"On 9 November 2023, the Health Service Executive Ireland (HSE) was notified of an unusually high pattern of opioid overdoses occurring in Dublin city centre among people attending homeless services. This represented the very early signs of drug market changes and the emergence of N-pyrrolidino protonitazene in Ireland. During the following 5 days there were 57 overdoses among people who use heroin in Dublin city centre, followed by a second outbreak over 6 days in the Cork region in December (n = 20) [1]. Rapid responses helped to protect people who use drugs through an urgent analytical review of samples, mobilization of frontline services to deliver tailored harm reduction measures and ‘Red Alert’ risk communications issued for these regions.
"Two additional alerts have since been issued in 2024 following the seizure in Dublin of another nitazene powder (protonitazene) and the identification of N-pyrrolidino protonitazene in a Dublin prison setting leading to a small number of overdoses (< 5) [1]. It is too early to speculate on the long-term impact of nitazenes in Ireland, but this is an area requiring intensive monitoring. Nitazenes sold as falsified medicines and as other drugs in the United Kingdom and Europe [2, 3] as well as the use of these substances by non-opioid using populations with no tolerance or access to naloxone, is a particular concern."
Killeen N, Lakes R, Webster M, et al. The emergence of nitazenes on the Irish heroin market and national preparation for possible future outbreaks. Addiction. 2024;119(9):1657-1658. doi:10.1111/add.16525
