Results of a Pilot Syringe Testing Project in Ireland for the ESCAPE Syringe Testing Project

Knowledge of what substances are being injected in a city or country is necessary to guide prevention strategies and plan the provision of treatment, as well as to inform law enforcement agencies.

Strategic Action 1.3.11 of the National Drugs Strategy ‘Reducing Harm Supporting Recovery: A Health-Led Response to Drug and Alcohol Use in Ireland 2017 – 2025’ mandates the HSE to review emerging drug trends and early harm reduction responses. To fulfil this action, further information is required to fully understand changing drug patterns and trends in Ireland.

Syringe analysis provides health care providers and policy maker’s with access to rapid and accurate data regarding emerging trends and threats to health Following the generic protocol in the EU ESCAPE European syringe collection & analysis enterprise, 155 syringes were collected from 3 locations in Ireland, both urban and rural, managed by Merchant’s Quay Ireland and extracts from the syringes were prepared for analysis.

Analysis was performed using an Agilent 1260 HPLC system equipped with a Sciex 4500 QTrap. The method uses Electrospray Ionisation with multi-reaction monitoring (MRM) - 2 MRM transitions for each compound tested coupled with Enhanced Product Ion monitoring (EPI) giving full scan data. The samples were subjected to 4 separate screens covering 236 individual compounds including those typically found in syringes and other new psychoactive substances of interest which have been identified in Europe in recent years. Analysis is ongoing but substances seen so far in syringes include Heroin, Cocaine, Methamphetamine, 2/3/4- Methylmethcathinone (MMC), Ketamine, Pregabalin, Flurazepam, Methadone, Paracetamol, Oxycodone, Zopiclone, Alprazolam, Diazepam and Phenacetin Initial results confirm significant use of Cocaine in people who use drugs in Ireland. Evidence of 2/3/4-MMC use in this population was also seen. A trend in probable injection of a prescribed benzodiazepine was also observed. The findings demonstrate the utility of this approach for informing on emerging new trends in drug use and support the proposal for converting this pilot to an annual exercise.

Disclosure of Interest: The authors declare that they have no conflict of interest and no pharmaceutical grants were received in the development of this study. The work was supported by the HSE Social Inclusion Office, the HSE National Drug Treatment Centre and by Merchant’s Quay Ireland.