Over the last decade Ireland's street drug culture has changed rapidly. These days you're more likely to find Dublin's street dealers selling Zimmovanes – strong sleeping tablets, commonly known as "Zimmos" – or benzodiazepines – sedative drugs like Valium, known as "benzos" – than what most people would consider "hard" drugs.
Dealers vary in what they sell, with only a handful touting Class As like opiates and amphetamines. Benzos and Zimmos, on the other hand, are now so popular that dealers in tracksuits on O'Connell Street – Dublin's main thoroughfare – shout out their names to passers-by.
The emergence of this thriving, illicit trade in commonly prescribed pharmaceuticals shows that the modus operandi has changed for Dublin's drug addicts. They are now likely to take more than one type of drug. It's the age of the "poly-drug" user. But according to those who help Ireland's addicts, drug policymakers still need to catch up.
Tony Duffin is CEO of Ana Liffey Drug Project, an organisation that focuses on harm reduction. He told me that, "A lot of our service users are dealing with an antiquated policy that doesn't factor in today's drug trends. There's been a huge movement towards what we know as 'prescription drugs', like benzos and Zimmovane. You can be pretty sure if someone's on heroin they're taking tablets and vice-versa."
But access to rehab units means fitting an "ideal addict" profile – one that doesn't include using these prescription drugs. Centres are bound by tight regulations governing who can receive treatment. People who use alcohol, heroin and benzodiazepine in combination – poly-drug users – are harder to treat and often don't have the "right" blood chemistry to enter into programmes, so they simply get turned away.
Tom Cunningham is a drug user of ten years. He described Dublin's street drug scene to me as a complicated collage of pharmaceuticals – one that includes a list of drugs commonly prescribed by doctors. "Tablets are everywhere in this city. That's how people on the streets overdose and die. They swallow full trays of Zopiclone, benzos, any of the generic drugs. Then they inject on top of them and then they go cold. Tablets are a huge problem now," he said.
According to figures from Ireland's Health Research Board, while only 124 deaths in 2008 specifically mentioned benzos, that figure jumped to 254 in 2011. Add to that the jump in people asking for help with their benzo addictions – 178 in 2008 to 358 in 2012 – and you've got one big benzo spike. This has shredded the idea of an "ideal addict" – one who fits a BB (Before Benzo) drug policy.
When I asked Tom about the clinical assessment criteria – the drug profile needed to access treatment – he grimaced and wrung his hands in frustration. "It's always the same lines," he said. "They say you have to go on a benzo detox before you can come into us, or you've to stop the methadone. Sometimes they'll take you with methadone in your system but not with benzos or they say they can't take you unless you're on methadone. It's mental."
Tony Duffin agreed. "There are all sorts of hurdles that prevent people from accessing treatment in this country. The reason we are told these blockades exist is to manage clinical risks, but there are services that exist outside Ireland and function well. The admission criteria for residential treatment needs to be reviewed. People come to centres with Xanax, benzodiazepine, heroin and alcohol in their system but the clinical assessments can often lock them out of treatment," he said.
Despite all the dealers shouting "benzoooo!" or "blooze!" on O'Connell Street in the middle of the day, there isn't a single clinic in the country dealing with addiction to benzos in Ireland.
Dr Gareth McGovern, who specialises in addiction, told me that having zero services for benzos pushes people further into addiction, instead of helping them get clean. "GPs are too frightened to prescribe benzos to someone they feel might have a problem. This in turn forces people into the black market. We ploughed all our money into opiates but the benzo problem is huge," he said.
Withdrawal from benzos ranges from person to person, but can be fatal. Some people experience seizures, "rattling" shakes and wild mood swings. Cold turkey is sadly not an option for many.
"We have to accept the severity of the problem," Dr McGovern continued. "When someone is addicted to benzos you cannot just stop their script. The process varies from person to person and involves detox along with psychotherapy. Unfortunately the only place people can get that kind of help now is in our private clinics and hospitals, which most people can't afford. If you're poor and on benzos, there's nothing there for you," he said.
Despite calls from Independent TDs (MPs), Irish policy makers refuse to move beyond the 1990s "heroin zombie" stereotype and into a more rounded picture of drug addiction in 21st Century Ireland. So, while drug patterns change with the decades, those without the Department of Health approved blood chemistry will continue to remain locked out of services supposedly devised to meet their needs.
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