I attended a community meeting called to address the local “Drug Crisis”. My invitation to join the panel was at short notice but I accepted; I am the local pharmacist and I am a concerned citizen. The last time this problem got out of hand I ended up with the point of a Bowie knife up my nose. The stimulus for the meeting was the weekend deaths of two local young men from drug overdose. A 27 year old was found dead on Sunday morning and an 18 year old, found unconscious the same day, had his life support machine turned off on Wednesday. The community were shocked everyone was horrified. Something needed to be done. Where are these drug dealers selling drugs to our children? We need a meeting!
That was two years ago. That was Drug Crisis 2015. My brief then was to educate, to cover the types of drugs involved and to inform the meeting of what had worked elsewhere. I know nothing much about illicit drugs and less still about successful drug policy or strategy and I had my reservations too about the meeting organisers. So, as all experts do, I took to the Internet. Drugs abused and misused are familiar to all and include; the opioids (tramadol, codeine, morphine, heroin) the amphetamines (ecstasy (MDMA)), the synthetic cannabinoids (spice and other legal highs), cannabis, benzodiazepines ( “the blues”) and off course alcohol.
I told the 150-strong audience who turned out for the meeting that two young lives cut short is doubly tragic but in the bigger scheme of things we were pretty well off by comparison. In the last 10 years in Belfast of all the 46,240 preventable deaths the Public Health Agency has identified, there were 2,524 linked to “drug use disorders” and 2,476 linked to “alcohol related disease”. There were only 46 deaths attributed to “illicit drugs use”. Boring prescription drugs and the booze, it seemed, far out-shown the petty death rate from headline grabbing illegal drugs.
What was happening locally, I continued, had happened here before, was happening elsewhere and would happen again. In the summer of 2013, ten deaths in young men were eventually linked to use of a toxic metabolic variant of the rave drug ecstacy. Ecstacy, an amphetamine-based stimulant, was back on the scene with a vengeance. A lab in the Netherlands, according to the Irish Times, was producing MDMA tablet with strengths of between 150 mg and 300 mg and they delightfully called it “Cherry”. This was an improvement on the standard 1990s tablet strength of about 80 mgs. The Dutch lab also had a powder formulation they touchingly named “Molly” because methylenedioxymethamphetamine is a bit of a mouthful. Ironically MDMA is relatively safe.
But that was then; now in the Spring of 2017 it is happening again. In the year 2016 up to November police figures suggest there were 78 deaths due to drugs more than from road traffic accidents. Last weekend locally we had the deaths of three young people. These deaths are linked to drug use and it is likely that they resulted from the cumulative effects of a cocktail of drugs; benzodiazepines, opioids and alcohol. Tramadol features strongly in this story and it is ironic that it was launched as a prescription medicine as a safer, less addictive version of codeine.
I told the 2015 meeting of a heroin user who claimed to have gone to a dealer to buy cannabis and finding it of particularly “good quality” returned a few times for more. Finding that she now could think of nothing but the cannabis, and unable to afford to buy, was refused a supply “on loan” while being told that his cannabis is laced with heroin. This normal 29 year old found herself in Belfast City centre stealing clothes to maintain a habit.
I finished up by saying that social deprivation was a strong indicator for an illicit drug culture and indeed in my part of Belfast there is plenty of that. In addition, availability of the drug was key, as was the fact that most drug deaths are associated with taking a cocktail with alcohol.
The deaths last weekend, which we are yet to learn more about, and the recorded drug deaths last year, seem to suggest that we are back again at a Drug Crisis –the 2017 Drug Crisis. But these spikes mask an underlying problem affecting mostly young men who have lives totally consumed by and with the procurement and consumption of drugs; any drugs.
This morning things took a more sinister turn when a 26 year old, highly agitated man stabbed two pharmacists in a botched hold up on the Falls Road. My colleagues – who are also friends – were lucky to survive the violent attack which I understand was in no way provoked. Two months back a stabbing occurred in another West Belfast pharmacy.
Just as in the 2015 Drug Crisis there will be calls for meetings. I am unconvinced that meetings will solve the 2017 Drug Crisis. It will take a powerful community effort to better support young men whose lives are obviously so impoverished; material, spiritually and socially that they don’t care.
I am a pharmacist in Belfast.