A spate of overdoses in Dublin earlier this month has been linked in part to a synthetic drug responsible for dozens of fatalities in the US and UK.
Since November 9th, there have been 57 overdoses among drug users in the Dublin city centre area, with the majority of those occurring in the first few days.
In at least once case, forensic analysis of substances taken from the scene confirmed the presence of a nitazene, a type of synthetic opioid similar to fentanyl which has become common in Europe and the US over the last year.
Shortly after the spike in overdoses, a large-scale public health campaign was established by the HSE and drug treatment agencies to warn Dublin heroin users of the dangers of this new substance, with road signs and posters erected around the city.
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Since then, further testing has identified the nitazene specifically as “N-Pyrrolidino Protonitazene”. It is the first time the substance has been identified in Ireland.
The substance is estimated to be 25 times stronger than fentanyl, which itself is responsible for huge numbers of overdose deaths in the US but has yet to take hold in Ireland or Europe.
It is understood two of the overdoses reported to the HSE this month have been fatal. One was linked to heroin use and the other to cocaine use. However they have yet to be definitively linked to the new substance.
N-Pyrrolidino Protonitazene was first detected in the US in January 2023. According to an alert issued by the US base Centre for Forensic Science Research and Education (CFSRE) in August, it has been responsible for 20 overdose deaths in the US and UK.
It is often mixed with fentanyl, cocaine and benzodiazepines. The CFSRE said the drug “has the potential to cause harm and is of high public health concern globally”.
There are fears among drug workers and gardaí that the almost complete cessation of heroin production in Afghanistan since the Taliban took power in 2021 is causing dealers to source the drug from new and potentially more dangerous sources more willing to cut it with synthetic opioids.
A HSE spokeswoman said there is still an “extreme risk” in Dublin and that drug users are urged “to avoid new batches of heroin, buying from new suppliers or trying new types of drugs”.
Experts warned the substance could become a regular ingredient in imports of heroin into Ireland.
“The concern now is we’re going to have peaks of overdoses like this,” said Tony Duffin, chief executive of Ana Liffey Drug Project. “Nitazene isn’t going away.”
Both the HSE and Mr Duffin said naloxone, which can reverse the effects of heroin overdoses, will play a vital role in saving lives. The drug was used successfully in several overdose cases in Dublin over the last month.
The HSE spokeswoman said it is advising users to carry naloxone which provides a “crucial window while emergency services arrive”. It is available free at every Dublin Addiction Service location.
“Work with the services is ongoing regarding preparedness for any future incidents and we continue to monitor the situation and review the available data,” the spokeswoman said.
