Chemical chaos: the new drugs

The recent deaths of two men in Kinsale highlight the wide availability of new synthetic drugs. Their ingredients are often unknown to users, and their effects can be lethal

LAST MONDAY SHOULD have been Michael Coleman’s second week in his new job at Eli Lilly, the pharmaceutical company. Having graduated from Cork Institute of Technology as a chemical engineer, the 22-year-old had recently moved to a cottage in Kinsale with his partner. One neighbour reported having seen a fire lighting in the house in recent weeks and said the young couple had looked very happy. Liam Coffey, who was also 22, had stayed with the couple for the weekend. At 6.10am last Sunday the bodies of Coleman and Coffey were discovered.

Unusually, in the days that followed, the HSE warned about the substance gardaí believe was linked to the deaths of both men. The warning urged medical workers and drug users to watch out for a substance known to contain two amphetamines: methylamphetamine, also known as MDMA or ecstasy, and paramethoxymethamphetamine, or PMMA, a stimulant and psychedelic sometimes known as “Dr Death” or “Mandy”. The warning included a photograph of a brown powder in a clear bag and listed symptoms users and front-line staff should be aware of.

Also unusually, the HSE detailed “practical steps that drug users can take to prevent overdose”. These included avoiding mixing the drug with alcohol or other drugs, and knowing your tolerance levels. This is the first warning in Ireland relating to a mix of MDMA and PMMA, and it follows similar moves in other countries, among them Israel, where dozens of deaths have been linked to the new drug since 2007. Deaths have also been reported in Australia, Scotland, Canada and the US.

Sinead O’Mahony Carey, of the HSE’s substance-misuse service in south Co Tipperary, says drugs such as PMMA have come to regional agencies’ attention in recent years. “Since ‘legal highs’ were made illegal in 2010, we are seeing the emergence of a range of new chemicals, particularly in the recreational-drug scene,” she says.

Some users say they first encountered a powdered form of MDMA more than a decade ago; they regarded it as a purer type of tablet ecstasy. The trend of mixing it with other components, such as PMMA, is more recent. The Garda has reported a decline in the use of ecstasy during the past five years but a marked increase in that of new synthetic substances. One 32-year-old professional who moved to Dublin from the US and is an occasional user of MDMA was surprised at how socially acceptable that drug and its variations are here.

“I moved here in 2004, and within six months I was going to parties and MDMA was freely available. I was surprised by how casual and cheap it was compared with in the US. When taking the pill format you get a confined experience, but with the powder you take a dab or two on your finger, rub it into your gums and you can prolong it. I assume the powdered MDMA is mixed with all kinds of awful things, but I suppose there is a sort of trust with those you buy it from. The culture of MDMA in Ireland is very casual.”

Some of these drugs are widely available on the internet through drug forums, particularly after the closure of headshops. Another regular user, a 33-year-old woman from south Kerry, started taking powdered MDMA in 2001, after regularly using tablet ecstasy since 1996. “The pills were great, and then they got bad, and then this powder came around. I think it is the same as pills used to be years ago. You can pay anything from €50 to €100 for a bag of it. The average, though, is about €70-80 for a gram. It lasts longer and it is much stronger. A lot of people snort it. I don’t, because I get sick.”

She says that users tend to regard powdered MDMA as a purer version of ecstasy, although this is impossible to verify, and she is somewhat sceptical of the claims. “My friends say it is a lot cleaner, but I’m not sure. I think people who take drugs tell themselves a lot of stuff about the drugs to justify buying them. If you get the good stuff you are up a long time, and it is very strong, much stronger than pills in their pure form. It is very widely available. [From 2007] in my town, in west Kerry, there was a huge boom in it.

“I also hear people talking about 2-CB; there is loads of it in Tralee – it is a mixture of acid and ecstasy. One gram of MDMA could last one person three or four days. I dab my finger in it; lots of people snort, but I’ve never done that. I’d be afraid I’d be too high. One friend of mine went out on Thursday; I rang him on Tuesday and he was still up. He hadn’t slept from Thursday to Tuesday and was in a state.”

Tony Geoghegan, chief executive of the homeless and drugs service Merchants Quay Ireland, says many people who take the powdered form of MDMA, PMMA and other derivatives don’t see themselves as drug users and are unlikely to ask for treatment or to come to the notice of the authorities. This makes it harder to get a handle on the problem.

“People who take it, by and large, never present at drug services. Cannabis is like that, in that cannabis users rarely tend to present . . . I’m not saying they don’t need [services], but they tend to see it as recreational drug use. A lot who take it are experimental users, and unfortunately it is recreational users who are most at risk, as they know very little about drugs. Those with more experience will know signs and symptoms and what to do if someone gets into distress.”

Dr Chris Luke, a consultant in emergency medicine at Cork University Hospital, is among the staff treating patients who have taken chemicals that are increasingly difficult to identify. Two decades ago, he says, six or eight types of drug were available; now there is a myriad. “To be honest, talking about powdered ecstasy or MDMA is a red herring. Something different will come along next week. We need to move on from talking about specific species to classes of drugs, such as stimulants and hallucinogens, in a much broader sense. There has been this huge proliferation of chemicals available on the streets, and I’d rather talk about that than focus on narrow definitions.”

While society looks for answers, families such as the Colemans and the Coffeys are left to imagine lives that could have been. Attempts will continue to retrospectively identify particular strains of these new illegal drugs, but the street chemists are probably already on to the next manufactured high.

Meanwhile, medics are diagnosing in the dark. “We are now reaching what I call a chemical chaos,” says Luke. “The notion that powdered MDMA is somehow less dangerous is pure nonsense. If you scratch below the MDMA surface you’ll find something like 230 derivatives. As doctors and nurses we have to take on the problem, and sometimes we are making judgments without really knowing. Often we simply have to wing it and hope for the best.”

Analysis: More Mandy, snow blow and legal X seized

CONOR LALLY, Crime Correspondent

SIX-MONTH REPEAT prescriptions are desirable items for anyone who takes drugs, whether recreationally or more heavily. The pills the scripts can yield are funded by the State on a medical card and can be sold or bartered for other drugs.

Some GPs will facilitate this process, says one source. “It can be anything: tranquillisers such as Valium, antidepressants or whatever. If it’s available on a script you’ll find a doctor and convince them you need it. And they would probably be too busy to properly examine you to check whether you really need the tablets.”

The black-market trade in legal but controlled medicines is evident on the streets of every city and many big towns in the Republic. The circulation of niche or secondary drug types is more covert. It was, however, brought home last weekend with the deaths of Michael Coleman and Liam Coffey from suspected overdoses of MDMA and PMMA, also known as ‘Dr Death’ and ‘Mandy’.

MDMA-based ecstasy has been well known for more than two decades; PMMA is less well known. It was recorded as a drug seizure for the first time last year, when gardaí found quantities with a combined value of €5,900.

Some drug users have told The Irish Times that the era of the headshop, which ended two years ago when the products they sold were banned, ushered in a new culture of synthetic drugs. Many headshop products have gone underground and are now available from dealers of heroin, cocaine and cannabis.

The factories that produced them in the Far East and eastern Europe appear to be producing the same range, as well as new products that are reaching Ireland, some via online purchases from overseas.

The list of drug types seized in recent years has grown to include many substances from the headshop era. Mephedrone, for example, had been available in headshops. Also known as snow blow, the stimulant, believed to be manufactured mostly in China, was banned two years ago. In 2010 about €200,000 worth of it was seized, rising to €274,000 last year.

Appearing for the first time on the official list of Garda drug seizures last year were JWH-018 and JWH-073. Typically, these have been sold as “spice” incense, labelled “Not for human consumption”; they belong to the cannabis family. Combined seizures of both last year ran to just over €1 million, more than the value of the ecstasy that was seized.

About €33,000 worth of methylone, an ecstasy-style substance with hallucinogenic properties, was seized in the Republic last year. The Garda also impounded €161,800 worth of 2C-B, which has been used to treat psychiatric patients and been sold commercially as an aphrodisiac.

Dr Seán McDermott, director of operations at Eolaíocht Fhóiréinseach Éireann, the forensic-science laboratory in Dublin where many of the new substances are analysed, says MDMA is often now mixed with a large variety of other chemicals. “Typically, MDMA will contain things such as caffeine and paracetamol and drugs such as ketamine and other amphetamines, including compounds related to MDMA, PMMA or MDEA, which is part of the amphetamine family. These clandestine drugs are made in backstreet labs and cut with whatever is available to the street chemist.”

Amphetamines – a generic term that includes both amphetamine and methamphetamine – and ecstasy remain among the most commonly used drugs in Europe. Some agencies say PMMA is cheaper than MDMA to make, and it can be slower to take effect, sometimes causing users to take fatal doses.

Another ecstasy-type drug, BZP, which was sold in headshops, remains in circulation, as does MDPV, sold as “super coke” in headshops. Seizures of TFMPP, which headshops called legal X, reached €72,900 last year.

Deaths among so-called recreational drug users are rare, but Dr Jean Long of the Health Research Board says there have been a number of ecstasy-related deaths this year. “We are seeing the re-emergence of ecstasy. It has usually been on its own rather than mixed with other substances. But there have been sporadic cases of deaths and serious issues presenting at hospitals this year.”

Experts in drug treatment warn that “recreational users” who mix drugs are most vulnerable to serious outcomes. Paul Conlon of Coolmine Therapeutic Community, in Dublin, says that because they do not seek treatment it can be hard to establish which drugs are popular and which are most problematic.

“The drugs being sold are changing all the time anyway,” he says. So-called recreational users, who do not have a tolerance to drugs, need to be particularly careful, he says. While small bags of drugs are offered for sale on the streets supposedly in uniform quantities, the doses can vary and consumers can take more than they intend to. This, combined with the unknown effects of mixing drugs, can increase the risk of blacking out. Conlon also points out combining excessive quantities of alcohol with high levels of drugs can have very bad, even fatal, consequences.

The effects of illegal amphetamine use can include, in the short term, restlessness, anxiety and dizziness; with long-term use, they can lead to depression and have other psychological and psychiatric effects. MDMA and PMMA can cause increased heart rate, high body temperature and even fatal overdose.

Though the drug scene is depressed because the use of cocaine has plummeted, drug users and treatment professionals are encountering a new climate with a greater choice of synthetic drugs. The extension of the official Garda list of seized drug types appears to support that theory. (Additional reporting by Brian O’Connell)

Drug seizures: Garda figures for 2011

Cannabis €22 million

Cocaine €14.3 million

MDMA (ecstasy) €864,000

JWH-018 (cannabis-related) €678,000

Amphetamine €538,000

JWH-073 (cannabis-related) €385,000

Mephedrone €275,000

Diazepam (depressant) €209,000

BZP (ecstasy) €173,000

2C-B (amphetamine) €162,000

MDEA (ecstasy) €79,000

TFMPP €73,0000

Methadone €58,000

Methylone €33,000

LSD €27,000

MDPV (ecstasy) €13,000

Ketamine €11,000

PMMA €6,000