Research conducted by the EU drugs agency shows the Mater Hospital had 1,083 such presentations to its emergency department between 2013 and 2015.
There were 526 cases between October 2013 and September 2014 and 557 between October 2014 and September 2015. It placed the Dublin hospital behind Oslo Emergency Outpatient Clinic and London St Thomas’ Hospital, but ahead of London King’s College Hospital and hospitals in Paris, Basel, Munich, Barcelona, and Copenhagen.
Our Lady of Lourdes in Drogheda, meanwhile, had the second lowest number of emergencies, at 49 (36 in the first year and 13 in the second).
The research found that, of 10,956 emergencies overall, three-quarters involved males. Presentations were most common in the 20-39 age group, followed by the 30-39 cohort. The research, conducted by the European Drug Emergencies Network for the European Monitoring Centre for Drugs and Drug Addiction, found most presentations to hospitals were in the summer and at weekends.
The main illegal drugs —heroin, cocaine, and cannabis — accounted for 64% of emergencies, while prescription drugs took up 25% of cases.
New psychoactive substances (NPS) accounted for 7%, but rose from 5.6% in the first year to 8.5% in the following year. In the Mater, they made up more than 10%.
Heroin was by far the most common drug involved, although heroin-related numbers dropped between 2013 and 2015, as did cases which involved cocaine and cannabis. Numbers increased in cases of GHB (except Ireland, where it did not feature much), amphetamine, and mephedrone.
In 6% of cases, the people were admitted to critical care, while 4% were referred to a psychiatric ward.
The research identified 49 deaths, 23 from opioids, including 12 from heroin. A further 15 were from stimulants, most commonly cocaine, amphetamine, mephedrone and MDMA. An examination over one-year found:
- 662 cases of heroin: Average age was 36 and 80% were male. Main place of use was the street and common effects were coma, low respiratory rate, agitation, and hypertension;
- 421 cases of cocaine: Average age was 30 and 76% were male. Some 60% also involved cocaine. Main place of use was the home and common effects were anxiety, chest pain, palpitations, and agitation;
- 421 cases of cannabis: Average age was 24 and 72% were male. Some 49% also involved alcohol. Main place of use was the home and the common effects were anxiety, agitation, vomiting, and palpitations;
- The main prescription drugs causing patients to present were were benzodiazepines and Z-drugs. MDMA (ecstasy) accounted for 8% of cases, but 10% in Drogheda. Effects included agitation, heart problems and chest pain.
Dealing in death
Gardaí suspect that four out of the five people who have so far died from super-strong synthetic heroin got the substance through normal drug-dealing networks, strengthening fears that more of the substance is available.
Three deaths linked to fentanyl, which is 600 times stronger than morphine, have been recorded in Dublin, with two in Cork.
The first death occurred in Cork on April 27, followed by three in Dublin at the end of May, and a fifth in Cork on July 25.
Three of the deceased in Dublin are thought to have been intravenous heroin users and were homeless.
All five victims are believed to have been aged in their 20s and 30s and from Dublin or Cork. The first user is known to have sourced the drug online on the darknet.
Gardaí believe the remaining four victims sourced it on the streets, suggesting a more traditional drug-dealing system supplied the drug.
Sources said this suggests more of the drug may be out there and that greater quantities can be brought in.
Gardaí suspect the drug is being sold as heroin and is typically mixed with paracetamol.
Gardaí and health workers fear there will be more deaths and that some may already have taken place.
It is understood that it takes six to seven weeks for lab results to be returned.
Garda sources said it was “really important to get on top of this as quickly as possible”.
Sources said if gardaí seize a supply quantity of the drug, they might be able to track the supply route.
A senior source added that the drug is “so toxic that 2mg is enough to kill”.
Fentanyl has caused significant numbers of deaths in the Baltic states and Russia, and in more recent times has spread to other parts of Europe, including the UK.
Figures from the EU drugs agency show there were 650 deaths linked to fentanyl in Estonia between 2005 and 2012; 160 in Germany, mostly since 2008, and 50 in the UK.