Senior medics have urged that a national programme be developed to tackle the rapidly rising use of cocaine, crack cocaine and other stimulants.
Dennis O'Dioscail of the Irish Pharmacy Union (IPU) said that despite the significant increase in the use of these drugs, most drug treatment programme prioritises opioid addiction.
He was addressing the Oireachtas Joint Committee on Drugs Use, which also heard that Ireland has the highest level of drug deaths in the EU, at well over four times the bloc's average.
Bernard Kenny, the Director of the Addiction Management in Primary Care Programme with the Irish College of General Practitioners (ICGP), noted that Ireland has "the highest rate among EU member states, at 97 deaths per million of population compared with the EU average of 22".
The committee was told that the rate in Northern Ireland is even higher.
Last year, 13,000 people were treated for drug abuse in the State, the highest number ever recorded, Dr Kenny added.
Sinn Féin TD Mark Ward drew attention to "the postcode lottery of care," which means some of those who need treatment do not get it.
Each of the expert witnesses advocated for the decriminalisation of drug users - but not of the drugs themselves.
Dr Kenny said that criminalising drug users further isolates those struggling with addiction, as do housing insecurity and homelessness.
While Mr O'Dioscail said that having a criminal record poses serious challenges to someone who has beaten their addiction and is trying to take up a proactive and constructive role in society.
Tom Murray, President of the IPU, warned that "criminalisation is a barrier to access to healthcare".
But he emphasised: "We would not be in favour of decriminalising any product."
Several of the witnesses spoke of the damage caused by drugs whose use they could not condone.
Dr Des Crowley of the ICGP said that drug users "are coming with an illness and they deserve compassion".
Demonstrating this non-judgemental attitude "is really, really important when we talk about relapse," he added.
This is because re-engaging with health services - which can prevent fatal overdosing - is difficult, in part due to the stigma around relapsing.
"There is a close causal relation between addiction, social deprivation and childhood trauma," he said.
"GPs see drug users as patients and members of our communities rather than criminals," Dr Kenny said.
The barriers those seeking treatment encounter include fear of punishment or criminal conviction, as well as social stigma.
He supports a pivot from a narrow focus on decriminalisation towards a more holistic bio-psychosocial approach, as recommended by the Citizen's Assembly on Drugs.
Merchants Quay reports rise in demand for services
Meanwhile, there has been an increase in demand for addiction, homelessness and mental health services at the drug treatment charity Merchants Quay Ireland for the tenth consecutive year.
More than 13,500 people sought support from the charity in 2023 and it provided over 66,000 hot meals to some of the most vulnerable people, a 54% increase year-on-year.
The Chief Executive Officer of Merchants Quay Ireland Eddie Mullins said the demand in the community is enormous for people who have really complex needs and the investment in recovery and detox is simply not enough to meet the demand.
Speaking on RTÉ's Morning Ireland, he said: "Last year, we would have 123 people [who] went through our detox and recovery programs and for the most part they are living normal lives now.
"They have reconnected with family members, rebuilt their lives and they see a future they have hope."
He said that staff involved in recovery are to be praised.
"The commitment and the empathy and the compassion that's shown by our staff is inspiring," he said.
"Everyday I'm inspired by what I see. But it does cost money. There's no question about it," he added.
Finbar is one of the clients of Merchant's Quay Ireland who is now in recovery after accessing their services.
He told RTÉ’s Morning Ireland how addiction was part of his life story, describing it as leading to a very chaotic lifestyle.
"It led me to homelessness, that seems to go hand in hand with addiction," he said.
Finbar said his addiction got to a point where he could not see a way out, but he was introduced to Merchants Quay where he got help.
He was given access to the detox unit which, he said, was a safe place to detox from the street drugs and the medication he was on.
"The nurses in the detox unit almost loved me back to good health," Finbar said, to get him ready for the next stage of rehabilitation.
He said it was a six-month day programme and a six-month place in the recovery house, which he described as vital.
"It was that secondary care that Merchant’s Quay provided," he said, adding it was "one of the deciding factors that really helped me".
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Mr Mullins said the Government need to do more to help treatment programmes like the programmes Merchant’s Quay Ireland provide.
He said: "In the current economic climate, the Government are running record budget surpluses, we’re asking the minister to put a tiny amount of that into recovery, detox and residential treatment programs for people because it works.
"The return on investment will be profound."
While Mr Mullins would not give a figure that he thinks the Government should invest in the area, he said that "every little additional amount that's set aside for people, probably the most vulnerable people in our society" will make a difference.
"We do see every day, when people are given the right support and when they are supported through the recovery journey, we see the difference it makes for their lives for their families, it has a huge impact on society," he said.
He added that there has been an increased demand every day.
"If we doubled our accommodation in the morning, we still wouldn't beat the demand that's out there," he said.
"So, there is a severe shortage of detox, residential and recovery beds and also aftercare beds," he added.
Mr Mullins said the "journey that people go on, it's a long journey and it's lifelong in many respects".
"So, supports are required for a long period of time to help a person," he added.
Minister of State with responsibility for Public Health, Wellbeing and the National Drugs Strategy Colm Burke said he was "fully committed to ensuring that a person-centred approach to reducing harm and supporting recovery will continue to be at the core of Ireland’s drug policy going forward".
Launching the charity’s report, Minister Burke said he looked forward to the opening of the medically supervised injecting facility in Merchant Quay Ireland.
He said it will reduce the harms associated in injecting drug use and help to save the lives of people who use drugs.
