Concern over use of legal party drug.

Dr Chris Luke, an AE consultant at Cork University Hospital and the Mercy University Hospital (MUH) in Cork, said three young men had to be hospitalised at MUH last month after presenting with a severe reaction to benzylpiperazine.

"In the space of two days last month, we had three young adult males, average age of around 20, who presented with severe reaction to benzylpiperazine and had to be hospitalised as a result - we had one case last year who again had to be hospitalised."

Dr Luke said benzylpiperazine was originally developed as a veterinary worming product to kill parasites but was now often marketed as "a party drug, a kind of cousin of ecstasy which is said to have a mix of psychedelic and aphrodisiac effects".

"It's most notoriously associated with New Zealand where many cases have been described over the last few years and where it was recently banned," he said.

"But it has recently entered the youth scene here in Ireland - it's obtained over the net or in novelty shops or so called 'head shops'," he said.

Dr Luke said hospital staff believe the three cases that presented at CUH were prompted by purchases from shops in Cork and there was some anecdotal evidence that it is also turning up in eastern European shops in the city.

"We believe there are several potential outlets for these 'party drugs' which are technically legal but are likely to be pharmacologically quite toxic to some individuals," he said.

"It's being sold over the counter and in one case we came across was being marketed as XXX."

Dr Luke said the medical literature suggests that benzylpiperazine is most likely to be fatal when consumed with other drugs and there is one reported death in the literature from New Zealand but it can have very damaging effects on some who take it.

"There's only one death reported in the southern hemisphere literature and if it's going to be fatal, it's going to be in a case of multiple drug consumption but it can lead to paranoia, panic, palpitations, nausea and vomiting in some cases," he said.

"It's typically young men in their late teens or early 20s who might be a little bit vulnerable and who are most at risk, people with mild psychological ailments and it's particularly dangerous for people with psychiatric conditions or neurological conditions such as epilepsy," he said.

The cases that have presented in Cork have typically been people who had taken the drug in clubs, and treatment has been symptomatic and generic with monitoring for adverse cardiac, neurological and psychiatric complications, Dr Luke explained.

According to an article in the British Medical Journal in May 2007, piperazines have become a popular recreational drug because, in the right blend, they mimic the high induced by ecstasy and have an undeserved reputation for safety.

Doctors have yet to catch up with the new recreational drugs and could easily mistake piperazine poisoning for the more familiar amphetamine poisoning as the symptoms are similar and include nausea, vomiting, hypertension, agitation, and seizures, according to the authors of the article.

Source: Barry Roche, The Irish Times, 19/08/2008