How Heroin Got into Ireland's Bloodstream

There was much celebrating in Garda circles last week when convicted heroin dealer Christy Kinahan had his collar felt again in the Spanish resort town of Estepona where he’d been living since 2003 in a €6 million villa. His was one of a series of 34 arrests, which took place in Spain, Brazil, Belgium, England and Ireland under the auspices of Operation Shovel.

“Today’s arrests will have dealt a major blow to an organised criminal business suspected of supplying drugs and gangs in cities across Europe,” said the Spanish Interior Minister Alfredo Perez Rubalcab shortly afterwards. “This is a mafia family fairly well-known in the United Kingdom and Ireland. In Spain not so much, but they were hiding out on the Costa del Sol and this has been a long drawn-out operation that has taken more than a year of investigations and of working with Europol and the police of the three countries. We also believe this network has been offering a global investment service, ploughing hundreds of millions of pounds of dirty cash into offshore accounts, companies, and property on behalf of criminals.”
The Spanish legal system being notoriously slow in its machinations, Kinahan can now look forward to at least two years on remand before his case is heard. That’s some people’s idea of justice...
The Operation Shovel arrests came just a week after the Criminal Assets Bureau here had relieved another convicted heroin dealer, Tony Felloni, the man the tabloids tastefully dubbed King Scum, of €500,000 of his ill-gotten gains.
“We’d been feeling a bit toothless,” a National Drug Squad source tells Hot Press, “but Christy Kinahan being arrested and CAB concluding their case against Tony Felloni shows that these fuckers can’t get away with it. When it started in 1999 the whole Europol thing was a bit clunky, but now that it’s working properly it’s providing a constant flow of intelligence, which is what made Operation Shovel possible.”
Within 24 hours of Kinahan and his men being rounded up, heroin users in Dublin reported a citywide shortage of the drug. As their desperation rose, so did the price of black market methadone, which doubled to €50 for 40 ml. The cause of this, Hot Press has learned, wasn’t a disruption to supplies but dealers deciding to keep a low profile in case the Gardai tried to mount a spectacular of their own.
Amidst all the acres of Irish newsprint that have been devoted to Kinahan’s alleged wrongdoings, there’s been virtually no mention, much less analysis, of the growing domestic heroin problem the father of three is accused of helping to create.
It’s a very different scenario to a few years ago when the drug was top of the tabloid news agenda. Somebody who wants to see it put back there is Dr. Garrett McGovern, a Dublin G.P. who’s specialised in the treatment of heroin addiction since 1998. Though whether or not being headline news is enough to make a difference is another question.
“Maybe it’s because they’ve been so preoccupied writing about head shops,” Dr. McGovern proffers, “but journalists either haven’t noticed or have chosen to ignore the fact that there are serious heroin problems in parts of Ireland where there was little or no availability of the drug a few years ago. To give you an example, there’s been an absolute explosion in the number of people using heroin in Kildare.”
It isn’t just that there are users in parts of Ireland where heroin had previously failed to penetrate. The fact is that treatment is also non-existent in those places for addicts who find themselves in the grip of the drug.
“Heroin has been provoking the same reaction in rural communities that leprosy did all those years ago,” McGovern adds. “It’s not being talked about openly or addressed. The local GPs aren’t taking patients on, and the health board response has been nil. There are no treatment facilities down there – all they really have is small little groups of outreach workers, who are trying to do their best in a difficult situation. I was in Celbridge recently, where you have a key-worker operating out of the basement of a vestry in terrible conditions. That’s typical of many, many counties around Ireland. We’ve a really serious situation that neither the Government nor the Health Service Executive (HSE) are showing any signs of tackling in an effective way.”
They can’t say that they weren’t warned, with Dr. Jean Long, the head of the Alcohol and Drug Research Unit at the Health Research Board, drawing attention two years ago to a 96% increase in the number of new opiate cases outside of Dublin. That heroin use is no longer confined to the capital was evident again recently when the Gardai in Cork revealed 159 seizures of the drug in 2009 compared to just four in 2004. But these facts are being ignored where it matters: at the level where policies are formulated.
Also making for grim reading is the newly published Close to Home: A Study on the Misuse of Drugs and Alcohol in the Midland Region. Conducted by the Midland Regional Drugs Task Force, it highlights a 50% increase in opiate use between 2004 and 2007 in Westmeath, Longford, Offaly and Laois. Towns in all of these counties are identifiable now as blackspsots. During that same period, the number of prosecutions for possessing or supplying heroin rose from 62 to 133; intravenous heroin use was up by 30%; and heroin and other opiates were a factor in 29 of the area’s 55 drug-related deaths.
The report concluded by acknowledging the “excessively long” waiting-lists for any kind of heroin treatment, and the “chronic problem” in relation to addicts being able to access methadone maintenance programmes. And yet there is no sign of a response from Government or the HSE apart from the predictable efforts of the Drug Squad – who in any event don’t have the resources necessary to cover the country effectively, even if there were a point in it.
“It’s simply not good enough,” reflects Dr. Garrett McGovern. “The mortality rate from heroin is 13 times higher outside of treatment than it is in it. There’s no way of putting a number on it, but the truth is that people here have died from not being able to access treatment – and will continue to do so until there’s a political will to sort the situation out.”
Those sentiments are echoed by another specialist in the field who declined to be named.
“To give you an idea of how bad things are, the one clinic they have in Portlaoise is in a building which ought to be condemned – it’s falling down and totally inadequate for the large number of people using it,” Hot Press was told. “The way the system is supposed to work is that users present to a clinic and, after having their situation stabilised, are referred to local GPs so that others can in turn pass through it. The problem in Portlaoise, however, is that there are no GPs willing to take them on, because they don’t want their practices associated with drug users. As a result, the system’s completely log-jammed.”
That pattern, or variations on it, are repeated elsewhere. There’s one clinic in Waterford for the whole of the South-East, Hot Press has learned, which people don’t even bother phoning up because they know there’s already a year to 18 month waiting-list. We’ve spoken to users from New Ross, Gorey, Wexford, and Waterford itself – all towns with serious heroin problems – who desperately want treatment but who are unable to
get it.
All of this is known to the authorities. One of the addicts interviewed for the Midland Regional Drugs Task Force report talked about his frustration at effectively being turned away by clinics.
“It’s very, very difficult,” he said. “They’re understaffed, and you have to wait to be called and a lot of people who are using drugs… when they’re ready to give up, it has to be instant. It has to be done there and then. There’s no point in telling somebody that they have to wait three weeks, because in that three weeks they’re going to continue using. It’s a kind of vicious circle really.”
The chronic lack of treatment facilities and GPs who are unwilling to tackle the issue isn’t the only difference between the heroin problems outside Dublin and in the capital.
“The class distinction is much less apparent down the country than it would be in the capital,” maintains Garrett McGovern. “I see a lot of patients who come from the Kildare area, and they’re not all necessarily from broken homes or impoverished backgrounds. People who develop problems and have money have the option of travelling up to Dublin or heading to the UK where in most cases you’re assessed straight away and start treatment within a fortnight. One way of paying for treatment if you don’t have money is to start dealing yourself. Ironically, I suspect that’s how a lot of heroin problems in rural areas have mushroomed.”
Heroin is also an equal opportunities drug in Kerry, where the Director of Castleisland’s Talbot Grove treatment centre, Con Cremin, told a public meeting last September: “We’re not seeing what heroin is normally known for, which is pockets of users in areas of social deprivation. This year we have seen a real escalation. We have some contact every week from someone looking for support for heroin use, whether that is a user themselves or a family member. It is a very significant increase.”
At the same meeting, Sgt. Declan Liddane from the Kerry Regional Drug Unit revealed: “Heroin first came into Tralee through Listowel and gradually reached Killarney and our experience is that the main supply is still coming from Limerick. Most heroin dealers in Kerry are dealing to feed their own habit – there are no wealthy heroin dealers here.”
With regards to the range of people using the drug locally, Sgt. Liddane added: “The youngest we’ve come across is a 17-year-old and he was from what you’d describe as a decent, respectable family.”
“Decent” and “respectable” are two terms, which probably don’t apply to Limerick’s Dundon-McCarthy gang who are regarded as the main players in the city’s combined €50 million a year cocaine and heroin trades. In addition to Kerry, Hot Press has also identified Limerick as the source of much of the heroin that’s started to appear recently in Galway and Sligo. Other towns where its use has spiralled include Athlone, Kilkenny, Dundalk, Drogheda, Clonakilty, Letterkenny, Nenagh and Carlow.
So how bad is it? If the drug is spreading, how many addicts or users are there in Ireland?
“Official estimates of there being 14,542 heroin users in Ireland – half of whom are engaged in methadone maintenance programmes – are way too conservative,” another well-placed source confirms. “I’d estimate that it’s close to the 30,000 mark.”
This leads to another major health issue, which underlines the importance of intelligent, sympathetic action. Where heroin moves, HIV almost inevitably follows – especially if there aren’t effective needle exchange programmes in operation.
“With that surge in use, there is the very real threat in areas like the Midlands of an HIV epidemic,” the source confirms. “Experience has shown that if you’ve inadequate needle exchange and education, people will share syringes. Another thing that the country’s ripe for is an explosion in acquistive crime – users breaking into houses, stealing handbags, carrying out small armed robberies in shops and post offices and stuff like that. They have to produce €200, €300 a day and they’ll do anything they have to do to get it. One of the very basic things about methadone is that it gives you the drugs – you haven’t got to get that money every day. They may continue to be an eyesore along the canal, but they’re not out there 24/7 breaking into cars, which was what it was like in the ‘80s.
“If you want to number crunch some more, it costs €25,000 a year to treat someone with HIV, who’ll eventually die a very expensive death. That compares to the €5,000 cost of keeping them on a methadone maintenance programme. We have to get our act together and start providing people with proper services.”
Fine Gael leader Enda Kenny pulled no punches last week when he described the HSE as “a dysfunctional Frankenstein.” He was using the term in relation to the number of children who’ve died in care under the Executive’s watch, but it could just as easily have applied to their failure to come up with a coordinated response to areas that develop a heroin problem.
“In 2009,” our source continues, “a submission was made to the National Drugs Strategy, which suggested that GPs from other parts of the country who specialise in heroin treatment should be sent to places like Kildare. In the vicinity of Gorey, for instance, there are a hundred untreated heroin users whose needs could be looked after by two GPs if the cap on the number of patients they’re allowed to treat is lifted. Even though the submission included the fact that there were dozens of GPs willing to start immediately, they decided that, ‘No, recruitment would be too difficult.’ It was a golden opportunity and they blew it.”
Our source also insists that the treatment of heroin users is being compromised by doctors opposed to them being placed in methadone maintenance programmes.
“Even though it’s been the stated policy of the Irish government since 1990 and is fully endorsed by the World Health Organization, you’ve some doctors who are still advocating an abstinence model that simply doesn’t work. There are parts of the country such as Cork where there’s active opposition to methadone maintenance programmes being introduced, which is absolutely scandalous. They have now started a treatment centre down there, but it’s wholly inadequate for a city of that size and extent of problem.”
The final word goes to Dr. Garrett McGovern who says: “There are people saying inflammatory things like, ‘Ireland doesn’t have a heroin problem, it has a methadone problem’ who don’t know what they’re talking about. The bottom line is that this treatment works, and should be freely available to everybody who needs it.”

Has the heroin issue been neglected in the media?
Absolutely. There are waiting lists right across Dublin and then if you go outside Dublin it is even worse. Obviously where drug use has grown most is outside of Dublin. With the whole urbanisation of the country, there has been a corresponding increase in drug use around the country. That’s evidenced by people presenting for treatment in Waterford, Limerick, Athlone, Carlow, Drogheda – all these places. But also with arrests and seizures.
You operate a needle exchange programme. How many people are availing of the service?
We get people from all around the country. It’s incredible really. We’re the only needle exchange service that’s open all day, every day. There’s very few needle exchanges outside of Dublin. We have an outreach needle exchange in Athlone, Portlaoise and Mullingar, covering those areas, but that’s only a new initiative that we got up and running late last year with the Midlands Taskforce. Outside of that, needle exchange is difficult. You have to bear in mind that people who are experimenting with drugs often aren’t looking for drug treatment. What they want is to be able to get access to information and access to clean syringes. Of course, that can be viewed as enabling people to use drugs, rather than seeing it as health intervention and a way of engaging with people.
What, in your estimation, have been the key factors in the spread of heroin use?
Urbanisation is the real key to the surge. A lot of people have moved out of Dublin. Also, if you look back into the ‘80s and ‘90s, the Irish drug market was more of a stand-alone market. You had players from the Irish market who would have gone over to England and Amsterdam, places like that, sourced drugs and brought them back. Now, we’re part of a much bigger global network. In that kind of arena, markets will grow.
We’ve heard about a two-year waiting list in Waterford, and that the Portlaoise service is half-derelict. Is this true?
Yes. They are the facts. There’s a waiting list of over 12 months in Athlone and a two-year waiting list in Waterford. Then you’ve got ridiculous scenarios where, even when they’re able to provide a GP to prescribe for people, they then have to bus them 30 kilometres to the next town to get a pharmacist to dispense the methadone. That’s due to attitudinal problems, really. I don’t mean that they’re often doing it pejoratively, I think it’s more out of a lack of understanding. There are such stereotypical, negative views of drug users. If I say to you ‘drug user’, unconsciously in your mind it kicks up all kinds of images and baggage - “drug users, they’d rob the eye out of your head, they’d kill their mother for drugs” - all that. And even though on a conscious level we say, “Oh no, I’m perfectly fine”, on an unconscious level there’s a lot of prejudice there and a lot of fear.
How do you go about changing those types of public perceptions?
Trying to educate people, trying to provide support to GPs where, if you want them to take on some prescribing, you provide some support staff there. Generally, once GPs start to work with drug users, they find out that these people don’t have two heads, the sky doesn’t fall down if they come into the surgery. Other patients can be much more bolshy.
Is the profile of the average drug user changing?
Middle-class people have always used drugs. But they are probably less inclined to present to services like ourselves. Of course, the middle-class has expanded, or certainly delineated from what it was 20 years ago. The middle-class is a much, much broader church nowadays. A lot of people using our services would be called middle-class now. I think there is a whole other cohort of people that are using private services, that would go to John of Gods or The Forest or places like that and are able to buy treatment. If you’ve got an education behind you, if you’ve got a family that are supportive, if you’ve got other options in your life then, I’m not saying it’s easy, but when the crunch comes, the more wherewithal you have, the easier it is to move on. Whereas people who start from an underprivileged background, or lower socio-economic grouping, when they become dependent on heroin and try to move on, it’s much more difficult.
Do the official figures accurately represent the extent of the problem?
14,000 to 20,000 is the last estimate. I think that estimate is probably reasonable, but may in reality be an under-estimate. Certainly there’s absolutely no incentive for someone to put their name on a waiting-list if it’s going to be two years. Why would you bother putting your name down? Drug use is a hidden phenomenon. For all those people who feel they need treatment, it’s like a pyramid - if you start at the bottom and say “here’s all the people that experiment with drugs” and then you move up the pyramid, halfway, and say ‘here’s the people that are using them recreationally” - it’s only at the top where you have the people that become dependent. Not everyone is going to end up with problems and becoming dependent. I would imagine when we say there are 14,000 to 20,000 heroin users out there, there’s much more people out there using than that. It’s a hidden population.
Does the political will to tackle the problem exist?
Drug services have been cut for the last two years in a row. We’re talking about an average of about a 10% cut this year. Last year it was 18% across drug task forces. They are significant enough cuts. Having said that, Minister Pat Carey is a reasonable guy and has shown good interest in the area. But in the overall political domain, drugs wouldn’t be high on the agenda. If they are cutting old age pensions, hospital wards, nurses... even in terms of public empathy and sympathy, drugs won’t be right up there.
What’s your opinion of ‘the Swiss method’ whereby addicts are prescribed heroin, rather than methadone, through the health service?
The authorities here have invested in a kind of ‘one size fits all’ approach in that we provide methadone. That’s the sole plank of Ireland’s substitution treatment, but it doesn’t suit everybody. That’s the reality of the matter. Any one treatment isn’t going to suit everybody: there are differences. Heroin prescribing is a proven intervention, particularly for people who’ve not had success with methadone programmes.