The opiate substitution treatment of heroin is not working and this is reflected by the large number of drug related deaths across Europe. According to the European Monitoring Centre for Drugs and Drug Addiction report published this year, more than 6,000 users die from overdose on average in the European Union each year.This figure accounts for around 4% of all deaths of young adults aged 15-39 in Europe. In some countries however that proportion is much higher. In Ireland overdoses account for over 12% of the deaths among young adults. Most of the overdose deaths among users result from taking more than one drug, also known as polydrug use.
Opiate substitutes such as Methadone are used to try and wean people off heroin; but they are very dangerous and highly addictive drugs. In Ireland doctors are also prescribing powerful benzodiazepines such as Diazepam, Zimophane and Stilnoct. All of these drugs together make a lethal combination, are often difficult to control and can lead to accidental overdose. The figures clearly show that the way these drugs are being administered is not working, and they are actually contributing to more death in our society. Figures from the Health Research Board show that methadone was implicated in 113 deaths in 2011 in Ireland, rising from 60 deaths in 2010. This is a staggering increase of 88% in methadone related deaths in just one year. Due to the difficult nature in establishing an exact cause of death, toxicology reports can take up to 18 months and therefore up to date figures are rarely available.
The number of purely heroin related deaths has dropped in recent years and has been replaced by methadone and polydrug use related fatalities. There seems to be an unwillingness to tackle the problem at government level in Ireland. The problem is that many of the people who are addicted to these drugs are from poor socio economic areas that have been ignored by successive governments.
One former user gave me his view on the problem. “The resources are there as for every walk of life for people with money, everything is there to get someone from the right side of the tracks off it. Unfortunately, 90% of people who are on it come from the wrong side of the tracks and don’t have money and come from broken homes, come from no work, come from social welfare lives. They don’t vote, they have no say!”
He told me doctors were prescribing dangerously high quantities of methadone to users and that they would keep on upping the dose until an individual gave a urine sample that was clean of heroin. “I’ve heard of people being on 150ml a day, that’s a crazy amount.” Often they are not taking all of this methadone themselves. “Then there is the side of wanting loads, so they can sell it because there’s the black-market value of it.” Shockingly, he also informed me that methadone was far more addictive than heroin and that at these high levels if you stopped taking it, it could kill you. “Miss a day, they’d be very sick. They miss two days; it possibly could kill them. It’s lethal dangerous stuff.”
Maureen O’ Sullivan, Independent TD for Dublin Central, has been involved with helping those with addiction for many years and is acutely aware of the magnitude of the problem. The Government are clearly not prioritising the issue. “You can take the cynical attitude and say right, the government will put the money into methadone because it keeps people stable and they’re not out robbing.”
What Maureen is seeing on the ground is an increasingly dangerous level of polydrug use. “What we’re seeing now is people on methadone are into alcohol and tablets and that’s a lethal mix.” Deputy O’ Sullivan also believes that the Government have to look at the methadone protocol, in other words the way in which the drug is administered. “There should be limits, you’re on so many mils for a certain amount of time and then it is automatically reduced.” According to the EMCDDA, approximately seven in every one thousand people in Ireland are using opiates, a figure well above the European average.
The amount of beds available for those who genuinely want to come off heroin is also a serious problem. There are approximately 40 fully funded state provided detox beds for a conservative estimate of 20,000 heroin users in Ireland; 10,000 of whom are availing of a methadone programme. There are of course beds available in other institutions. Cuan Mhuire run by Sr Consilio provides almost 90 beds for drug and alcohol addiction. This institution gets some funding from the state but not nearly enough to keep these beds going. Private institutions also have detox beds but these are generally quite expensive. If an individual is on a methadone programme and wants to avail of a bed, they are put on a long waiting list. This only compounds the problem further as it is encouraging long-term methadone and benzodiazepine use.
“If somebody wants to come off, they want to do it now while the motivation is high, not be told there is a three month waiting list or a nine month waiting list,” explains Deputy O’ Sullivan. Unfortunately even if an addict gets a detox bed and gets clean, the majority have to go back to deprived communities that the government has long since forgotten about.
The government is ignoring the heroin problem and the opiate substitution treatment of it. The majority of people taking heroin are from a section of society that the government would rather just pacify and forget about. They are not perceived in a way that warrants proper help, they don’t command the same attention as wealthier sections of society. In 2010 when youngsters from all walks of life began having problems with legal drugs purchased from “Head Shops“, the government acted quickly to close these shops and make the sale of novel psychoactive substances a criminal offence.
Successive governments have ignored long term unemployment, generations of addiction and housing problems in deprived areas because tackling these issues does not constitute any political gain. These long-running attitudes have only served to compound the drug problem. Too many people are dying and society as a whole needs to be aware of this and force the government to take action.