THE DEATH LAST week in Cork of a 16-year-old boy brought shockwaves to the community that someone so young could be taken so soon, and in such tragic circumstances.
It has been reported that this death may be implicated with a drug that has hit the streets recently called U-47700, which most people, including many drug treatment specialists, will not be familiar with.
What is U-47700?
U-47700 is a powerful synthetic opiate painkiller which in recent years has been sold on the street as a so-called designer drug. The tablets that are finding their way into Ireland seem to be originating from clandestine laboratories in China.
It is sold as white or light pink chalky powder (hence the street name “Pink” or “Pinky”) and sold in small bags in very much the same way as heroin. Small quantities of this drug can cause death and there have been a number of fatalities across the US already.
In California, for example, this drug has been sold as a pain relieving medication called Norco and there have been cases of users arriving at emergency rooms in an opiate overdose with pin point pupils and decreasing levels of consciousness, whose lives have been saved with Naloxone (Narcan).
Naloxone reverses the respiratory depression caused by this drug and brings the person around. Without this intervention the risk of death is substantial.
HSE advice
Since the tragic news of the death in Cork, the HSE has issued a public health warning about the dangers of U-47700. It has advised that drug users who use illicit drugs should be careful about what they are buying, not to take them if possible and if they do use illicit drugs to use the lowest possible amount at any one time and try not to mix it with alcohol and/ or other drugs.
This is very sensible advice but sadly, there will be many users who ignore this guidance and use the drug anyway in an uncontrolled, hazardous and potentially lethal way.
The illicit drug landscape is changing
When I started working in the drug treatment field in the late 1990s the illicit drug trade tended to confine itself to a handful of drugs such as heroin, cocaine, ecstasy and cannabis. There were others but these drugs were a honey pot for major dealers, who wanted to build business empires that were illegal and outside the law.
In the past five or six years the number and range of drugs has proliferated, and there are many drugs which apparently mimic well established ones. For example mephedrone and synthetic cannabis were sold in “Head Shops” as a quasi-legal way of circumnavigating the laws around ecstasy and cannabis.
Hastily written laws banned the sale of these products in 2010, but failed to appreciate the unintended consequences of this ban. These drugs did not go away but found their way onto the illicit market, making them even riskier and more harmful.
The emergence of U-47700 and other similar drugs tells us that out of sight rarely means out of mind.
Failed drug policies
Ireland has consistently ranked highly in the EU league tables for drug-related deaths. It is clear that the measures the Government are taking to reduce the mortality and harm of illicit drugs are failing to hit the spot.
There are families across the country that have been, and will continue to be, devastated by illicit drugs. The very people who die are the ones who we need to protect most: the ones who are taking drugs in a risky way and purchasing these drugs without any information on dose or purity.
The Government believes that banning these drugs offers the best hope of protecting people from harm. There is scant empirical evidence of this, and with the emergence of these newer psychoactive drugs, the death toll is likely to grow.
We need enlightened and evidence based drug laws
Whilst we are probably a long way off legalisation, there have been two changes in direction in Irish drug policy. The first was the proposal by, the then Minister with responsibility for drugs, Aodhán O’Riordáin, to decriminalise the possession of small amounts of illegal drugs for personal use and treat drug use as a health issue rather than a crime, thus adopting an approach similar to that taken in Portugal in the early 2000s.
The second was to open supervised injecting rooms for heroin users in an effort to reduce the presence of injecting drug use on the streets by giving these users a safe place to take their drugs.
The effects of legalisation
There is no blueprint anywhere in the world for a fully legalised system of all psychoactive drugs, but there are examples where regulation of some drugs have already occurred.
The evidence is mounting that these approaches are having a positive effect on society, in terms of improving drug related deaths and the saving of money which would have otherwise been channelled to criminalising and policing drugs.
When cannabis became legal in Colorado in 2014 the huge increased prevalence of use predicted by sceptics never happened. In Switzerland and the Netherlands the prescribing of heroin to otherwise difficult to treat heroin users did not lead to an increase in heroin use among the general public. It reduced unsafe, illicit heroin use in the population who were treated with it. This has huge implications for society.
Ireland may feel it is not ready to embrace a more rational and open approach to drug policy but if the recent death in Cork attributed to U-47700 proves one thing, it is this: as long as we pretend that policing drugs is cost effective and deters users from taking drugs, we can expect more harm, more deaths and more taxpayers’ money frittered away with precious little to show for it.
Dr Garrett McGovern is a doctor who specialises in drug and alcohol addiction and is Medical Director at the Priority Medical Clinic in Dundrum.
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