A Dublin needle exchange for drug users has reported an increase in demand of nearly one third in recent years.
In its 2018 review, Merchants Quay Ireland said homelessness and addiction on Ireland's streets were increasingly being seen as normal.
The homeless and addiction charity said it had over 30,000 visits to its free needle service in the city centre last year, a 31% increase in five years.
The charity said Ireland has the fourth-highest number of drug-related deaths in Europe, and there was also an increase last year in the number of people reporting crack cocaine as their primary drug.
MQI Chief Executive Paula Byrne said they are deeply concerned that the number of drug deaths could increase significantly in coming years.
The charity is calling for a number of measures, including increased investment in detox services and increased housing support for people leaving drug treatment.