Cold meds posing greater threat

Addiction to over-the-counter cold and flu medication has appeared for the first time among reasons for referral to drug addiction services in County Cavan, though alcohol and heroin abuse remain the largest causes of referral for treatment to Cavan Drug and Alcohol Services (CDAS).
Last year, the service dealt with a case of a person reporting addiction to Pseudoephedrine in Co Cavan, with another for Nurofen Plus in Co Monaghan.
Pseudoephedrine’s use as a precursor in the manufacture of methamphetamine came to prominence in recent years through the popular US crime drama ‘Breaking Bad’. As a result, there has been tougher restrictions placed on buying over-the-counter cold and flu medicines from pharmacies.
CDAS coordinator Tim Murphy says agencies must be more proactive in tackling drug crises. He is calling for the introduction of an implementation framework for recommendations contained in last year’s much-vaunted National Drugs Strategy.
Mr Murphy’s comments come as evidence to date in 2018 point to a worsening heroin abuse, and a developing emergency surrounding addiction to drugs like crack cocaine and other opiates.

Pain medications like Fentanyl, linked to the deaths of musicians Prince and Tom Petty, Oxycontin, and the emergence of ‘Xanax Sticks’, which anecdotally have been linked to overdoses and at least one death locally, are now cropping up with greater frequency on the addiction charity’s radar.
This mirrors, albeit on a much lesser scale, the epidemic gripping large swathes of America. Mr Murphy told The Anglo-Celt: “What happens in America usually translates over here a few years later. We really need to stop chasing the curve and start looking at ways to get ahead of it.”
An examination of the “Main Reasons” for referral to Cavan Drug and Alcohol Services last year, showed among other startling statistics that children under the age of 18 are being referred to the addiction charity for abuse of alcohol and cannabis.
On the opposite end of the scale, a person over the age of 56 was referred to CDAS for heroin addiction.
“What’s alarming is the cohort of people we’re seeing abusing opioids are not who you’d fit in as habitual drug users, more people on prescriptions who’ve developed very real addictions.”
Where prescriptions run dry, Mr Murphy says “anything and nearly everything” is available through the black market, especially online. “In that regard trends are easy to predict. If there’s a market there, others will find a way to supply it.”

Heroin problem in Cavan
Heroin, Mr Murphy states, remains a “very, very significant problem” in Co Cavan.
“It hasn’t gone away,” he says earnestly.
According to a breakdown of service users last year, heroin remained one of the main reasons for referral to CDAS. At the same time, he reports witnessing an emerging crack cocaine problem that served to “complicate” matters further. 
Addiction to the latter ingrains itself, CDAS has learned, when addicts are desperately avoiding withdrawal symptoms and tragically source relief in the same places that crack is being sold. 
“It’s not surprising we’re now seeing a national rise in crack cocaine addiction on top of everything else,” says Mr Murphy.
By comparison, according to CDAS figures, referrals for heroin addiction in Monaghan are practically non-existent. Mr Murphy however believes that the heroin problem there “is much bigger than what we’re seeing”.
He suggests, for example, that addicts from rural counties such as Monaghan can become “displaced” to larger urgan centres as addicts, struggling to access GPs or treatment services, move elsewhere.
In Cavan, at one stage, the wait for methadone treatment was in excess of five months.
One suggestion Mr Murphy makes is introducing nurse prescribing as a way to take the pressure off GPs.
“There needs to be a model that can be delivered throughout rural Ireland,” said Mr Murphy, who also feels there needs to be greater access to prescribed alternatives, such as Suboxone, Subutex and others, some of which report a much lower abuse potential among recovering heroin addicts.
“We need to stop thinking about the small picture of what is the immediate consequences, the cost of medication or the cost of prescribing it, and start looking at the bigger picture and the wider cost to both the individual and society as a whole,” he argued.

Youth initiatives
One “positive development” which Mr Murphy praises is the growing input of youth services - Foróige, ISPCC and the Bounce Back initiative - the latter of which is operational in Bailieborough, Ballyjamesduff, Belturbet and Virginia. 
“All of these are really positive developments and are alleviating the pressure on us because, in many cases when drugs and alcohol are identified as an issue, an addiction agency isn’t really the place they should be. Now we have these other services that are able to do this work brilliantly and we work with them.”
Almost 50 per cent of referrals to CDAS were allocated a case worker according to a snapshot from mid-Feburary this year, with more than a quarter engaging in counselling.
A total of 30 CDAS clients completed non-accredited courses in the past year, with 15 others progressing through Community Employment Schemes.