Heroin most commonly injected drug, HSE syringe analysis project finds

Study shows cocaine injecting has re-emerged and reached ‘significant’ levels

Heroin is the most commonly used substance among those who inject themselves with drugs, while cocaine injecting has re-emerged and reached “significant” levels, according to a new report.

The Health Service Executive’s (HSE) national drug treatment centre laboratory led a syringe analysis pilot project, the first of its kind carried out in the State.

Under the project, the laboratory collaborated with Merchants Quay Ireland (MQI) to conduct an analysis of 155 syringes to inform health-led responses. Of the 155 syringe samples, 100 were from Dublin, 27 were from Longford and 28 from Offaly.

The presence of heroin was highly prevalent, with 93 per cent of syringes collected in Dublin and 98.2 per cent of those from the midlands areas found to contain the substance, according to the report. This, it states, is reflective of heroin being the most commonly used substance among needle exchange service users nationally.


Cocaine injecting has re-emerged in Ireland, according to the report, with significant levels of the substance detected in the Dublin (86.5 per cent) and Midlands Regions (89.1 per cent) as part of a pattern of people using multiple drugs, termed as poly-substance abuse.

The pilot project also identified new trends, such as the presence of synthetic cathinone 3-methylmethcathinone (3-MMC), a psychoactive substance that has raised concerns in other parts of Europe due to the risk of poisoning and death. The project also identified the presence of methamphetamine and the possible injecting of flurazepam, often used to treat insomnia, in the midlands region.

While similar trends were identified across Dublin and the midlands, the pilot found regional differences with niche trends presenting in the different locations. The presence of 3-MMC (23.6 per cent) was found to be higher in the Midlands Region, while the presence of oxycodone and ketamine was more widely detected in Dublin.

Prof Eamon Keenan, the HSE’s national clinical lead for addiction services, said he was “pleased” that the project had not identified the emergence of synthetic opioids in the syringe samples but that the situation needed to be monitored “closely”.

“The volatile nature of the drug market is a healthcare concern as new and more potent substances, including synthetic opioids continue to emerge on the European drug market,” he said. “Through this pilot project we have confirmed the presence of new psychoactive substances on the drug market and the re-emergence of cocaine injecting, these findings require tailored health responses and further monitoring.”

The report makes a number of recommendations in light of the findings, including the expansion of syringe analysis methodology for market monitoring purposes, to combine the methodology with service user research and to pilot the analysis methods among injecting user groups.

The report also called for the opening of a medically-supervised injecting centre to “reduce” the risk post for people who inject drugs.

Planning permission given to set up Ireland’s first supervised injecting facility was deemed invalid by An Bord Pleanála last year. However, the planning body is currently reconsidering an application by MQI to operate the facility, with a decision expected by the end of the month.

Shauna Bowers

Shauna Bowers

Shauna Bowers is a reporter for The Irish Times