Afghanistan's bumper poppy harvests may seriously increase the quantity and quality of heroin arriving here - leading to more overdoses, writes Kitty Holland
Success has paved the way for what the United Nations Office on Drugs and Crime predicts will be a "big heroin shock" for health and social services here. As the authorities, the media and public have grown increasingly transfixed by spiralling cocaine consumption here, the Taliban in Afghanistan have been championing bumper poppy crops which, according to the senior research analyst with the United Nations Office on Drugs and Crime (UNODC), will be on our streets by late summer.
Thomas Pietschmann, speaking to The Irish Times from UNODC in Vienna this week, said the "enormous poppy harvest" in southern Afghanistan's Kandahar province, of late April 2006, would be appearing on the streets of western Europe as heroin and illicit morphine by October.
"I fear that in the last few years the governments of Europe have been quite successful in stabilising the heroin situations in their countries, so in this context they could be in for a big heroin shock in the next few months.
"It usually takes 18 months from the poppies being harvested to being processed into heroin, to being trafficked and appearing on the streets, so most of the increase will appear later this year."
It is estimated that up to 95 per cent of the heroin smoked, injected and snorted by the estimated 5,500 heroin users here comes from Afghanistan.
There are a further 8,500 opiate addicts stabilised on methadone.
The one new variable that may reduce the impact of this bumper harvest here, says Pietschmann, is the emerging importance of the Chinese market.
"A year ago I would have said definitely there will be 40 to 50 per cent increase in supply in western Europe later this year but now it is harder to say because we have these rising markets in China and also in Iran. But there is huge potential for a big increase."
As well as an increase in supply, he warns of a sharp increase in purity and consequent probable increase in overdoses. Ireland already has one of the highest rates of preventable deaths by overdose, according to the Irish College of General Practitioners (ICGP).
Pietschmann points to analyses of heroin seizures in Britain by police forensic specialists as indications of how the purity of Afghan heroin increases in line with opium cultivation.
"In the second quarter of 1997, when the Taliban discouraged opium cultivation, purity levels were 35 per cent. In the first quarter of 2001, at a time when Taliban production went up, purity was 55 per cent.
"In later 2001 the Taliban introduced a poppy ban and by the first quarter of 2002 purity had gone down again to 27 per cent. There was a decline in the number of people dying of drug-related causes and it was a very positive result."
HOWEVER, AS THE security situation in southern Afghanistan deteriorated following the US invasion in October 2001, the Taliban has encouraged poppy cultivation to pay for its war effort.
Poppies are 10 times as lucrative as wheat, 13 per cent of the population now depends on the "industry" and, valued at $3.1 billion (€2.3 billion) a year, its worth is equivalent to 46 per cent of the country's licit economy.
Heroin seized in Britain in the middle of last year was registering a purity of 53 per cent, said Pietschmann.
"The trend is that dealers need a round price, a fixed number, so when there is more heroin they sell it purer, when there is less they sell it mixed with other substances. So users don't know until they have taken it if they have taken too much. When there is an oversupply there is a significant danger of increased overdoses."
Tony Geoghegan, director of Merchants Quay Ireland, the largest voluntary drug treatment centre in the State, believes many not immediately affected by heroin and its devastation may be under the impression that the drug is no longer a significant problem here.
"That's the kind of notion that's out there I think, even at Government level - that there are adequate services, that there are no waiting lists for treatment. People are caught up in a flurry about cocaine now and yes, you could say heroin is the forgotten drug."
Garda seizures indicate the drug is anything but under control. A senior source in the National Drug Squad said recently that such was its prevalence he feared a new "epidemic".
"We now see it not just in Dublin but in all the big cities like Galway, Cork, Limerick and Waterford and we've even seen seizures in places like Tullamore and Killybegs, which we wouldn't have seen before," he said.
SEIZURES LAST YEAR were three times that in 2005, while the two biggest seizures in the history of the State, which took place in a two-month period last year, had no impact on either availability or price.
As for treatment, there are huge waiting lists for methadone programmes in some areas, according to Geoghegan.
"I was staggered to learn a few days ago there are waiting times of up to a year in Ballyfermot for methadone. Then in the Cork region there isn't even a clinic."
Dr Ide Delargy, director of the Drug Misuse Programme at the ICGP, also speaks of a "lack of services in the old Southern Health Board region," with people forced to travel from Cork to Dublin twice a week for methadone. "I also see people coming from north Donegal for treatment."
Dr Des Corrigan, chair of the National Advisory Committee on Drugs, agrees there are not enough GPs trained to treat opiate addicts or clinics to cope with current demand.
"I am concerned that if there is an increased supply of cheap and purer heroin, there could be overdoses, especially among people whose tolerance has decreased - such as people leaving prison or who have just completed detoxification."
But, echoing the NDS source's fear of a new "epidemic", he said he was "more concerned about new people being recruited into using heroin and that we would see a resurgence of it in another generation. People quickly forget the devastation of heroin and we may see a new wave of users.
"I think sometimes people think Afghanistan is on the other side of the world and don't believe it has much to do with what's happening here," says Corrigan. "I have been saying for some time we need to pay more attention to what is happening there. I know at the NACD we have an 'early warning' subcommittee and this issue is always on the agenda."
However, he said the HSE was slow to react to warnings four years ago of increased cocaine prevalence.
"I would rather it didn't take so long for systems to respond and that this time, if the impact from Afghanistan does begin to appear, the HSE will look quickly at resources."
Pietschmann says authorities here should be preparing with information campaigns aimed at addicts about increased purity as well as preparatory increased investment in treatment capacity. Dr Joe Barry, consultant in the public health and population section at the HSE, said there were no plans yet to deal with a sharp increase in heroin purity and supply.
"But if there is a glut of purer heroin it will be apparent first on the streets and it will be an issue for us to advise clientele at clinics that there is stronger stuff."
He said in the event of growing numbers seeking treatment, there would be an increase in resources for clinics and, he hoped, more GPs willing to take on opiate addicts for methadone maintenance in their practices.
One addict from west Dublin who wanted to be known as "Dave", and who has been using heroin for three years, was unimpressed by promises that clinic places would increase as demand did.
"I went to get on a programme just before Christmas - was all motivated and wanted to get off the gear. I'm sick of being sick. They said I'd be waiting a year to a year and a half. So I have to keep scoring every day. Sometimes I feel like giving up on it, but I'm hanging in. It's a joke."
Asked what he thinks of predictions of an influx of cheap, pure heroin, he said: "It's already everywhere around here. You can't go out the door without someone offering you heroin. Can it get any worse?"