We have apologies from Deputy Máire Devine and Senator Lynn Ruane. Deputy Ó Murchú will be stepping in at some point for Deputy Devine.

I am delighted to open the 12th public meeting of the joint committee. Today we will be discussing the rising use and dangers of nitrous oxide and other inhalants. We are joined today by witnesses from the Health Research Board: Dr. Suzi Lyons, head of national health information systems with responsibility for the national drug treatment reporting system and the national drug-related deaths index; and Dr. Deirdre Mongan, research officer with responsibility for the national drug strategy and early warning system for drugs. From the HSE we are joined by Professor Bobby Smyth, consultant child and adolescent psychiatrist with adolescent addiction, Mr. Joe Doyle, national lead for social inclusion services and Ms Mary O'Kelly, integrated healthcare area manager. On behalf of the committee I also extend the warmest welcome to Mr. Dermot Maguire and Mrs. Yvonne Maguire, who are attending today's meeting in a personal capacity. Yvonne and Dermot are the parents of Daniel Maguire, a 14-year-old boy from Huntstown who died tragically in 2025 following the inhalation of aerosol deodorant. We are enormously grateful to Mr. and Mrs. Maguire coming in today and providing their testimony to the committee. We will all benefit from it massively.

Before we begin, I must read a note on privilege. All witnesses and members are reminded of the long-standing parliamentary practice to the effect that they should not criticise or make charges against any person or entity by name or in such a way as to make him, her or it identifiable or otherwise engage in speech that might be regarded as damaging to the good name of the person or entity. Therefore, if their statements are potentially defamatory in relation to an identifiable person or entity, they will be directed to discontinue their remarks and it is imperative that they comply with any such direction. I remind members of the constitutional requirement that, in order to participate in public meetings, they must be physically present within the confines of the place where Parliament has chosen to sit. Members of the committee attending remotely must do so from within the precincts of Leinster House. In this regard, I ask members taking part via MS Teams to confirm that they are on the grounds of the Leinster House complex before making a contribution to the meeting.

All opening statements have been circulated to members and will be published on the Oireachtas website following this session. As agreed, we will limit each opening statement to five minutes to allow plenty of time for questions. I am conscious that a wide range of issues will be discussed here today. If necessary, further and more detailed information can be sent to the clerk to the committee for circulation to members. Witnesses should note that due to other parliamentary commitments, members may be in and out of the committee room during the meeting. They should not take notice of that.

I thank Deputy Gannon and the committee for allowing us the opportunity to share our son Daniel's story. It is not easy.

Daniel was a marvellous young man. He was a beautiful young boy. He had the personality. He loved the gym. He had a huge group of friends. He was really fit and really healthy. He is the middle son of three boys. He was the best friend to Andrew, who was only 17 months younger. He idolised his older brother Adam. who is 24 years old. He is a huge loss not only to the family but to the community and his school as well.

On the night of 26 September, almost four months ago, I was locking up and I called up to Daniel to ask if he had key of the front door. He said he did. I asked if he would throw it down and he said, "Yes, Dad." Those were his last words.

A couple of seconds later I asked, "Daniel, are you throwing down the key?" No answer, so I was up the stairs. I was on him in 30 seconds. I went into his room. He was passed out on the floor. Adam and I worked on him with CPR. The emergency services arrived. They worked on him. They took him to Temple Street. All in all, I think he was worked on for about two hours, but I knew when they took him out that door he was already gone. He passed out; he never woke up. I do not think Daniel even knew he died. He fainted and that was it, and for a simple thing: deodorant. That was it.

I have a can here with me. I will not show the brand but it is a generic can of deodorant. This is what killed my son. It is in everybody's home. It is free for kids. They do not have to go looking online or meeting somebody down back alleys. This is free in anybody's home. Members may notice the warnings on these cans. The one that stands out: it is flammable. That is the only warning on this can that stands out. There is another warning on it. Even I am looking for it even though I know where it is. It is in the right-hand corner. It states, "Solvent abuse can kill instantly." That is it. That is the only warning on these things.

After Daniel died, the community support we received was amazing, from Paul, his wife Angela, etc., and from the teachers in the school. The latter came to us and asked did we want them to say why Daniel died. We said, "Yes, tell them everything. We need the kids to know." The kids knew straight away. Feedback from the schools has been very positive. We have had reports back of kids who have gone to teachers and said they had been doing this but had now stopped because of Daniel. We put out a video that went worldwide, with over 10 million views. There were articles in Argentina's media and Australia's media. This thing actually went worldwide. The traction it gained blew us away. We got messages from all around the world stating that this is not an Irish problem but a worldwide problem and from people who had lost their son, lost their daughter or lost parents. It is adults as well; it is not just kids. We got these messages from all over the world, but mainly from around Ireland. I found with a lot of the ones from Ireland that the people never went public with it. That was the thing. They never went public and that was it.

Basically, if a child inhales deodorant, one of three things is going to happen. The first thing is nothing. They are going to pass out or whatever, they are going to wake up, they are going to go home and nobody is going to be any the wiser. The second thing is cardiac arrest. They are going to drop on the spot. The third thing, which is what happened to Daniel, is that a blood clot in the lung cuts off oxygen supply to the brain. You pass out and you do not wake up. When the kids do this, they are rolling a dice and they are going to get one of those three options.

What we would like to see going forward is, obviously, warning labels on deodorants made bigger and more prominent. We are currently in the process of contacting all the major retailers in Ireland to request a ban on sales of aerosols to under-16s. We are only in the process of that at the moment. We are hoping for a positive response from the likes of Tesco, Musgrave, Aldi, Lidl and so on. Our main point with Daniel is education. Kids need to be educated on this. We are aware that teachers are not provided training on aerosol abuse. They are provided training on other drugs and stuff like that, but aerosol abuse is left out of their training. This needs to be brought in. We have been in touch with the Minister for Health and the Minister for education about this also and we have got some very positive responses. Going forward, we would like better warnings, restricted sales and education. The main thing for us is education.

Our children are dying. It needs to stop.

Thank you so much, Mr. Maguire, for making your contribution. I have no idea where you get the strength. We are really grateful for your coming before us today. Thank you, Mrs. Maguire.

From the Health Research Board, I call Dr. Suzi Lyons or Dr. Deirdre Mongan to give their contribution.

Before I start, I extend my sincere condolences to the Maguire family on Daniel's untimely death.

As regards the role of the Health Research Board, HRB, we are the lead agency for generating and disseminating evidence on drug and alcohol issues. Throughout this statement, when I talk about numbers and cases and statistics, it is important to acknowledge there are people behind all these numbers.

Inhalants are volatile substances that produce chemical vapours or gases that can be inhaled to produce a psychoactive effect. Examples include gases, glue, correction fluids, petroleum products and aerosols. Nitrous oxide, also known as laughing gas or hippy crack, is a colourless gas that has a number of legitimate medical and industrial uses, for example, medically as an anaesthetic and commercially to froth or as a propellant for food items. While it has been used recreationally for its brief euphoric effects for over 200 years, in the last decade the international literature has reported an increase in its recreational use and an increase in reported health harms. Its popularity has been attributed to the fact that it is cheap, readily available and undetectable on routine drug screening. At present, nitrous oxide is not a controlled substance under the Misuse of Drugs Act 1977. It can be legally sold for catering and industrial purposes.

There are limited data on either inhalant or nitrous oxide use among adults in Ireland. The only source of data on adult nitrous oxide use is the European Web Survey on Drugs, an online survey of adults aged 18 and over who use illicit drugs. In 2024, among Irish respondents, 5.3% had used nitrous oxide in the previous year. This increased to 9.2% among younger adults aged 18 to 24.

The European School Survey Project on Alcohol and Other Drugs, ESPAD, is a survey conducted among 15- to 16-year-old schoolchildren across Europe, including Ireland. In the most recent survey in 2024, 6.3% of Irish schoolchildren had ever used inhalants, almost identical to the European average of 6.4%. The survey also reported that, in Ireland, inhalants were the third most commonly used substance after alcohol and cannabis. Use of inhalants decreased since the 2019 survey, when 10% reported their use. In 2024, ESPAD included questions on nitrous oxide for the first time. Some 2.1% of Irish schoolchildren had used nitrous oxide - 3.4% of boys and 0.6% of girls.

What are the health harms associated with inhalants and nitrous oxide? Short-term adverse effects of inhalants include hallucinations, confusion, nausea and loss of co-ordination. Long-term effects can include damage to the brain, liver and kidneys. Inhalant use may lead to death from asphyxiation or suffocation. The range of adverse health harms related to nitrous oxide is yet to be fully elucidated. Frostbite injuries due to nitrous oxide have been reported. Nitrous oxide-induced myeloneuropathy is an umbrella term for the neurological harm caused by vitamin B12 deficiency arising from nitrous oxide use. The most common presenting symptom is tingling or numbness, primarily in the lower limbs, with other symptoms including gait disturbance, ataxia, and bladder and bowel dysfunction. Nitrous oxide can trigger psychological symptoms and primary psychiatric presentations, including delusions, hallucinations, paranoia, depression and acute psychosis.

I move on to the health harms reported in Ireland. There are no national data on the extent of nitrous oxide or inhalant hospitalisations, but there are a number of case reports. Between October 2022 and July 2024, 18 patients presented to Tallaght University Hospital with nitrous oxide-associated myeloneuropathy. From September 2022 to March 2023, seven frostbite injuries due to recreational nitrous oxide use were managed by adult and paediatric burns services in Ireland.

As regards treatment, the national drug treatment reporting system, NDTRS, is a national register of addiction treatment in Ireland. Since 2021, there has been a year-on-year increase in the number of cases entering treatment for volatile inhalants, including nitrous oxide. In 2021, 28 cases entering treatment reported use of volatile inhalants. This increased to 108 cases in 2024. The number of nitrous oxide cases was zero in 2021 and increased to 54 in 2024. Among cases entering treatment for nitrous oxide in 2024, 22% were aged 14 or under, 35% were 15 to 17 years, and 43% were aged 18 or over. The national psychiatric inpatient reporting system, NPIRS, recorded 69 admissions due to the misuse of inhalants in 2024, an increase from less than five in 2020.

Finally, I move on to mortality. The national drug-related deaths index, NDRDI, records and reports on drug poisoning deaths in Ireland. The main source of NDRDI data is closed coroner death investigation files. The latest NDRDI data on drug poisoning deaths is from 2022.

Between 2020 and 2022, the NDRDI recorded fewer than five deaths where volatile inhalants were implicated. No death had nitrous oxide implicated. Internationally, data shows that deaths involving nitrous oxide are rare and, in most cases, the cause is accidental asphyxiation.

Before I start, I acknowledge the bravery and willingness of the Maguire family in being vocal about this issue.

I thank the Chairman and members for the invitation to discuss these issues with the Joint Committee on Drugs Use. I am joined by my colleagues, Ms Mary O’Kelly, integrated healthcare area manager for Kildare and west Wicklow and HSE Dublin and midlands, and Mr. Joe Doyle, national lead of the HSE social inclusion, access and integration unit. Today, we will highlight the emerging trends relating to nitrous oxide and inhalants and will outline a number of actions undertaken by the HSE in response to these trends.

The Irish drug landscape has significantly changed and seems to be ever-evolving, with use now occurring across all strands of society. Historically, attention was mainly focused on certain at-risk populations and people who had high levels of risk factors that seems associated with drug use. The current situation is certainly more complex than this view of the past, with young people navigating a very different social context. As a result, it is harder to predict what young person will use and be at risk of harm across our society. This is a concern for all of us, whether we are wearing our hats as healthcare providers, as I am today, or whether we are thinking as parents.

Despite these new concerns, the evidence base remains consistent in guiding how we should prevent and respond to new trends. An effective drug prevention system requires co-ordination and collaboration across sectors at national and local levels. Drug prevention activities not only include structured programmes specifically focusing on drug use but also wider activities that aim to support positive health and social development well-being and promote the protective factors that seem to be associated with a reduced likelihood of problems in this area.

We are aware that the committee has previously discussed drug prevention and received presentations from the HSE's health and well-being unit before Christmas. Today, we will outline the available information on the emergence of nitrous oxide and inhalants and the recommended best practice response these trends.

As an immediate response to nitrous oxide, the HSE undertook a number of specific actions a number of years ago, such as adding nitrous oxide to the information on the website called drugs.ie and collaborating with both regional and local drug and alcohol task forces, which each have a preventative and education committee, to develop educational webinars for front-line services and to support local communities where concerns were initially arising. To inform the public, the HSE developed information fact sheets for those who use nitrous oxide and for parents to inform them about this drug and give guidance on how to discuss its use and risks with their teenagers. Between the period 2023 to 2025, over 8,000 people engaged with our nitrous oxide content on the drugs.ie website. The HSE is currently in the process of redeveloping drugs.ie and it is hoped a new website will be launched early this year. This will offer an improved site which we anticipate will increase engagement with the public, including among parents, young people and people who use drugs. The topic of nitrous oxide is a common feature on our drugs.ie social media channels to help create awareness.

One thing to keep in mind is the fact that communication of information about substances, including nitrous oxide and inhalants to adolescents, does require careful consideration. Large-scale campaigns relating to drugs can have unintended consequences and there is a risk that they could inadvertently increase interest in and use of substances by creating knowledge or interest that was not there before the campaign. In line with best practice, and in addition to school-based prevention strategies, the pillar intervention of which in Ireland is the Know the Score programme, a number of areas are recommended as suitable responses to the emergence of nitrous oxide such as through youth and outreach projects, training professionals and support for parents through strengthening their knowledge. These approaches can be adapted to any new trend which present, including the use of inhalants.

In 2023, the Parents Matter webinar series was developed by the HSE to specifically target parents to deliver education and prevention initiatives within their own home. The series involves updates on emerging trends, youth development, guidance on prevention strategies and signposting towards support services. The last webinar in October 2025 had close to 3,500 parents register, and over 1,500 actually attended the live event. The core principles of prevention from these webinars can be applied in response to any drug which presents.

As we approach a new drug strategy, prevention and education should be prioritised to build a sustainable national infrastructure for drug prevention, which requires resourcing, training, staff support, research and evaluation to make sure that what we are doing is actually effective. Other prevention and early intervention tools, such as the HSE’s SAOR screening and brief intervention programme, can be further promoted in relevant sectors such as youth education and training spaces and primary healthcare settings, including hospital emergency departments. Prevention works best when it begins early, is sustained and is supported by the whole community and within schools, families, services and policy systems working in collaboration. The HSE is committed to continuing to collaborate with its partners over the coming months and years to achieve this. Emerging drug trends require a whole-system approach to identify, monitor and determine suitable responses. We anticipate that new drugs will continue to present public health challenges in the years ahead. Future drug policies need to reflect, be adaptable and nimble to this reality to respond to these trends and ensure rapid responses when public health challenges emerge.

I thank our guests for their presentations. We will now move on to questions by members. Deputy Brabazon is first.

I thank Yvonne and Dermot Maguire for their testimony here today. It has been extremely moving. I saw their presentation. I think it was on a "Prime Time" episode in recent weeks and it was one of the most moving things I have ever witnessed. I cannot imagine what Yvonne and Dermot are going through. I commend them on what somebody described here as their bravery when the easiest thing would have been to roll up in a ball, but they have come here and they really want to make a difference in this whole sphere. I strongly commend them on that.

What Yvonne and Dermot Maguire have been put through makes me feel the heavy burden of being a legislator. They have highlighted the actions required in terms of labelling and educational information. I know I and other members will be very cognisant of all that and will strive to work on that. I know we in our reports will recommend all of those things going forward. I think there is an urgency about it as well. We cannot wait around for all that because we do not want any other parents to go through what they are experiencing.

I have some questions for the other witnesses. Nitrous oxide seems to be in widespread use, which I know from being a member of one of the local Tidy Towns groups. We as a Tidy Towns group go out litter picking on a regular basis and find boxes of empty canisters. Am I right in saying that we do not yet know the implications of long-term use of nitrous oxide? Is it like vapes? Vapes are a recent thing and we do not have a lot of information on those.

The use of nitrous oxide is quite a new thing, both in Ireland and internationally. There is no real sense yet of the long-term health harms. There is very little data. It is really only in the last ten years that we have seen nitrous oxide emerge.

The data is only starting to catch up with its use.

When it comes to intensive use over a period of weeks or months, one thing we know is that our colleagues who work in neurology are seeing young people present with symptoms of neuropathy. It is causing damage to the spinal nerves which presents as weakness, loss of sensation and so on. That is just from a few months of intensive, heavy use. We cannot answer as of yet what the long-term impacts are for people who use it occasionally over a period of many years because it is a relatively new phenomenon. While nitrous oxide, as a substance, has been around for decades, it is only widely used in this way in the last five or six years.

Are the witnesses concerned about it as a public health issue?

Yes, I am certainly increasingly concerned by it. The trends over the last five or six years are certainly worrying. Again, it is symptomatic of a sort of normalisation of substance use. That is not a pattern we want to see expand any further for a whole range of reasons.

Okay. If we have not gathered national data on the extent of nitrous oxide and inhalant hospitalisations, how are we so sure that no deaths have occurred as a result?

While we have no data from accident and emergency hospitals, there are data on admissions to both hospitals and psychiatric hospitals. We know there were 69 admissions because of inhalant use to psychiatric hospitals in 2024. We also have good data from the NDTRS about people receiving addiction treatment for both inhalant and nitrous oxide use. We also have good coverage of the publicly funded addiction treatment services and adolescent services. We know that, in 2024, there were 108 incidents of treatment for inhalant use, half of which related to nitrous oxide. The number of cases for nitrous oxide treatment has increased from zero in 2021 to 54 in 2024. Overall, the number of inhalant-related cases treated in addiction services represents less than 1% of all cases treated, which is very much in line with what we see internationally.

Additionally, due to the NDRDI, which is the national census on all drug-related deaths, we are very sure about the number of overall deaths due to inhalants. The latest figures we have are for the years 2020-2022 in which there were fewer than five deaths due to inhalants. Nitrous oxide was not implicated in those deaths. Going forward, the HRB will be able to continue to monitor very clearly any increase in deaths or change in admissions for treatment, for example.

Does Dr. Lyons feel the data she has are sufficient to inform policy direction? Does she have sufficient data in that regard?

For drug-related deaths, the NDRDI is probably one of the best systems in Europe. We rely on data from the coroner service. It is almost a complete census. That is only one part of the picture, however. For drug treatment data, we have very good coverage that is consistent and in line with what we see in other jurisdictions. We are comfortable that we can show the number of people who are entering treatment. Of course, many more people use inhalants than those who present for treatment in the country.

First, I thank Dermot and Yvonne for being here. My deepest sympathies go to you both, and to Adam and Andrew. I genuinely cannot begin to imagine what you are going through. You all have my deepest sympathies. We all hear you on the three clear requests you have on aerosols, namely, the labelling, warning and restriction of sale as well as that prevention and education piece. We will, as a committee, take them up and we do not need to wait for the report at the end to do so. I am glad to hear there has been engagement from the Minister already. We will push for urgent action. It is unbelievably sad. I am truly sorry for your loss.

I thank both the HSE and the HRB for coming in here today to help us with our work. The witnesses from the HRB spoke about how its data show a sharp rise in nitrous oxide-related harms, including 18 hospital presentations for neurological damage and multiple frostbite injuries. It is quite a steep increase in the treatment numbers, from 28 in 2021 to 108 in 2024. They are quite stark numbers. Given these clear indicators of escalation, what additional prevention resources are needed?

The remit of the HRB is to collect the data and provide the information. My colleague, Professor Smyth, is better placed to talk about the prevention strategies.

I outlined some of the initiatives that already occurring in the area of prevention. When it comes to nitrous oxide, aerosols and newer trends, the challenge is to integrate information regarding these newer substances into the existing models, which include social, personal and health education, SPHE, in our secondary schools. As I mentioned, there are prevention and education committees that operate under both the local and regional drug task forces, which can deliver and lead on local initiatives.

I will interrupt for a moment. To be fair to Professor Smyth, he acknowledged and called out in his opening statement the fact that the activity of drugs use, substance use and substance abuse has changed in our society and country. It has changed dramatically, and although it might be a little bit of an exaggeration to say it is all pervasive, it is certainly not confined in the way it was historically to marginalised demographics and groups. It is a society-wide issue. I will put my question to the HSE then. In that context and given that substances are ever-emerging - today we are hearing about an aerosol can, which is just a deodorant, but we hear about fentanyl and all of the other substances - what are the infrastructure requirements needed to scale? We are all familiar with the pilot projects, the local drugs task forces, the youth services and local interventions. What is required to scale to a point where we have a society-wide prevention model?

That is a big and important question.

It is the one we are trying to answer, to be honest.

The current drug strategy in Ireland, including what does and does not happen, is very much driven by the drugs strategy. Prevention in Ireland and across Europe seems to fall a little bit down the priority list. We are very focused on harm reduction interventions for people already grappling with the most severe addictions. My understanding of the current national drugs strategy and its evolution, that is, the new one, is that the stakeholders’ report and the initial evaluations all seem to have highlighted a need for more attention to be paid to prevention. For me, there is a clearer role for more public health leadership on this.

I am conscious that I am a child and adolescent psychiatrist and my expertise is in addiction treatment. I look forward to a growing role for public health in the area of leading on prevention and bringing their expertise to this issue. We would then be guided by what they think needs to be added in to the equation. I do not think it is going to be terribly different from what is currently happening.

What does Professor Smyth think is not going to be terribly different?

In terms of the menu of options that are there and that we are drawing upon.

Is the concern that the continuing focus will be on the drug user, on responding to the drug user in terms of harm reduction and addiction recovery? Is that Professor Smyth's concern, that there is not a sufficient shift towards an emphasis on prevention? It would strike me that the largest part of our response has historically been in responding to the drug user, trying to reduce harm and achieve recovery and continue beyond that. Regarding the preventative element, it is even in the statistics. We have great statistics on people when they have died but where are the statistics on what people are actually using in the day to day? We do not have that type of data, and not at the level we should have as a society. That would be my opinion.

We have the ESPAD survey. Planet Youth surveys have been conducted in about one third of the counties in Ireland now, which are providing real-time data in terms of what young people use.

It is a start. I think that is excellent but we need to scale it.

I think we are all hoping there is an increased focus on prevention. It has moved well up the priority list.

I apologise. I have to go for a vote in the Seanad.

I thank Mr. Maguire and Mrs. Maguire for coming here today. I have no doubt it is very difficult. I offer my sincere condolences to them both, and to Andrew and Adam. No family should have to deal with this, not for a 14-year-old child. We will support you in any way we can through this committee. I am the Sinn Féin spokesperson on drugs and alcohol. People I speak to are very aware of the nitrous oxide but we do not hear too much about other inhalants. I definitely agree that an education programme is needed. The one the HSE mentioned seems to have quite a number of people. I am not sure how we draw people in. Maybe that is something that should be rolled out through schools. We can discuss that later. I am not going to ask Yvonne and Dermot any questions because they have covered everything. I, with Deputy Paul Donnelly, will absolutely support them on anything we can do for them.

For the Health Research Board, there was reference to the ease with which people can buy nitrous oxide online or through groups. It is big business now. There are very unscrupulous people bringing it in. It is a business, it is targeted at young people. I would like to know how the witnesses think we could deal with that without criminalising those who are actually using nitrous oxide.

The Deputy is correct. Because it has its legitimate uses, that makes it much more difficult to try to control, as opposed to a different substance. Looking further afield at the European data, very few countries have grappled with this issue. It is about how to manage or control it. There are not really any good European examples of how to reduce the sale of it. I know in Western Australia they have banned the use of larger containers, so it is only allowed for sale in smaller containers. That may be one way of doing it. Looking further afield, it is proving very difficult to deal with as a problem.

Sinn Féin brought forward a Bill this week and, very disappointingly, the Government put in an amendment which kicks it down the line for nine months. It does mean it will be going to the committees in nine months' time. That gives us a timeframe to look at what we are going to do. It is a scourge. We have all spoken on this. Not only is there a health element but also there is an environmental element. I came out of my house last week and there were 15 canisters on a small green space opposite the door. Everywhere you go, they are there. It is kind of acceptable. We need to get the message out to young people. That is the thing more than anything else. We can try to block anything we want but there are always ways and means of getting stuff. As Dermot and Yvonne have said, it could be a can of deodorant. The message we need to get across is that this stuff is bad for you, rather than even dealing with the rules around them.

On the education programme and reaching out to parents, large numbers of people seem to have signed up to the podcast. There are obviously people who want to know what is going on. Parents are worried. They are reading these things, they are not so sure about the data, they do not know the numbers, but they know it is an issue. How do we get that message out further and wider? Could it be done through the schools or through parents' groups? Is there an easier way for the podcast to share that with a group of people who are interested?

In the last couple of years there have been both podcasts and webinars. While we were delighted to see the huge interest in the event there last October, which had about 1,500 people attending, there are about 2 million parents in Ireland. It is a drop in the ocean. The challenge is how we build interest. In terms of the points we touched upon, as the Maguire family's experience has demonstrated, this is an issue that is relevant to every family in the country. I think most parents do not quite see it that way. Most parents think it is an issue for other kids in other areas. We need some measure that succeeds in causing the wider body of parents and public to realise this is something we all have to think about for ourselves. The actions of the Maguire family in going public really demonstrate that, without getting caught up in the very specific issue of aerosols. This is an issue that can visit every home in the country. Every parent needs to be a little bit more tuned in to it and should potentially consider accessing the information and advice we give, such as it is.

This is a health and safety thing for our young people. In the main it is young people, although I know there are some adults. Mostly it is targeted at young people for the nitrous oxide and the use of deodorants. They learn from somewhere that this works or this is a thing. With any other programme we have geared towards young people, we start with the schools. We do an education programme and teach them from a very young age, for example, the safe cross code and how to cross the road. How do we get the message across to kids? Start in the schools with an education programme. Tell them this is the outcome. Use shock treatment if needs be. This is what is going to happen to you if you do this. Start with the kids. Most parents if you ask them will say their child would not do that in a million years, because they do not know. These are good kids. They are just experimenting with things, as everybody did. Unfortunately, what they are experimenting with is dangerous and life-threatening and it can end in loss of life. The committee could look at how we would get a programme running.

Dermot and Yvonne's loss is absolutely heart-rending. We felt it over the last few months, the grief and pain that people experience: themselves, their family, the community and his friends. We have seen it in the park, with people coming together.

That has been really powerful. It is a powerful message both of them, through their own strength, are giving to other families, to give them a bit of strength to come out to say this is an issue, a problem and something that we all have. One of the scariest things for parents is the fact it is something that is in every single person's bathroom. It is in our bedrooms and in our homes. It is everywhere, so going along the line of prohibition is impossible because it is a product that everybody uses every day. It is about education, awareness and highlighting the dangers. If we can get to one person - just one person - who maybe thinks twice before they do it, then everything Dermot and Yvonne have done so far in their own grief will have been a success. I thank them for that. Again, when we talk about drug use and misuse, and whether it is solvents or heroin does not really matter, it is something that will always be with us. It is a societal issue. It is something we are never going to stop, but what we can do is try to mitigate the damage that is being done. That is the importance of what we do here today.

I have a couple of questions about the education and awareness piece around solvents. Dermot and Yvonne have already done a huge piece in highlighting that, but what are the specifics around highlighting solvent abuse? Sometimes, we go to the big one, which is nitrous oxide at the moment. People are talking about nitrous oxide, but my question is particularly about solvent abuse. There is another issue around HHC, which is a synthetic cannabinoid that is used through vapes by a lot of young people. I am involved in both the community drug team and a youth initiative. People in both of those were talking about the use of synthetic cannabinoids through the use of vapes. Maybe we could talk a little about that.

There is another thing I will talk about. Maybe we can just chat about this one because going back to when nitrous oxide first emerged as a problem in the last number of years, there were little silver bullets. These were tiny bullets we were finding all over the place. We were asking what in the name of God this was, until we found out it was nitrous oxide and it was being used and abused. Very quickly, and this is just my opinion, the companies that produced nitrous oxide decided this was a really good product for them to market outside of where they would traditionally sell it, which was for making whipped cream and for catering purposes. They changed their packaging to make it lovely and colourful. They changed their sales methods in that they sold online and delivered to your door wherever you wanted. They also changed the volume of the canisters that were being sold, which are huge. We all see them. In fact, the waste energy group that has the incinerator in town gets 3,000 of them per week. It is causing them huge problems because obviously these canisters are dangerous. That group alone is getting 3,000 canisters. There has to be an element of legal responsibility for people who produce this. I have no doubt, when you see it across the board, that they have changed the way they sell this because they are directly targeting it for abuse. We have to call that one out. We have to call out the people who produce this as well. I would like the witnesses to answer those questions.

Is there any question in particular?

On HHC and the education and awareness piece.

On FastGas, as it is called, we have obviously looked into all this, with Daniel's case and that. The Deputy mentioned the lovely bright packaging; "Go fast or go home" is written on it. It is designed for kids. To go back to deodorants, I mentioned that deodorant abuse goes back 40 years, but we have never done anything about it. Why not? That is our big question. FastGas is to the fore now. As was said, nobody has died from FastGas yet. We are aware of young people who are now wheelchair-bound because of FastGas. That information has come to us. The aerosols are actually killing people, so these need to be segregated to a certain extent. FastGas is a major issue. We saw it in our own community after Daniel died. We spoke to the kids, who have all been very open with us. The community has been fantastic; it is Deputy Donnelly's community as well. I asked the kids where they get the FastGas and every answer was the same: Snapchat. Every single answer was the same. It was Snapchat. They go on Snapchat, click a button and that is it. They have it. It is readily available to them.

Nitrous oxide is obviously used for catering purposes and now it is being used recreationally. Would it be possible to only order it in Ireland through an invoice for, say, restaurants or whatever, and ban the sale of it online to customers in general?

Deputy Donnelly might talk about the Bill he did.

Again, primarily what we are looking to do is to make sure that it cannot be bought as it is currently. It is a catering product. That is what it is designed for. Ultimately, we have a responsibility as legislators to make sure that when we know something like this is being produced to be abused, we cut off those lines of access for young people.

Our great difficulty is that it was traditionally used for catering and now it is being used recreationally. There are kids with major neurological problems from it and the whole lot. To go back to the figures, from 2020 to 2022, it was said there were five aerosol abuse cases, none of which were linked to nitrous oxide. This is our worry. People think the whole highlight is on laughing gas - rightly so, and I do understand that - but there are control measures you can have, such as an invoiced business only being able to order it through a registered business number, whereas we are not going to stop the sale of deodorant. Unfortunately, as Councillor Angela Donnelly said in her newsletter, and Deputy Donnelly and Councillor Donnelly have been extremely supportive of us in the community, aerosols are more dangerous. Deodorant is more dangerous because it can kill instantly. There is just not enough publicity around it.

Deputy Donnelly said 3,000 canisters have gone to waste collection. Of those that are cans of deodorant, how many have kids used? We do not know. Deodorant is produced for antiperspirant use while FastGas is produced for whipped cream. We all wear antiperspirant but we do not all have cans of whipped cream. That could be tackled a bit more. We lost Daniel through a can of deodorant. That is why we are here. We are trying to think of something. As Dermot said, education is definitely key. As our hands are tied because we cannot ban aerosols, education is definitely a thing. There is the SPHE book, which mentions alcohol, cannabis and nicotine vapes, but there is nothing about deodorant. Our younger lad is now struggling through first year without his brother. He watched his brother die on his bedroom floor because of a can of Lynx, but there is nothing in the SPHE book. The Minister for education said she would bring in a stronger emphasis on training the teachers to get it further out there, but our battle now is that laughing gas is being very widely publicised without what actually killed our child.

I know I am out of time. What about HHC?

HHC has been a huge concern for those of us working in adolescent addiction services nationally. It is also a big concern for mental health services. Legislation was put in place to add it to the Misuse of Drugs Act at the end of last August, but that seems to have only resulted in a change in the packaging. To be brief about it, young people accessing our services still seem to believe they are buying HHC when they go into vape stores. It has certainly been a request, with regard to the next national drugs strategy, that we get much more nimble in responding to these trends ahead of time, rather than waiting for it to get as messy as the HHC situation has.

I will get to my own questions in a minute or two. I am sitting here thinking of things we have done in the committee so far and this has probably been one of the meetings that has left me the coldest. This committee was formed following the Citizen's Assembly on Drug Use. We are to give legislative and policy recommendations to that citizen's assembly. The more we pull at a particular thread the more we realise how far behind we are, even in relation to nitrous oxide. Nitrous oxide for consumption is banned under the Criminal Justice (Psychoactive Substances) Act but it is just very rarely enforced, which leads us to a general sense of dismay. When we come to look at areas around education ,everybody talks about how do we educate young people in schools, yet at the same time we had the unions in before Christmas who told us that a very small percentage of their members who are teachers and who are actually trained in this area. All of that is leading to a mammoth challenge. We are really grateful for the witnesses contributing on this.

Deputy Donnelly probably has a better memory of this than I have. Even 30 years ago in inner city Dublin we would have seen a parent coming into a community hall demanding responses to the sale of heroin. I never would have imagined then that we would have a grieving family coming in with a deodorant can in hand. It is a demonstration of how much this issue has evolved. We are conscious in the House of how far behind we sometimes are in keeping up with trends. How do we get nimble, as Professor Smyth said, within that capacity? My first question is for him. Who else should be around this table? When we are talking to witnesses such as him, and it is his third time in front of this committee, we hear about deficits, and that maybe this is for schools, and then the educators will tell us about the different problems they have. Professor Smyth talked about an increased focus on prevention. Will he tell us, as plainly as he can, what that means? He talked about an increased focus on prevention. In order for this committee to achieve this aim in our report in June, who else should be around the table designing or telling us where the holes are? He is obviously here from a health-related perspective. Who should be here from education? Who should we hear from? How do we formulate this position as holistically as possible?

The group who maybe have the most to contribute, and who have not been massively involved to date, although they are getting more involved, is public health professionals. They are a key group. Professor Joe Barry was the public health voice historically who really focused on all aspects of addiction. He retired a couple of years ago and no one has stepped in to fill that void. The expertise of public health is about preventing or curtailing the behaviours that lead to illness.

With regard to the Health Research Board and trends that we know of in relation to the aerosols and nitrous oxide, I am very conscious of the figures. For example, we talked about deaths from nitrous oxide. Professor Smyth is using figures from 2020 to 2022 and I understand the reasons for that but does that leave us too far behind? Deputy Graves talked about it being an issue mostly impacting young people but if we had representatives in here from the homeless services, they would talk to me about how aerosol cans are being used in homeless accommodation, and paint stripper in some ways. Do we have the data that tells us how all-impacting the issue of nitrous oxide is, or are we behind?

With something like nitrous oxide, we are probably catching up a little bit because it is something new. We do a lot of work in the HRB and with the European Union Drugs Agency. They harmonise a lot of drug data collection. When something new comes in it can take a little while before it becomes embedded in the systems. To that end, we are trying to improve our data. For example, we have been in contact with the managers of the health behaviour in school children survey. It is the largest school survey in Ireland with some 9,000 children between the ages of ten and 17. In their next survey they will include a question on nitrous oxide for the first time. That will allow us to look at different ages and across adolescence and help us to look then at risk factors. There is always a lag between something happening and the data being available.

Is it possible to address the lag? Given Mr. Maguire's recommendation that we ban the sale of aerosols to under 16, if that happens tomorrow I would be very conscious of a displacement factor where young people would find something else that we would not be aware of. How do we live track this issue and feed it into the data, even in an ideal world that possibly does not even exist yet? Does AI help?

We are moving towards something like that . We are trying to develop more early warning systems because drug use has changed and it has very much changed in the last decade with hexahydrocannabinol, HHC, and with nitrous oxide. The HRB and the HSE are working towards developing early warning systems to look at getting in those data before it becomes too late and so we can pick up on signals of a new trend happening and we can pre-empt something becoming a public health issue.

When I ask the next question it is absolutely no reflection on Dr. Mongan's work or of the HRB. I am very conscious of the amazing work they do. I am speaking in the context of how we improve things. When she says that the HRB is looking at it, can she give me the bones of what that actually means? How many people are looking at it? When should we expect it?

We are starting. We are trying to develop a system. No country in Europe has a proper system developed so it is not like we can just take something off the shelf and do it. We are working towards and developing a web-based platform. This work is starting in 2026. It takes a long time to try to develop these things but we do hope that this will help going forward. We continue with our other data collection systems. For example, we will have treatment data. We know there is a lag with deaths data but it is not as long for our other systems. Perhaps Dr. Lyons will talk on the treatment data.

Our drug treatment data are very good. The national drug treatment reporting system has the capacity to be almost real time or a month in arrears. Of course drug treatment is further down the line so by the time a young person presents in drug treatment they may have been using for quite a period. It is important and it is one of the ways we can gain a proxy measure of use in the population. We know now from the studies we do that many more people who are using inhalants will then turn up in drug treatment.

On drug-related deaths, our data are so good because we get data from closed coronial files and closed inquests. The nature of that is that they do take some time. We should be reporting on 2023 and 2024 data by the end of this year. Because of the nature of the data, that would be the closest we could get for real-time data.

My fear is that oftentimes aerosols, and not just nitrous oxide, are almost a gateway to other drugs for which treatment options are probably more available. By the time we catch up with the young persons who are using aerosols, not just nitrous oxide, sometimes they are being treated for the more prevalent drugs that are more established than the new lexicons. Some other time I would like to see this committee as being an innovator in Europe and somewhere that was actually developing practices that may not exist.

Can we engage with patient service users? That is a good way of keeping up to speed with what the trends are and engaging with young people. We have a plethora of youth work projects, and the schools, and there is a lot of expertise there. It is around utilising that piece.

Absolutely. There are some suggestions. If there are other suggestions, send them in to this committee. This committee wants to be ahead of the curve I imagine. Even if we are imagining things that do not exist yet, please send them in because resources need to be thrown at this. As the Maguire family has captured, young lives are being lost . Please let us be ambitious with our suggestions.

I know this has been touched on but social media is a massively complicating factor in trying to design any prevention programme. It has completely changed the game. Young people are hearing about substance use by word of mouth among peers in localities. In the past, going back 30 or 40 years, occasionally we would have a hot spot where it was glue sniffing in one particular area but it was not widespread. Social media means there is a lot of pro-drug information being churned out to huge portions of the population. I assume there must be mechanisms whereby we can monitor that.

I have no idea how one would go about doing that.

It could involve turning off the algorithms.

Equally, social media is potentially a tool in the armoury of prevention that we need to better harness but again, that is outside my scope of expertise. It requires people with the expertise to be brought in to guide us, to be resourced to be ahead of the curve on these trends and to respond to them with correct information and so on.

Deputy Ó Murchú is next and I am sure he will have lots to say on social media algorithms.

Yes, indeed. First, I cannot imagine what Dermot and Yvonne have been through. It is very brave and worthwhile of them to be here to highlight the dangers of aerosols. It is something that I had forgotten about. It was something that used to come up every ten or 15 years, when we would hear of a spike. Today we can trip over what used to be "silver bullets", which have now morphed into bigger, indusrial-sized canisters of laughing gas. In fairness to Yvonne, she said that explicitly and that is what Deputy Mark Ward's legislation was about. The idea was to have registered users who have a legitimate right to use nitrous oxide rather than a situation where people have produced something to sell so that kids can get high. It is as simple as that. They are making money off it. People did not need those big, industrial-sized canisters until the use of inhalants started going through the roof. If there are licensed users, then it is not available to unlicensed users. It is as simple as that. I have no problem with the Government coming up with its own legislation. However, it has argued that it needs more time but that begs the question as to what it has been doing up to now.

I agree that there is a huge issue regarding the use of HHC in the context of mental health issues. The Cathaoirleach spoke about the need to be flexible, the ability to react quickly and the importance of making sure we have the correct information. How do we get the message out there? Unfortunately, the message is that if people want something to get high on, it is straightforward. Such is the power of social media in this day and age. I agree that we should get rid of the recommender settings. They are the means through which social media companies make money and they are not particularly worried about what people are looking at, as long as they are making money. Some of this stuff should not be allowed, in any way, shape or form. In the age of AI, there is the possibility for them to be a lot better. However, I also accept that even before the advent of social media people went out and sought ways to get high. My fear is that when people are young, they feel that they are going to live forever. When they hear of a terrible scenario, they think it affects others and will not happen to them. They think that under the law of averages, they will be okay. They are living in the minute. How do we propose to tackle that?

As Mr. Doyle said, we often say that we need to talk to young people. It is obvious that we need to talk to the people who are at the coalface, that is, the people who are actually dealing with this. We also need to talk to those who are dealing with the worst-case scenarios, where it has blown up in people's lives and they are in addiction services or in hospital. What do we do in terms of catching as much of this as possible and ensuring that the lives of as few people as possible are impacted detrimentally or destroyed and lost?

Again, I express both my sympathy to, and my admiration for the bravery of, the Maguire family. It really is, as Mr. Doyle said, about a whole-system approach. We need a health-led response across all sectors of society. I include here the local authorities, education providers and sporting organisations. They are the front-line, feet-on-the ground people who actually interact with young people every day. They are seeing the trends. Indeed, they are often the first to see the trends emerging rather than those providing the treatment services. There is a piece about looking at that. As Professor Smyth said, the preventative piece is so important in the context of social media-----

That is one piece but how do we get the message out? Years ago, if something was on the news, that was how people found out they could do it and it led to spikes.

That is a massive concern and that is an evidence-based concern. The evidence is there in terms of actually promoting some things. Young people are naturally curious; that is their job. It is about a preventative programme that really speaks to harm and then the harm reduction around it. We need a new strategy that really emphasises prevention rather than harm reduction.

Intuitively, we always believed that scared straight worked but we found out years later that it did not because the human brain-----

Young people are risk-takers. Part of the job of growing up is to take risks and move on. It is about detaching from parents and moving on. That is a concern and we do not have a good answer to that right now. It is about all of the key stakeholders looking at this together in terms of health promotion, like the school programme that was mentioned earlier. It is about having a wider piece than just the drugs that we already talk about.

It is also about testing it. That is the bit that we do not do. We put a plan in place and then we defend it, no matter what, as opposed to learning from what works and what does not through engagement. That is the piece that the committee can do in engaging on this specific issue, outside of how we deal with the overall drug problem that is absolutely destroying communities at the minute.

It is about a wider prevention strategy emerging, which is what Professor Smyth was talking about in his opening statement. Today we are here to discuss one aspect but we know that there is so much else emerging at the moment and the strategy must speak to that and be ahead of it, in terms of the prevention piece.

It is that piece of what we can do. We know what we can do in relation to laughing gas. That is straightforward. Even with the banning of aerosols, something else will be found but we have to be able to do this better because the traditional means of doing it have not worked.

As I said the last time I was here, we should never get hopeless about our ability or capacity to influence patterns and trends like this. We have to accept that there is always going to be drug use and always going to be new issues that arrive and depart but -----..

We have had huge success in certain areas in the past but what I would like to see more of is more ambition - a real and declared ambition to try to reduce drug use across society. We need an all-substance-use goal and ambition coming from the absolute top down. That would be helpful.

Deputy Ó Murchú's time is up. We will have a second round of questioning, beginning with Deputy Graves.

I do not really have any more questions but would like to respond to what has been said thus far. Ms Maguire mentioned licensing and so on, which is what the Sinn Féin Bill was about. The Bill was based on the model used for alcohol, whereby suppliers have to have a licence and people have to be over 18 to sell it or to buy it. It is simpler because it is a specific product but when it comes to inhalants, it could be anything. It could be a deodorant, paint stripper or something else, which makes it that bit more difficult. Labelling works but we will have our job cut out for us to get companies to cooperate. We have been calling for labels on alcohol products for export for the last number of years but the vintner's lobby group is very strong. It has been pushed down the road, even though we know it works. We have seen it work with cigarettes and it will work with alcohol. Strangely enough, some alcohol products that are being exported to particular markets must have a label, so it is being done anyway. At Government level, however, it is not agreed yet. That is something that is ongoing. I would push for labelling because it does work but the issue is that we are looking at a whole range of products. Ultimately, it is about education. It is about getting into the schools. I know that this affects people of all ages but in the main, it is young people. Nitrous oxide is targeted at young people.

Also, you do not know with a child who is harmed by inhaling a deodorant or whatever else whether it is their first time, whether it is something they are in the habit of doing or whether they tried it because somebody else in school was trying it. You do not really have that evidence because it is not like general drug use, where there are all the signs and symptoms.

We are happy to support Mr. and Mrs. Maguire and answer any questions they have. If they want to come back, they can just contact us.

The Deputy is absolutely spot on. This is the thing. With other drug use there is paraphernalia. Like Deputy Ó Murchú said, the little silver bullets are now big canisters with colourful writing on the side. It is very evident when this is being used. We are in a minefield now. Deputy Graves is absolutely right that we have a hard road ahead to try to get the labels on these because they are imported and so on. She has hit the nail on the head. It is very hard to try to regulate or notice because this is a household item. That is where we are bringing it all to the committee to see if anything can be done about it.

The small warning currently on aerosols such as deodorants is not very highlighted but it is there. I believe that was actually put there voluntarily by the industry. We will go after the big retailers and ask them and plead with them and we will not take no for an answer.

Good for you.

I have been around long enough to have seen the beginning of the local drugs task forces back in the nineties. I remember that all the senior people from the different organisations - at the time it was the VEC, which turned into the ETB, the Garda, housing managers, all those - were mandated to be at those meetings. The reason there were senior people at the table was that senior people make decisions. That is how you then get implementation of a strategy, whatever the strategy is. That has massively fallen off and gone to a great extent. I have not been on task forces in the past couple of years, but if we are talking about a strategy and implementation of a strategy, we need to get back to ensuring that all the agencies that are responsible for the multifaceted approach to drug use and misuse in our communities are back at the table. They have to be mandated back to the table and they have to be senior enough to be able to make the decisions.

The other thing I will talk about is how we collect data and how we respond quickly to new and emerging trends. There are enough organisations on the ground that see emerging trends come very quickly, even as regards the waste of energy. They say there are 3,000 canisters coming in every week, so we know on the ground, we know anecdotally, and we know now with concrete evidence that this is a huge problem. Sometimes, however, I find that the agencies wait for the HRB or wait for the data to come in and then we sit around at meetings like this and we say this is now a problem because we have the data coming in from the HRB, but we will have known a year, a year and a half or two years beforehand that this was an emerging problem. Sometimes, as I said, it is just too slow in trying to get that strategy in place and get those senior people in place to be able to deal with that particular strategy.

We know young people use social media to buy drugs. Does the HSE use social media to create awareness? Does it use Snapchat, TikTok or Instagram to get the message out there around drug use, or are we still with posters?

Would any of our witnesses from the HSE like to comment?

We do use social media. We work very closely with HSE communications. Our website, drugs.ie, is heavily promoted and gets a lot of visits. More recently, we have been holding the parents' information sessions that Professor Smyth alluded to. Also, we have the wastewater initiative whereby we are doing an analysis of water to try to get a greater understanding of what substances are being used. We will continue to do what we are doing and expand as necessary, and we await the new strategy.

I have just never seen an awareness programme on social media. That is probably because of my age. The algorithms are probably not throwing that towards me. I will have a look at the HSE's social media because this is very important. We have to go where the young people are. If they are on Snapchat, TikTok and Instagram, that is where we need to be.

That is a very good point. If they can buy this on social media, why are awareness programmes not targeting them and flashing up?

We will finish this session. Some of our witnesses have to leave. We have confirmation from the Minister of State with responsibility for drug use, Deputy Jennifer Murnane O'Connor, that we will have the national drugs strategy in the next couple of days. I think there is an intensive job ahead for this committee in terms of scrutinising. I assure Professor Smyth that this committee is not despondent in terms of the task ahead of us to be innovative, ambitious and motivated by the heartbreaking stories but more the courage of families like the Maguires. We understand the task in front of us to deliver a report that is commensurate with the scale of the challenge of addressing drug use, drug deaths and drug harm in this country. I thank the witnesses.