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Synthetic opioid preparation

HSE Update on the emergence of synthetic opioids on the Irish market

This page will be kept up to date with the latetst developments and resources for people who use drugs and professionals in response to the emergence of nitazenes on the Irish market. 

Latest update: 14th June 2023 

A new alert has been issued following the identification of a nitazene-type substance in yellow tablets sold as benzodiazepines across the Mid-West, Dublin and Galway Regions. These tablets have been linked with overdose clusters. As of the 14th June, the HSE will monitor the situation with relevant stakeholders and update as necessray.

Download this alert here

15th March 2024 HSE extends Red Alert to Prison settings

The HSE is extending its current Red Alert to Irish Prison settings following a small number of related overdoses. 

Analysis conducted by HSE National Drug Treatment Centre Laboratory has confirmed the presence of a nitazene type substance, called N-Pyrrolidino protonitazene, associated with overdoses in Irish prisons. Red Alerts continue to remain in place for the Dublin and Cork Regions as there is an on-going risk of these substances continuing to emerge on the market. 



Alert issued 2nd February 2024 regarding new batch of nitazene powder 

A new alert was issued on the 2nd of February following the identification of a new batch of nitazenes.

The most recent information from the HSE is that nitazenes could now appear in a variety of coloured powders.



National Red Alert Group (NRAG)

A Irish National Red Alert Group (NRAG) has been formed to monitor cases of concern and to rapidly respond to future outbreaks should they occur. This cross-sector group is coordinated by the HSE National Clinical Lead for Addiction Services and includes representatives from the National Social Inclusion Office, The National Ambulance Service Director, The HSE National Drugs Treatment Centre Laboratory, The Garda National Drugs and Organised Crime Bureau, Forensic Science Ireland, The State Laboratory, hospital network ED representative, Trinity College Dublin and HSE Communications Division.

Resources for people who use drugs and service providers 

At present, it is only the heroin market which is impacted by the emergence of nitazenes in Ireland. Of concern is the emergence of these substances being sold as falsified tablets in the UK (mainly as benzodiazepines and oxycodone).

This is an area that needs to be intensively monitored for future developments. There are always risks and all drug user groups are advised to follow harm reduction measures and get medical help immediately if a person becomes unwell.

WATCH BACK: HSE Webinar: Safeguarding communities against nitazenes (22nd February 2024)

In light of the overdose outbreaks in Dublin City Centre and Cork due to the emergence of N-Pyrrolidino protonitazene in November and December 2023 respectively, and the recent identification of a second batch in Dublin's drug market, the HSE National Social Inclusion Office developed this webinar to equip frontline service providers.

Watch online here

Information for medical care providers

Emergency service providers and hospitals are being advised on the requirement for additional doses of naloxone to treat synthetic opioid overdose presentations, with preparations now required to ensure medical service providers have adequate supplies of naloxone should outbreaks begin to occur nationally. With N-pyrrolidino protonitazene now under intensive monitoring by the EMCDDA, all drug market shifts and overdose clusters should be reported to the NRAG for urgent review and action if deemed appropriate..

All organisations that provide emergency care for opioid overdose should ensure staff are supported to:

Resources for medical care providers

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