This bank holiday weekend, we’re taking a step back to look at the issue of drugs in Ireland in two different ways.

On Saturday, Kate tracked the inexorable rise in this country’s cocaine consumption, not only in the trendy nightclubs of Dublin or in deprived neighbourhoods affected by its crack form, but also in settings as commonplace as rural construction sites. 

Tomorrow, Rosanna will detail the trials under way to try and unlock the therapeutic potential of psychedelic drugs such as those contained in so-called magic mushrooms. She talked to Irish academics and entrepreneurs taking part in this research and hoping to reap its benefits, and identified the limitations of what those benefits are likely to be.

The quest for the healing powers of psychedelics against certain mental health disorders is nothing new. It was an active field in the 1960s, before the US government of President Richard Nixon shut it down by declaring the war on drugs.

In Ireland, too, a strong emphasis on law enforcement has delivered the appearance of results. One by one, drug kingpins are jailed, their trafficking networks are exposed through increasing judicial collaboration across Europe and the Atlantic, and growing volumes of illegal drugs are seized. On July 16 alone, Garda raids on illegal drugs labs in Cos Kildare and Westmeath yielded cocaine worth €2 million, cannabis worth €125,000 and €112,000 in cash, according to the force.

Yet drug use – and misuse – keeps rising too, along with its consequences. The latest figures from the Health Research Board show that, after fluctuating between 350 and 400 for much of the past decade, the number of annual “poisoning deaths” due to drugs has been on a continued upward trend above 400 since 2017, hitting a high of 474 in 2020 – the most recent year for which figures are available.

Of those, 65 were due to alcohol only and 407 involved illegally used drugs, but 80 per cent of those fatal overdoses in fact came from a cocktail of multiple substances, often including alcohol.

Forget the cliché of the young man lost to heroin. The median age of death by overdose was in the early forties, only one in five had injected drugs and nearly four in ten were women.

The curve of deaths caused by almost every type of drug is pointing upwards, especially cocaine, which was responsible for four times as many fatal overdoses in 2020 as a decade earlier. And those deaths are the tip of the iceberg. Once you include other fatal outcomes linked to drugs, from car crashes to suicides, and the wider damage done to users, their families and their communities, the costs to society are astronomical.

They show that the repressive approach is insufficient. One Dublin-based addiction clinician I contacted in preparation for this article, who previously worked in the US, assessed that Americans would be in a much better place with drugs if their government had spent its war on drugs budget on treatment instead.

The Irish version of this debate is now unfolding before the Citizens’ Assembly on drugs use, which is half way through the six meetings it is due to hold this year before making recommendations on national policy. Those meetings are available to watch online and they make for essential viewing. 

The courageous individuals who came to share their personal experience of drug use have to come first. Gillian O’Donnell told the Assembly of being born with heroin addiction to parents who used the drug and spending the first three months of her life in hospital, before growing up in late 1970s central Dublin where the heroin epidemic was taking over. “The younger kids got involved at running drugs from one part of the flats to the other part of the flats,” she recalled. “It was part of the infrastructure.”

O’Donnell later became addicted to crack cocaine. “I don’t think it’s actually the drug, I think the drug is a symptom,” she said. “I was traumatised being an emergency accommodation. I was traumatised at losing my children so obviously the addiction escalated and I tried different drugs that I probably wouldn’t have tried if I hadn’t been traumatised.”

If you think drug misuse is confined to disadvantaged families such as O’Donnell’s, think again. She was followed by Fionn Connolly-Sexton, an articulate student fresh out of his primary degree. He described various level of acceptability of drugs between groups of college students and linked it directly to the successive crises experienced by his generation. 

“Growing up, all of our brothers, sisters, cousins left the country in 2008, 2009. There’s a huge deficit, not only from the brain drain that we talked about 10 or 15 years ago, but there’s a massive emotional drain there,” Connolly-Sexton said. “There was a lot of people without a brother or sister or a father or a mother or an auntie or an uncle that could have helped them along.”

Financially, the strain on students’ finances have led many to work long hours to pay their way through college, he added. 

“At the end of your 12-hour shift, one of your co-workers says hey, let’s go out and have a couple of drinks – I know you’re very tired but if you take a line of this you can continue drinking,” Connolly-Sexton said. Echoing Kate’s report, he added: “Now the drinking bit is a bit superfluous. They can go out and they can just do cocaine for a night and bounce around to different clubs, or they can do an ecstasy pill or a line of MDMA.”

Substance as a substitute

The common thread to many testimonies before the Citizens’ Assembly is that drugs emerge as a substitute for missing social, health or emotional support. The mutually reinforcing links between homelessness and addiction described by O’Donnell are a striking example.

Catherine Kenny, the chief executive of the Dublin Simon Community homeless charity, told the Assembly: “Our clients encounter loads of barriers on health supports, but there are no barriers to drugs. When services are closed or out of hours, drugs are still there. Overdoses and mental health crises are still there. In fact, drugs have never been more accessible. Our clients can use Snapchat and have drugs delivered to their door quicker than food.”

She added that “stability is critical” to escape this vicious circle, quoting a client of Dublin Simon as saying: “Once you have a fixed address, you have a base and you can work on everything else.”

The Citizen’s Assembly offers an opportunity to put all the pieces of the drugs jigsaw on the table and look for a way of putting it together. Arresting and jailing major drug dealers is of course necessary, but a purely judicial approach has failed. 

Yet decriminalising personal drug use will do little good if no supports are available to help those suffering from addiction reduce their use of drugs. Professionals say that outside a small number of HSE-run clinics, the State has entirely outsourced residential addiction services. At one end of the spectrum, those with money or high-end health insurance can tackle their drug problem in private hospitals.

At the other end, those on welfare payments or experiencing homelessness are eligible to residential detox programmes run by charities. Yet this voluntary sector is creaking under staff shortages and claims insufficient state funding affects its recruitment and retention capacity in the face of better pay and conditions in other areas of the health system. 

This leaves an increasingly large middle ground of drug users with little hope of ever accessing addiction services, like David, the construction worker interviewed by Kate who used to do cocaine “almost like a coffee”.

Tackling the supply side of the drugs market will never be enough. To stem demand, society as a whole needs to address the factors that drive some among its ranks to feel so damaged and unable to find help that they seek refuge in drugs (including alcohol). And when they do, the State must step in with robust medical treatment irrespective of their financial means.

This may be expensive but the alternative costs are a lot higher.

*****

Elsewhere this week, Joe investigated a group of companies selling spyware, phone interceptors and military-grade radios around the world. The entrepreneurs at the heart of this global surveillance business are Irish.

Sean explained how the latest European decisions on the application of GDPR to Meta’s social networks will result in Facebook and Instagram having to seek consent from users before using their data for targeting advertising, while leaving open the option of charging for those services instead.

The Derry-based construction company Errigal has offered to invest in the troubled fit-out contractor Mac-Interiors and take it out of examinership, saving more than 40 highly skilled jobs. Francesca reported the breakthrough in a rare case between Northern Ireland companies subject to court approval in the Republic.