Heroin explosion

HOW things have changed.

Just nine years ago, the Government issued this statement: “Both treatment data and data from An Garda Síochána indicate that heroin misuse remains, almost exclusively, a Dublin phenomenon.”

That was the almost comforting view painted in the executive summary of the National Drugs Strategy (NDS) 2001-2008.

But before the strategy had come to an end, barely a county hadn’t been infected by the heroin virus.

As figures published in the Irish Examiner today show, there were five garda divisions in 2002 that didn’t have any prosecutions for heroin and a further nine with less than 10 cases.

By 2007 (the most recent figures available), all divisions recorded prosecutions for heroin and just four had less than 10 cases.

The scale of the increase reflects both a hike in usage and greater garda activity. Nationally, the figures show a trebling in the number of heroin-related prosecutions, with the greatest increases outside Dublin. These include:

* A 2,000% jump in the South-East region, from just seven cases in 2002 to 144 in 2007. Both Tipperary and Waterford/Kilkenny reported no cases in 2002, but had 32 and 75 respectively within five years.

* An 860% hike in the Southern region, from 36 in 2002 to 345 in 2007. A relatively large number of prosecutions were made in Cork city in 2002, dropping dramatically to just three cases in the next three years. The problem mushroomed in 2006 and has grown since. Nationally, Limerick has seen the greatest increase (up a colossal 8,550%), from two cases in 2002 to 173 in 2007, higher than Cork city. Kerry saw a 1,800% rise, from one to 19.

* A 640% rise in the Northern Region, from eight to 59 cases, with the Cavan/Monaghan division experiencing a rise of over 1,000%.

* A 635% increase in the Eastern Region, from 44 to 324. This includes a 2,000% jump in Laois/Offaly (from five to 104), a 1,300% hike in Louth/Meath (five to 71) and a 760% rise in Carlow/Kildare (from 10 to 86).

* A rise of 39% in the Western Region, from 20 to 99. Galway west jumped from 12 to 69 (up 475%), but the biggest rise was in Clare (up 1,600%), from one to 17.

The gardaí stopped recording these figures in 2005 and since then the Central Statistics Office has tried to compile them, but it is a complicated and time-consuming task.

It is not clear how prosecutions have gone since 2007. The number of drug offences increased from 18,500 in 2007 to 23,400 in 2008, before falling to 22,000 in 2009, still well above 2007 figures.

Other figures seen by the Irish Examiner, recording the number of heroin users seeking treatment for the first time, support the data.

These figures, compiled by the Health Research Board, cover the period up to 2008. They show, on average, a rise of more than double in new heroin cases in drug task forces outside Dublin, including:

* A rise of 310% in the mid-west (Limerick, Clare, Tipperary north), from 20 in 2002 to 82 in 2008.

* An increase of 280% in the western region (Galway, Mayo, Roscommon), from 23 to 87.

* A jump of 270% in the south-eastern region (Carlow, Kilkenny, Waterford, Wexford and south Tipperary), from 32 to 118.

* A rise of 260% in the midlands (Laois, Longford, Offaly and Westmeath), from 21 to 75.

* An increase of 240% in the southern region (Cork, Kerry), from 21 to 71.

* A rise of 560% in the north-west region (Donegal, Sligo, Leitrim, West Cavan), from an estimated three cases in 2002 to 20 in 2008.

* An 63% increase in the north east region (Louth, Meath, Monaghan and east Cavan), from 57 to 93.

These numbers are for new cases each year, considered the best treatment indicator for assessing trends.

“The figures are worrying. Not only is the increase worrying but the scale of the increase is worrying,” said Dr Des Corrigan, chairman of the National Advisory Committee on Drugs.

“It is almost inevitable those already dependant will recruit others, either ideologically, because they are enjoying it and want everyone to turn on or, financially, to pay for their own drugs.”

He said if the problem was left unchecked, it could “get out of control, as in Dublin”.

While national data for 2009 is not yet available, most reports suggest the heroin problem is continuing to increase.

Last August, the head of the HSE drug and alcohol treatment services in the mid-west, Rory Keane, said there was 175 heroin addicts (existing and new) undergoing methadone treatment in the region.

Mr Keane said that for every person in treatment, it is estimated there were two or three times that number in the community not in treatment, suggesting a total heroin population of more than 500.

The Garda divisional drugs unit recently estimated that there were between 300 and 600 heroin addicts in greater Limerick.

Mr Keane told the Irish Examiner there were “very real concerns at the increase in heroin use” in Limerick: “We are seeing certainly a lot of younger clients, people in their early 20s beginning to present themselves. Over the past 18 months we have begun to see the figures go up on a steady basis.”

Also, last August, gardaí in Kerry said there were at least 10 regular heroin users in Killarney and upwards of 100 in Tralee, where three dealers had recently been jailed.

In July, reflecting the threat posed by heroin in Cork city, Judge Con Murphy imposed an eight year sentence, with three suspended, for a dealer caught with €2,000 worth of the drug, a relatively small amount in itself. “Given that heroin has only reared its ugly head in the last four years or so, those caught with it have to be dealt with severely.”

Heroin claimed the lives of 20 people in the city in 2008 and 2009, although the number has dropped this year.

A Garda spokesman said their experience is similar to that of treatment services. “Corresponding to the treatment figures, there have been seizures scattered throughout the country and there has been a growth in seizures of heroin. This is reflective of police activity as well, although one follows the other.

“If addicts set up shop in say Carlow, the police operation follows.”

It’s hard to judge from nationwide heroin seizures the prevalence or availability of the drug. Just 22kgs have been intercepted to September this year, compared to 82kgs in 2009, a high of 213kgs in 2008, and 149kgs in 2007.

The Garda spokesman said the drop in seizures could, in part, reflect the impact head shops had on the heroin and cocaine trade.

Heroin addicts were buying vast quantities of mephedrone and other drugs in head shops in the last two years and it’s only recently that trade has ended.

The Garda spokesman said heroin hauls overseas, often partly the result of garda intelligence, were not included in Irish seizure figures.

“Heroin is quite a difficult drug to seize, although we do manage to seize a lot of it and a lot of suppliers have been charged. It is small and easy to transport and dealers don’t store it in warehouses for three weeks lying around, it is split up and moved quickly. Also users and street dealers hide it within their bodies.

“The difference between heroin and, say, cocaine or hash is people have to have it, they can’t wander the streets looking for it for a week. Sometimes there are shortages, if a shipment is caught, but the market balances it out. If you have 18,000 or so addicts in the country, they buy a corresponding amount of it.”

He said while law enforcement agencies try and restrict the supply of heroin, that alone wouldn’t stem the spread of heroin.

“At the end of the day, if a large consumer base is addicted to a substance, you need a multi-agency response. Police can restrict it and dismantle networks, but you have got to assist people to get off it.”

The central plank to the Governments’ national drug strategies has been to get addicts onto methadone, a substitute for the drug. This allows them to reduce their drug usage, improve their health and reduce drug-related crime. Research shows it works in this regard.

The number of people on methadone has increased from 4,900 in 2001, to 7,000 in 2004, 8,800 in March 2009, to 9,200 last August.

“That has been a huge achievement, to get 9,000 people into treatment,” said Dr Corrigan.

“People don’t realise how big that is. An awful lot of very hard work was gone into that.”

But the main problem has been the delay in setting up treatment services throughout the country and, in ares of high demand, expanding the existing services.

Services in Limerick and Cork were late starting. Areas like Wexford, Kilkenny, Tralee and Dundalk don’t have any treatment services.

Last May, a report by the Midland Regional Drug Task Force said that while there had been a jump in heroin use, there was a “chronic problem” accessing treatment.

Dr Corrigan said the figures published in the Irish Examiner highlighted the need for investment in existing services and expansion in areas under pressure.

“There needs to be action on that, otherwise people will continue to use and most likely will kill themselves before they access treatment. If left unchecked, [the problem] could get control, as in Dublin, and cost far more in the long term.”

He said international research had shown that for every €1 spent on drug treatment, more than €3 was saved on law enforcement costs alone. “I know it’s difficult at this time, and people are almost thanking their lucky stars that existing services are maintained, but I would argue that is very short sighted.

“Getting people into treatment is a win-win situation. It reduces crime, it reduces the spread of blood born viruses. For the individual drug user there are benefits, for the family there are benefits and for the community – who pay the price – there are benefits.”

A spokeswoman for the HSE said that as of August 1 last, there were 9,204 on methadone, almost 5,900 in HSE clinics and 3,300 in the community. She said there were 464 on waiting lists. She said under 18s are prioritised and none of them wait for treatment.

The breakdown of the waiting list, by regional drug task force (RDTF) area, on that date was:

* 14 in the Southern RDTF (average waiting time of one month).

* 66 in the South-East RDTF (one year).

* 31 in the Mid-West RDTF (more than one month).

* 18 in the Western RDTF (more than one month).

* None in the North-West RDTF.

* 46 in the North Eastern RDTF (more than six months).

* 122 in the Midland RDTF (more than a year).

“The crucial thing to look at is the figure for waiting lists,” said Dr Corrigan. “Action 32 of the NDS is quite clear, that people are assessed and treated within one month of presenting. It’s quite evident that is not happening.”

In September 2009, at the launch of the 2009-2016 NDS, then drugs minister John Curran said €1.1 million had been cleared for treatment clinics in Limerick, Cork, Waterford, Enniscorthy, Drogheda and Dundalk. Treatment would be available in all locations early in 2010.

The HSE spokeswoman said two additional clinics had been set up in Cork city. She said that before the end of this year additional clinics would be provided in Wexford, Waterford and Kilkenny, Tralee, Limerick city, Drogheda and Dundalk.

She said they were “progressing plans” to have clinics in Gorey and Cork city and two additional clinics in the midlands.

Also last September, Mr Curran said that needle exchange services would be provided at 65 locations through a scheme with chemists, funded by the Elton John charity.

The status of that project is not clear, although Dr Corrigan said he was being told it was developing.

Tony Geoghegan, of Merchants Quay Ireland drug and homeless charity, said the main failing of the state was not to provide rehabilitation services for recovering addicts.

“The state adopted essentially a containment strategy, to get people onto methadone, but they haven’t moved beyond that,” he said. “I’m delighted the methadone services have been put in, but the clients aren’t being moved on.”

Speaking at the launch of Merchant Quay’s annual review last month, former governor of Mountjoy Prison, John Lonergan, said “red lights” should be attached to the review. He said there was “danger on the horizon” and that the Government was “sleep walking” into a national disaster.