The newly published Street Tablet Use In Ireland: A Trendspotter Study On Use, Markets & Harms shows an upsurge in the number of deaths and non-fatal overdoses involving prescribable drugs like benzodiazepines, z-drugs and gabapentinoids.
Used by doctors to treat the likes of insomnia, anxiety and neuropathic pain, they're increasingly being bought illegally online from countries like India and Pakistan where contamination and counterfeiting is rife.
Deaths involving pregabalin, a medication that's also used to treat epilepsy, fibromyalgia and restless leg syndrome, increased between 2015 and 2016 by 33%.
As the result of joint Health Products Regulatory Authority, Revenue's Custom Service and Garda action, 56 websites were forced in 2018 to either close or cease selling medicines in Ireland. This action also lead to the confiscation of nearly 400,000 dosages of illegally supplied online medicines valued at €1.39 million. Laboratory analysis confirmed that they often contain too little or too much of the active ingredient.
"For many individuals, street tablets are a cheap, effective and accessible way to self-medicate for how they are feeling and to help them deal with the trauma they have experienced," reflects Tony Duffin, the Ana Liffey Drug Project CEO. "Perhaps there is also a familiarity with these drugs as they are widely and legitimately used in the
healthcare system. Unfortunately, street tablets often come from unregulated sources and you simply cannot tell what’s in them, even if they appear to be in a genuine pharmaceutical blister pack. This is also true for ‘online pharmacies’ which allow purchases without prescription.
Remember – unless you get your medications from a doctor or pharmacist you can’t be sure what’s in them."
Dr. Austin O'Carroll, the Clinical Lead for Homeless COVID-19 Response in the Dublin Region, adds: "As a General Practitioner that specialises
in working with people who are homeless, I have seen the harm caused by street tablet use among this cohort increase in recent years. I have known many patients to take many multiples of blister packs of street tablets in a day, far in excess of any therapeutic dose."
Dr. O'Carroll agrees with the report's conclusion that Ireland can't just police its way out of the problem.
"During the COVID-19 emergency I have learned that crisis is the mother of innovation, and we are managing to work differently with this cohort," he resumes. "Looking ahead, to when the COVID-19 crisis passes, we need to bring this ‘can-do’ attitude to addiction treatment generally, ensuring that people are not punished for their own personal drug use, but are supported to access services that are individualised for them."
Branded drugs commonly seized in Dublin include Tranax, Zimovane, Valium, Dalmane and Lyrica. Citing confidential interviews with users, the report says: "Often, their supply of benzodiazepines was from the same supplier as their heroin and as such, benzodiazepine usage perpetuating heroin usage was evident."
The full report can be read at https://www.aldp.ie/content/uploads/2020/04/Trendspotter-Report_Street-Tablets-Ireland_FINAL-21.04.20.pdf

Street Tablet Use In Ireland: A Trendspotter Study On Use, Markets & Harms is the result of a collaboration between Ana Liffey Drug Project, the School of Public Health at University College Cork (UCC), the Health Research Board (HRB) and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).