Diversity of drugs market unprecedented, says Dr Chris Luke

There is an “unprecedented” diversity to the drugs market with hundreds of new substances available and a new cohort of users, according to an emergency medical consultant in Cork.

Dr Chris Luke, who works at Cork University Hospital and the Mercy University Hospital, was speaking after the HSE issued an alert as the powerful opiate fentanyl, which led to the death of pop star Prince, was implicated in the deaths of five people.

The drug, which can be up to 600 times more potent than morphine, is believed to have played a part in the deaths which occurred in Dublin and Cork in recent weeks.

Dr Luke said opiate misuse had become “a massive epidemic” internationally. “Doctors have been prescribing artificial drugs like fentanyl for years, but it’s become a huge problem as a substitute for heroin, which is the more natural, organic stuff,” he said.

Chemical chaos

“Unfortunately, the nature of drug use is that with globalisation and the internet, we are now seeing a complexity and diversity that is absolutely unprecedented. There are hundreds of drugs now flooding the market that have been identified.

“We’ve moved from a very sort of old fashioned simplistic situation where we had about 10 or 15 drugs being misused to this situation where we have what I call chemical chaos. You have a bewildering menu of new and old drugs.”

Dr Luke also said the profile of patients presenting to the emergency department had changed.

“We see people in their 40s coming in after taking head shop drugs they got online and had delivered through the post,” he said. “People in tiny villages coming in with life threatening illnesses due to drugs they’ve bought online at the age of 45. So you’ve got a change of the whole demographic and spectacular diversity and toxicity.”

Lethal

In terms of fentanyl, he said the drug becomes “lethal very quickly” with the chief cause of concern arising when individuals who take the drug see their tolerance diminished.

“When you’re taking heroin or morphine or opiates regularly, you become tolerant so you go from a dose of one to say a dose of 20 over a couple of weeks,” he said. “If you stay off it for two weeks, go back on it, and take 20 again, it may well kill you.

“Fentanyl represents the same kind of problem. If people who take X amount of heroin take X amount of fentanyl, they are effectively taking 10-100 times more heroin than they are used to.”