Dr. Bobby Smyth began specialist training in the area of addiction treatment in 1992, at the Drug Treatment Centre Board’s Trinity Court facility on Pearse Street in Dublin. He is now a consultant child and adolescent psychiatrist working with the centre’s programme for young drug users, a position he has held for the last four years. Dr. Smyth is well placed to observe changes in drug use.

“When I arrived initially, the overwhelming issue was the injection of heroin. If you were a 15-year-old growing up in some of the city’s heroin blackspots, you had a one-in-four or one-in-five chance of ending up strung out on it,” he recalls. “The injection of morphine sulphate tablets was also a problem at the time – but I haven’t encountered a case of that in four or five years.”
Since then, according to Smyth, there has been a significant reduction in the incidence of heroin abuse in problem communities in the city. “That’s the good news,” says Dr. Smyth. “The bad news is that heroin use has now spread across the country and the profile of heroin users seems to have changed. The people I see these days, many of them are not stereotypical youngsters from deprived communities where half the street was on heroin. They are coming from more stable middle-class-type families, in smaller towns around Dublin, from Louth to Meath to Kildare to Wicklow.”
Dr. Smyth has also observed a massive shift in the gender profile. “People who were accessing treatments for serious drug problems like heroin 10 or 15 years ago were probably 75 percent male,” he explains. “Of the young people now with serious drug problems at the age of 17 or 18, at least half of them are female. A generation or so ago, being female seemed to protect you from both drug and alcohol problems, whereas that protection is now gone.”
Garda drug seizures back up Dr. Smyth’s observations of more widespread heroin abuse. During 2007, Garda investigations seized heroin in west Cork and in Cork city, while an operation in Galway led to the arrest of 15 suspected street sellers, dealing solely in heroin. Drugs were also found in Clonmel, Cahir and Cashel in Tipperary, as well as Ballina.

HIGHER DRUG USE IN THE NORTH
Dr. Smyth cautions against use of the term ‘epidemic’ in relation to cocaine. “There certainly has been an escalation in cocaine use both at population level and also among established drug users,” he says. “The lab at the Drug Centre Board has been noting a steady increase in the number of people testing positive for cocaine since about 2000.”
Nationally, an increase has also been observed in the number of people seeking treatment for cocaine addiction, with 203 new cases reported in 2004 (the latest available figures), compared to just 33 in 2000. Cocaine has spread across the country: no “cocaine-related deaths” were recorded outside Dublin or Limerick until 2003, but since then fatalities have been observed in Meath, Carlow, Galway, Cork and Offaly. While the victims fell mainly within the 25-34 age group, Dr. Smyth observes that cocaine users can be found amongst all social backgrounds.
Polydrug use is also on the increase: today cocaine is more likely than ever to feature in the drug repertoire of heroin addicts.
Meanwhile, the final figures from the 2006/2007 Drug Prevalence Survey – based on almost 7,000 interviews carried out throughout the island of Ireland – were released last week. Here, in the Republic of Ireland, in terms of lifetime use, cocaine still lagged behind cannabis and magic mushrooms, in joint third place with Ecstasy. 5% of 15-64 year-olds admitted having used the drug, almost exactly the same as in Northern Ireland (5.1%). Interestingly, there is generally a higher level of drug use in Northern Ireland, with 28% having used illegal drugs as against 24% in the Republic – a 17% higher rate. Poppers (8%), LSD (7%) and Ecstasy (8%) were all far more popular in Northern Ireland.
What is all the more fascinating is this: given that an equal level of usage, why have there been so few so-called “cocaine-related deaths” in Northern Ireland, compared to the Republic?