More than 17,000 new injectors attended a syringe exchange in Dublin last year according to the annual report from the Merchants Quay Ireland.
The group provides services for drug users and homeless people.
The review shows that while the majority attending the syringe exchange were heroin users 20% were also using cocaine.
Similar exchanges are now needed throughout the country according to Merchants Quay Director Tony Geoghegan.
"Syringe exchange services are effective not only in minimising the serious risk of blood borne infection such as HIV and Hepatitis but also in encouraging user to take up drug treatment and to work towards a better life," he said.
The report also shows an increase in the numbers from new EU member states seeking help from the group's homeless services.