CHRISTMAS IS A time of indulgence, and not just of savoury treats and sweets. For many, it is also a time of consumption of substances both legal and illegal, including alcohol and often to excess.

PsyCare Ireland, Welfare and Harm Reduction CLG is a volunteer-led organisation with a mission to provide non-judgemental psychological support and offer mental health crisis intervention in settings where substance use is common, such as music festivals and events. With party season upon us, harm reduction messages are crucial for staying safe and looking after our mental health, especially during the darker months.

There is an increase in socialising at this time of year, along with reconnections and celebrations as the year draws to a close. It isn’t a happy time for everyone and can stir painful memories, especially for those affected by loss, bereavement and interpersonal or financial stressors. For many, these circumstances come with an increase in big nights out, big nights in, including house parties, leading to regular and heavy consumption of alcohol and often drugs.

Recently, we saw the welcome official announcement of semi permanent welfare zones in Dublin City for people on nights out. This initiative represents another key step towards recognition by authorities of the need for physical and mental health supports in public spaces where substance use may occur.

These supports have been in place at some summer festivals, with PsyCare Ireland providing drop-in welfare services at eight music events this year alone. Of 294 people who utilised this service, 243 or 82.6% attended due to a mental health crisis brought on secondary to intentional substance use (drugs or alcohol). No person ever expects to need a mental health service such as PsyCare when attending an event, however, when people consume drugs and/or alcohol, their underlying vulnerabilities can become exposed.

Non-judgemental support

While PsyCare Ireland neither condones nor recommends the use of illegal substances, the facts are that drugs are going to be used all across Ireland this holiday season. Results from the fifth general population survey on illicit drug use in Ireland show that the proportion of respondents aged 15–64 years who reported using any illicit drug in their lifetime has increased from almost 19% in 2002/03 to 27.1% in 2019/20, with 9.8% of persons aged 15–34 years having reported illegal drug use within the previous month.

The PsyCare harm reduction team at the Fuinneamh festival. PsyCare PsyCare

According to the UN, Ireland has the 4th highest per capita use of cocaine in the world and in 2023 4,923 people sought cocaine addiction treatment, with 75.6% of them for powdered cocaine. Meanwhile, other drugs such as ketamine have been noted by the HSE to be on the rise within Irish society. Other popular substances include MDMA (including ecstasy pills); however pill strengths can vary wildly, with seemingly identical batches containing dangerously different amounts of MDMA.

This can contribute significantly to dangerous outcomes including overdoses, a number of which have been reported on in recent years. Add to this the amount of alcohol that will be consumed over the course of the next few weeks and a stark picture for many people’s mental and physical health emerges.

At PsyCare Ireland, we acknowledge that the harms from substance use will not be eliminated through condemnation or stigma. We believe the values of a health-led approach must be prioritised, and that adequate psychological support and harm reduction information should be provided to empower people to make safer choices for their mental and physical health.

With that in mind, whether Christmas is a hard time, a time of celebration (or both), if you drink and/or take drugs, it’s important to consider the following:

Key harm reduction advice for Christmas

Check in with yourself

First and foremost, asking yourself how you’ve been feeling lately can inform your habits around social gatherings, as well as substance and alcohol use.

Looking ahead to see what occasions are coming up can help you to decide what your own limits are in terms of the number of nights as well as the level of consumption while empowering you to take control over your well-being into the New Year.

Take a break

In a heady period like Christmas, partying for consecutive days can take an increased physical and mental toll. Therefore, we would always recommend taking breaks between days of consuming alcohol and drugs to allow your body and mind to recover.

Create space in the Christmas period for time for you and your mental health — allow breaks from socialising that involves drinking or drugs and try to catch up on the sleep you’ve lost, spend time in nature and exercise.

Set some intentions

If you’re planning a night with friends where a lot of drink or drugs will be around, set an intention, for example: how much you will drink, what time you intend to head home and if you decide to take drugs, what amounts and how you will ensure this is done as safely as possible. Check resources like drugs.ie for information on different drugs and mixing them.

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Check in with and look after your friends

If choosing to take drugs with friends on a night out or concert, always tell someone what you intend to take and stick together. Never leave someone intoxicated or on drugs alone or leave them unconscious to sleep something off; if you have to leave someone alone, on their side in the recovery position is safest.

Start low and go slow

Although back-of-house drug testing has come into being at some music events in recent years, there still isn’t a publicly available way for people to test drugs to know their strength or purity. Therefore, the advice would be to always take things at very low doses initially. Caution is key. 

Call for help sooner rather than later

Know some of the signs of an emergency and how to respond. Symptoms such as chest pain, seizures, loss of consciousness, changes in breathing and extreme changes in body temperature indicate physical danger, so don’t delay calling emergency services (999).

Looking forward

Let us approach this festive season with awareness, compassion and a commitment to well-being, including practical and realistic public messaging. People need access to accurate information, non-judgmental support and community resources. Organisations and initiatives like the HSE’s Safer Nightlife campaign, Give Us The Night, PsyCare Ireland and the new Dublin City Welfare zones are timely examples of how we can integrate harm reduction into broader public health strategies.

As Ireland continues to evolve in its understanding of harm reduction, let’s advocate for more accessible resources, widespread education and an inclusive approach to public health. Together, we can ensure that the holidays remain a time of celebration, free from preventable harm and tragedy.

Michael Ledden is an accredited Psychotherapist and Kathryn Ledden is a medical doctor. Together with several others, they are the co-founders and clinical leads of PsyCare Ireland: Welfare and Harm Reduction CLG a non-profit dedicated to harm reduction and supporting people having difficult psychological experiences and difficult substance-induced experiences at Irish Festivals and Music Events. Get more information on PsyCare Ireland here.