion of men are over 44 years (37% compared to 25%).
- Between 2014 and 2023, the number of people experiencing homelessness and receiving treatment under 44 years of age has increased by 57%, while there has been a 10% increase in the number over 44 years being treated.
- The main service provider that people experiencing homelessness received OAT between 2014 and 2023 was a clinic (72%), followed by prison (15%) and General Practitioner (GP) (14%).
- The main medication administered was methadone (97%) and oral buprenorphine (3%). Oral buprenorphine administration has increased by 356% since 2020.
- Nine out of ten (90%) people experiencing homelessness that were treated were receiving a maintenance programme, with 7% receiving detoxification and 3% stabilisation.
Key Recommendations
- The feasibility of transferring people experiencing homelessness from clinics to a GP in order to free up capacity in clinics should be investigated.
- Alternative models of delivering GP services to homeless services such as community outreach services should be enhanced.
- Treatment patterns among the prison population should be monitored and reported regularly to ensure that needs are being met.
- Future monitoring should collect more detailed information (e.g. length of time in treatment, treatment retention, access to GP) to help identify areas of service delivery that may require improvement.
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