The extremely dangerous benzodiazepines have become 'a very big Cork thing'
“Little ticking time bombs” are being passed around on the streets or outside pharmacies every day, unseen or not noticed by much of the population.
But these little white pills are quietly hooking teenagers and adults alike and contributing to multiple deaths and violent attacks every year.
Blackouts, violence and “a feeling that you’re invincible, that you don’t care" caused by the prescribable tranquilliser drugs benzodiazepines have caused them to be christened colloquially as ‘charge sheets’.
Benzodiazepines are causing mayhem on the streets and behind closed doors in homes across the country, a leading addiction therapist and recovering addicts have told the.
But the problem is particularly deeply rooted in Cork, which historically had the highest level of benzodiazepine dependence in the country.
Counterfeit benzodiazepine pills now flooding the streets are “a ticking time bomb” for users, stuffed with unknown chemicals that could cause serious illness or death, senior addiction therapist with Cuan Mhuire addiction treatment centres, Michael Guerin, said.
€14,000 worth of suspected Xanax tablets were seized by gardaí at a house in Watergrasshill, Cork in April.
The search was part of an ongoing operation targeting individuals believed to be involved in illegally selling prescription medications in Cork city and county.
And while “the big, sexy drugs like crystal meth or cocaine” grab the headlines, benzodiazepines are silently implicated in more overdose deaths than any one substance other than alcohol.
According to the most recent drug-related deaths figures from the Health Research Board, 376 people died in 2017 from overdose.
Prescription drugs were implicated in more overdose deaths than any other substance, accounting for two in three (253) people who died from poisoning.
Benzodiazepines were the most common prescription drug group, implicated in 139 individual poisoning deaths, followed by methadone with 95 deaths.
Heroin was implicated in 77 poisoning deaths, cocaine 42 while alcohol had the most of any single substance, implicated in 125 overdose deaths.
All benzodiazepine related deaths also involved other drugs, mainly opioids.
As one user told the Irish Examiner, benzodiazepines “go with every other drug”.
According to Mr Guerin, “Benzodiazepines are as tradable on the streets as anything else - cocaine, cannabis, heroin.
“It’s very common to see benzodiazepine misuse forming part of polysubstance misuse that you would see in a young person.
“A lot of tablets on the street are counterfeit, so you don’t know what’s in them. They could be adulterated with anything that could cause illness or death.
"It’s extremely dangerous. There is always the risk that the next batch will be contaminated with something lethal and no-one will know.
“And the hallmark of mixing benzodiazepines and alcohol is violence and aggression and domestic conflict. Every user will tell you that when they mix benzos and alcohol they get in trouble. It seems to bring out the worst in people.”
And the problem is particularly acute in Cork, he said.
“Benzodiazepines are a very big Cork thing," Mr Guerin said.
“The highest per capita rate of benzodiazepine dependence in the country is in the north side of Cork. It’s a serious issue there.”
“Benzodiazepines get a psychological hook into their users that’s probably unrivalled by any other substance. The client becomes so reliant on the drug. They’re very difficult clients to work to get drug-free.”
Cuan Mhuire Bruree is one of the few facilities nationwide that detoxes individuals from benzodiazepine misuse, he said.
“The number of benzodiazepine detox beds in Ireland is quite small considering that the problem is so vast," he said.
“You have two distinct cohorts, the people who are prescribed benzos and are supplementing with street-bought tablets and then you have the people fully relying on street-bought benzodiazepines to feed their habit.
“Benzodiazepine misuse forms part of our daily work in terms of dealing with young, polysubstance misusing males.
“Most people want to talk about big, sexy stuff, like crystal meth and cocaine, but benzodiazepines and alcohol are really where it's at in terms of the number of people getting in serious trouble and losing their lives.”
The HSE said that detoxification from benzodiazepines or ‘Z’ drugs is usually handled in the community through a tapered dose reduction and psychosocial support.
Residential detoxification from benzodiazepines is usually required when it is part of polysubstance misuse.
The most recent treatment data from the HRB’s National Drug Treatment Reporting System (NDTRS), shows that from 2013–2019, the annual number of treated cases reporting a benzodiazepine as a problem substance increased by just over 5%, from 3,337 in 2013 to 3,512 in 2019.
The annual number of cases who reported benzodiazepines as their main problem substance increased over the reporting period from 810 cases in 2013 to 1,082 in 2019. The number of cases who reported benzodiazepines as an additional problem substance was much larger, however it decreased slightly (by 3.8%), from 2,527 in 2013 to 2,430 in 2019.
Mark was 16 when he was first prescribed Xanax for anxiety.
But that innocent request for help spiralled into an addiction that saw him taking up to 60 pills a day, going into seizures when he didn’t have them and waking up in Garda cells, covered in blood with criminal charges and no memory of how he got them.
Prescribed the pills until he was 18, his doctor withdrew the prescription when he realised that Mark was addicted. The subsequent ‘sickness’ of withdrawal drove Mark onto the street to source them elsewhere.
“You’d get them anywhere, cities, small towns, rural places, anywhere,” he said.
“They were €20 a tray when I was buying them first. That was 10 tablets. They were from different countries, with different languages on the packaging.
“Then I started on Xanax sticks, they’re supposed to be 2mg benzos but I’d say there’s no benzos in them at all. There’d be an effect but you wouldn’t know what was in them.
And if the pills were mixed with alcohol, the result could be “mental” and violent, he said.
“They can make people very violent when mixed with alcohol. You wouldn’t know what you’d be capable of. You just don’t care and you don’t remember it either. That’s the scary part about it. Loads of violence happens over it.
“You’d wake up in a cell and have no memory of what happened. No idea how you got there. Did I kill someone? Covered in blood. You just can’t remember anything.
“They call them charge sheets. If you’re drinking with them you may as well hand yourself into the guards because something is going to happen, you’re going to get a charge sheet.”
The 25-year-old, who asked for his anonymity to be protected, said that a frequent user could quickly start taking large amounts.
“Your body becomes immune to them. By the end of my active addiction I was taking 50 - 60 a day.
“I’d take 10 in the morning just to get rid of the sickness.
“If I didn’t have them for a day I couldn’t shower, I couldn’t get in the water because the feeling of it on your skin. I couldn’t sleep if I didn’t have something for the next day.
“It was a horrible feeling, a horrible feeling.
“If you tried to sleep your legs would be going, your head was going.
“You’d do anything to get rid of that sickness.”
Mark became so reliant on the pills that he would have seizures without them.
“I’d often take six or seven benzo seizures in one day from not having them. Just a lack of benzos in your system would cause you to seizure.
“You’d start shaking and convulsing, bang your head. I ended up a few times in hospital over it. They’d figure out that it was a benzo seizure and give you a small dose to stop you seizing.” He said that his addiction nearly killed him “a few times”.
“I remember waking up in intensive care in hospital and my mother had got a phone call to say that I might never wake up. I had taken a load of tablets, an incident happened and my head was split open. They thought I wasn’t going to come out of it.
“I remember coming out and trying to get tablets in the hospital. That’s how much of a hold it has on you. Addiction is running you until you come into recovery. I’m in control now.”
Mark successfully completed rehab at Cuan Mhuire, Bruree almost two years ago before moving on to secondary treatment at Teach Mhuire, Western Road, Cork. He has remained drug-free since.
“I remember taking the call from Bruree in my mother’s back yard and tears came out of my eyes because I knew I was going to get better. I really wanted it this time. When I knew I was going in I knew the pain was ending,” he said.
“Things had gotten bad. My son was taken into care. I tried to commit suicide a few times. And the way your head was, the thoughts. It’s just crazy. All these horrible feelings just for this drug.
“But the help is out there if you want it. But you have to feel enough pain before you want it.”
Recovery has been far easier than active addiction, he said, and he is grateful every day that he has turned his life around “360•”.
“I wouldn’t swap what I have today for anything.
“I’m not sick in the mornings, I have a bit of gratitude in my life. I have a car on the road. I’m holding down a full-time job now, I never had a job in my life. And I love my job, some mornings I get excited going to work. I’ve been working on building sites and I want to be a rigger.
“You don’t have to watch your back anymore, owing money to this fella or that fella. I can go to bed at night, put my head on the pillow, and sleep. I can go to work in the morning and be there on time. Simple things that I could never do before. I’m grateful for what I have in my life today.”
He said that he feels no resentment towards the doctor who originally prescribed the medication to him but said that medication for anxiety is just a quick fix and children should be taught emotional coping mechanisms much younger.
“Learning how to deal with anxiety younger is so important. Even bringing kids into meditation. Meditation slows down the head and anxiety is just overthinking. That’s all it is. Overthinking and being in the future when you should be in the present.”
“I can narrow down every disastrous thing that happened in my life to taking benzodiazepines,” Colm said, after more than a decade of drug misuse.
“When I was doing other drugs, even smoking heroin, I still had my wits about me. I’d never wake up and say ‘oh, what happened last night?’
“But if I took benzodiazepines anything could happen. I mean car crashes, trouble with the police, anything.
“Ask any other addict, ask a heroin addict, they’ll tell you that benzodiazepines are the worst out of all of them.
“Because you could be taking benzodiazepines for a week and wake up and not remember anything from that week. You could have been going to work, driving a car, doing anything and you wouldn’t remember.”
And counterfeit pills are particularly dangerous, he said.
“Any kind of random chemicals are pulled together and put in a pill press and sold to people. They could be made in someone’s back garden.
“You could take ten of those one day and be fine. But the next day you could take two from the same batch and black out for two or three days. You just don’t know what effect it’s going to have.
“But you wouldn’t care because if you’re in addiction and you’re sick you’re not worried about what’s in them. You just want to get them into your system so you can take away whatever you’re trying to escape from, be that pain or whatever.”
Colm, not his real name, said that he started taking drugs for fun. He came from a stable, loving family and had a good upbringing but drugs eventually consumed his life.
“People were surprised the road I went down with tablets and heroin. A lot of people would come into treatment and tell stories about their hard upbringing or trauma but I didn’t have those excuses. It was completely my own doing.”
Colm grew up on Cork city’s north side and said that doctors were “handing out scripts to everyone” when he first started taking benzodiazepines, aged 19.
“Everyone had them for sale. I’d take them when smoking weed to enhance the buzz you’d get.
“The moment I took one, you’d chase that feeling forever but you build up a tolerance very quickly. So you’re always chasing this high.
“In 2010 we’d take boxes and boxes of them and not leave the apartment.
“Me and my friends called them charge sheets because if you took them there was a massive chance that you’d get into some type of trouble.
“I was taking nearly every drug under the sun but when I was taking those benzodiazepines, disastrous stuff happened.” Colm eventually became homeless but was given a room at St Vincent’s Hostel in Cork.
“I was actually very lucky, Vincent’s took me in the day that I was kicked out of home. I went down there with a bag on my back, absolutely heartbroken. The people in Vincent's do great work, particularly with what they have to deal with. I’ll be forever grateful to them. The relief when they gave me a room was unbelievable.”
But Colm’s drug taking continued. He was warned by Arbour House that he would die within months if he did not get treatment for his addiction.
“I had no weight left in my body, my skin was all discoloured, my cheeks were all sunken in.”
A broken relationship was one of the first catalysts for Colm to go into treatment.
“I remember waking up in her house one morning and the fear in her face. She had to break up with me because it was her first time seeing me out of my head on those Xanax.
“When she was gone I had nothing left that was good. As long as I had her I had an excuse not to go to treatment or try to get help.” Another serious incentive was the knowledge that he would be given benzodiazepines while detoxing from heroin in a treatment centre.
But detox and treatment at Bruree, Co Limerick, was a revelation, and despite a shaky start, he stuck with sobriety, for both himself and for his family.
“I was in addiction for years. I’m clean now two years. I’m so lucky that I’m alive and away from it all.
“People say ‘it must be hard to come off drugs and stay off them’. But I say, ‘it was a lot harder to be on them.’ I’m forever grateful to Bruree for helping me.
“And I’m forever grateful to my family, my mother.
“My family is the number one reason I stayed clean. I had the support of my family and particularly my mother. I might not get the amount of [Narcotics Anonymous] meetings I want every week, partly due to the pandemic, but I would talk to my mam on a daily basis about life and the past and my recovery. And that, in a sense, is like a meeting for me everyday.
“I think the lockdowns are a massive issue for people with addictions, particularly people just coming out of treatment. I listened to this lecture on addiction and this guy said ‘the opposite of addiction is connection’ and it is.
“But with these lockdowns getting that connection can be harder. In the winter you couldn’t go sit down to have a coffee with a friend in recovery. Or go to a restaurant and eat nice food. Those small things I loved about recovery.
“That’s mostly been taken away from people.”
- For more information or to seek help with addiction: HSE Drugs & Alcohol Helpline freephone 1800 459 459 or email firstname.lastname@example.org Monday to Friday, 9.30am-5.30pm.