Dozens of people have overdosed on heroin in Dublin in recent days, a development which gardaí believe is linked to disruption to regular supplies of the drug due to the banning of opium production in Afghanistan.
The number of confirmed heroin overdoses had risen to 40 as of Friday evening with health authorities concerned that the total could rise significantly over the weekend.
In response to the crisis, drug workers are asking members of the public to call an ambulance if they spot anyone unconscious on the streets or in doorways in the coming days.
“If you’re walking down Henry Street or wherever, and you see someone lying there and it doesn’t look right, call an ambulance. Don’t assume they’re sleeping or that someone else will call,” said Tony Duffin, chief executive of Ana Liffey Drug Project. “You don’t have to wait around. Just call.”
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None of the overdoses so far are believed to have been fatal. It is understood the use of Naxolone, a medication which can quickly reverse the effects of an overdose, has been critical in saving the lives of many people in the last week.
Gardaí, health authorities and Forensic Science Ireland (FSI) are still examining the causes of the overdoses but sources said it appears they are linked to a new supply of heroin which is significantly stronger than what was available previously.
[ HSE issues warning after sharp increase in heroin overdoses in DublinOpens in new window ]
In a statement on Friday evening, the HSE said testing by FSI had found a “trace amount of a Nitazene-type substance” in a brown powder associated with a Dublin overdose.
Nitazene is a synthetic opioid that has in the last two years become common in the UK, where it has been linked to many overdose deaths.
Professor Eamon Keenan, HSE national clinical lead for addiction services, said he was “urging extreme caution following a sharp rise in the number of overdoses related to a powder being sold as heroin in the Dublin region. “These pose a substantial risk of overdose, hospitalisation and death.”
The HSE said it was advising users that there is “extra risk at this time and strongly recommends people do not try new types of drugs or new batches being sold on the market”.
Most of the overdose victims are long-term drug addicts who take a set amount of heroin every day to stop themselves becoming sick. Many are homeless or rough sleepers.
Garda sources said more investigation is needed and only a fraction of Irish heroin users have reported issues.
Gardaí believe a massive drop-off in the amount of heroin coming from Afghanistan has caused dealers to source supplies of the drug elsewhere which are much stronger than that to which users are accustomed.
A recent report from the United Nations (UN) found that poppy cultivation and opium production in Afghanistan has fallen by 95 per cent in the last year following a nationwide ban by the Taliban, which seized control of the country in 2021.
The HSE is advising users to avoid buying heroin from new sources and to avoid new batches of heroin “as there is increased risk at this moment in time”. If people do take heroin, they should “start low and go slow” and take it in the presence of friends, it said. Additional supplies of Naxolone have been ordered to prepare for further overdoses.
Mr Duffin said that if the ban remains in Afghanistan, criminals may turn to other producers in regions such as Myanmar for their supply. “Or it could be replaced by synthetic opioids,” he added.
The UN has warned that the “experience in North America with fentanyl overtaking heroin in major drug markets is illustrative of how a cheaper and readily available synthetic opioid can easily displace heroin”.
Fentanyl abuse has yet to become widespread in Europe. Nitazene has in the last two years become common in the UK, where it has been linked to many overdose deaths.
“We don’t have a problem with that right now but as they’re our closest neighbour, that could be something which is used to substitute heroin in the future,” said Mr Duffin.