Abstract

This study examines the relationship between economic cycles and cocaine-related harm in Ireland from 2004 to 2024. Previous research has suggested that cocaine use declines during recessions and increases during economic booms, yet the mechanisms underlying this pattern remain poorly understood, particularly regarding treatment system capacity. Using annual data from the Health Research Board's National Drug Treatment Reporting System (NDTRS), the Central Statistics Office, and the European Union Drugs Agency, this research analyses trends in treatment demand, employment status, accommodation status, and gender distribution across four economic periods: the Celtic Tiger boom (2004-2007), the recession and austerity period (2008-2012), the recovery (2013-2019), and the post-COVID era (2020-2024). The analysis employs descriptive statistics and draws on qualitative testimony from frontline service providers, advocacy groups, and academic experts. The findings reveal that cocaine-related harm did not decline during the recession but was suppressed by falling disposable income and contracting treatment capacity, only to surge dramatically during the subsequent recovery. Between 2013 and 2024, cocaine treatment cases increased by 647%, homelessness among cocaine users nearly doubled, and unemployment among this population reached 60%. The number of women seeking treatment for cocaine increased almost seven-fold between 2017 and 2025, driven by a 906% increase in crack cocaine cases. These findings challenge the assumption that economic growth automatically reduces drug-related problems and suggest that Ireland's pro-cyclical funding model - cutting services during recessions and expanding them too slowly during recoveries - has amplified harm. The research contributes to the wider debate on drug policy by demonstrating that treatment capacity must be responsive to economic cycles. It will be used to inform recommendations for counter-cyclical funding mechanisms, integrated housing-first interventions, and dedicated services for women users. The next steps for this project include further analysis of regional variation in treatment access and the development of a policy framework for counter-cyclical drug service funding.