As Ireland’s biggest festival gets underway tonight, the HSE are warning revellers to keep vigilant, with new synthetic drugs raising fears of overdose and drug harm.

Dr Geraldine Dowling, forensic toxicologist, Atlantic Technological University, said:

What types of drugs are in circulation?

“The European drug market now includes a more varied array of substances, some of which are more potent and pure.

Cannabis remains the most widely used controlled drug across Europe and the cannabis market has evolved, with more highly concentrated products becoming increasingly obtainable. This rise in potency has led to greater psychological harms eg. psychosis. In fact, many new markets for cannabis products have emerged throughout Europe, along with cannabis edibles such as branded drinks, sweets and cakes, but also vaping products which can be very attractive at events like music festivals. It is vital to remember cannabis is illegal in Ireland for recreational use. 

Drugs designed to imitate cannabis are on the rise globally. Of particular concern are reports indicating the presence of synthetic cannabinoids in cannabis products across Europe, with some also being detected in Ireland.  

Cocaine is, after cannabis, the second most commonly used illicit drug in Europe.

Synthetic cathinones are a type of stimulant that are chemically similar to cathinone, the active ingredient found in the khat plant Catha edulis. Since cathinone shares similarities with amphetamine and is regulated worldwide, synthetic cathinones have become a major focus of monitoring by the EU Early Warning System. These substances are often sold as ‘legal’ alternatives to banned stimulants like amphetamines, ecstasy and cocaine. The evolving European drug market is evident from the growing reports of synthetic cathinones being found, a relatively new class of drugs in Europe. Data continues to show significant trafficking of these synthetic cathinones into Europe from source countries like India.

Synthetic opioids like fentanyl derivatives have not appeared as frequently in certain regions compared to North America. However, this trend remains a significant concern due to the potential health threats and the risk of unforeseen contamination in future batches of drugs.”

What are the issues with synthetic drugs?

“New Psychoactive Substances (NPS) is a broad term used to describe various drugs initially designed to imitate or replace traditional drugs such as cannabis, cocaine or amphetamines but there are many more produced over the years. By slightly modifying the chemical structures of established drugs, NPS can be created to bypass international law enforcement regulations. 

NPS often can share chemical similarities with traditional drugs but they frequently have quite different effects and this is problematic. The chemicals in these newly produced, illicitly manufactured NPS vary from batch to batch because there is no quality control. As a result, even though they are packed and promoted the same, different packets may have different concentrations of substances and different effects. In addition, the unregulated production of NPS may result in products containing harmful by-products and contaminants heightening the risk of toxicity. NPS have been found in many products and at many events such as music festivals, house parties or in prisons.”

“Polydrug use refers to the practice of taking two or more psychoactive substances, whether legal or illegal, either simultaneously or in succession. It is important to highlight that drugs sold to individuals might contain unexpected substances, either mixed with or replacing the intended drug. This means that users may be unaware of the actual contents they are consuming. Combining different drugs can increase health risks and complicate treatment, particularly in emergencies such as acute poisoning. With the introduction of New Psychoactive Substances (NPS) and the emergence of unforeseen substances in the drug market, authorities face even greater polydrug challenges.”

How do we find out about new drugs in circulation?

“Early warning systems are essential for identifying, tracking and mitigating the risks posed by the increasing number of NPS entering global markets each year. Effective drug detection technologies and trained personnel are crucial for managing these challenges. The European Union operates an Early Warning System and other jurisdictions have their own monitoring systems globally to address NPS-related issues. In 2024, a key challenge for drug surveillance is to better understand the specific drugs being used and their combinations. Improving the monitoring of polydrug use patterns and developing effective interventions will be crucial areas of focus moving forward.

Today, a broader range of people are using drugs and facing drug-related issues. Increased funding is crucial to support all stakeholders in advancing drug detection technologies.”

Note: Dr Dowling is also Treasurer of the United Kingdom and Ireland Association of Forensic Toxicologists, is the Regional Representative for Ireland for the International Association of Forensic Toxicologists and is a founding member of The Alliance of Clinical and Forensic Toxicologists. She is also a Visiting Senior Lecturer at the Department of Analytical, Environmental and Forensic Science, Faculty of Life Sciences & Medicine at Kings College London, United Kingdom. She is also Honorary Senior Lecturer at Cameron Forensic Medical Sciences at William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, United Kingdom.

Declaration of interest: Dr Geraldine Dowling was invited to join the Irish Government’s working group established to produce the 2021 Emerging Drug Trends and Drug Checking Report for the Minister of State for Public Health, Wellbeing and National Drugs Strategy by the HSE National Social Inclusion.