A newly arrived and extremely dangerous heroin substitute, which caused dozens of overdoses last year, is continuing to pose risks to drug users.
Nitazene, a synthetic opioid which can be 25 times stronger than fentanyl, was first detected in Ireland last November when it caused 57 overdoses in a four-day period, prompting the HSE and gardaí to issue a “red alert”.
Further analysis determined the drug was a form of nitazene called N-Pyrrolidino protonitazene. It was the first time it was detected in Ireland and only the third detection in Europe.
Since then, more overdoses have been recorded, including several in Cork. A meeting of the Dublin City Joint Policing Committee on Monday heard there were five overdoses caused by nitazene in Dublin city centre in “a very short space of time” earlier this month.
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“So it’s still a significant problem and concern for us,” said Eddie Mullins, chief executive of Merchants Quay Ireland and a former governor of Mountjoy Prison. The red alert issued last November remains in place, he said.
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Det Supt Sé McCormack of the Garda National Drugs and Organised Crime Bureau said there may have been more overdoses caused by the drug which did not come to the attention of authorities.
He said naloxone, a drug which reverses the effects opioid overdoses, has been instrumental in saving lives since the arrival of nitazene.
Nitazene was first formulated in the 1950s as a safer alternative to existing opioid painkillers. However, it was never released on the commercial market due to safety concerns. It only started to emerge on the illicit market two years ago.
Det Supt Boland said a “national red alert group” has now been formed to monitor cases of concern and “hopefully rapidly respond to future outbreaks should they occur.” It includes representatives from various health, policing and academic groups and has met several times so far.
In recent years, there have been repeated warnings of fentanyl, another dangerous synthetic opioid, appearing in Ireland and causing mass overdoses. However, as of now, there is no evidence of fentanyl on the Irish market, the Garda said.
“This narrative around fentanyl is possibly diluting the narrative around opioids advice and opioid use and synthetic opioids,” he said.
The meeting also heard Ireland’s first medically supervised injection facility, which is due to open in Dublin city centre in September, will accommodate roughly 14 people per day.
Mr Mullins said the facility, which has been the subject of numerous objections in recent years, will operate for seven hours a day, seven days a week.
Each client will spend around 30 minutes in the facility, translating to about 14 users per day.
Drug users will likely to be reluctant to use the facility at first due to a distrust of authority. The centre will have a “green zone” around it in which users will not be arrested for heroin possession, Mr Mullins said.
“We don’t expect an avalanche,” he said of the facility, which will be located on Merchants Quay.
He said they anticipate a client base of around 120 people. The centre will not have capacity for any more than 300 interventions per week.
“We do not minimise or in any way underestimate the challenges or the concerns of the local community,” Mr Mullins said.
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