1638. Deputy Colm Burke asked the Minister for Health if his attention has been drawn to reports of increasing the misuse of fentanyl (details supplied); the measures that the Department is taking to tackle fentanyl misuse; and if he will make a statement on the matter. [1059/24]

Hildegarde Naughton, Minister of State at the Department of Health: The Department of Health and the HSE are acutely aware of the dangers of new drugs, including synthetic opioids. They work in collaboration with European partners to prepare and respond to fentanyl or other new synthetic opioids, or other drugs, that may emerge.

An Garda Siochana has not reported any seizures of fentanyl. There has been no laboratory analytical confirmation of fentanyl being detected recently in Ireland. No hospital Emergency Department has reported presentations associated with fentanyl. No individual has presented for treatment to addiction services reporting dependence on fentanyl.

Two outbreaks of overdose clusters have occurred in Dublin and the Cork region since November 2023 as a result of the emergence of a synthetic opioid, a nitazene called N-Pyrrolidino protonitazene. Red Alerts continue to remain in place in these areas as the HSE monitors the situation. The HSE and NRAG (see below) continue the ongoing review of cases since November and at this point in time have not detected nitazenes outside of the Dublin and Cork Regions. Recent studies from Ghent University suggest that this compound is approximately 25 times more potent than fentanyl

Naloxone provision and rapid responses from front-line services and paramedics undoubtedly saved lives during the two outbreak clusters given the potency of the compounds involved. What differentiates responses to nitazenes compared to heroin is the requirement for additional doses of naloxone to revive the person. As a result, the HSE has ensured that additional supplies of naloxone have been available during outbreak periods.

The HSE Naloxone programme continues to expand and is a vitally important tool in the national effort to minimise the harms caused by substance use.

The HSE  has convened a national red alert group (NRAG) 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 a wide range of stakeholders including Dublin Fire Brigade, the National Drugs Treatment Centre Laboratory, the Garda National Drugs and Organised Crime Bureau. NRAG will meet on a monthly basis to review the current situation, risk communications, and to develop resources. A factsheet for medical care providers to be issued by the group shortly.

The HSE has issued interim guidelines to prepare for possible outbreaks nationally and has asked services to directly report on overdoses of concern and changes to drug trends. CHOs have been asked to prepare for the possible emergence of nitazenes and report on cases of concern or increases in overdoses to the HSE and the NRAG so they can continue to monitor the situation.

Work is also underway on the establishment of a Medically Supervised Injecting Facility at Merchants Quay, which will help save lives and enable people with opioid dependency to inject in a safe place and interact with medical services.

I am very appreciative of the efforts of the HSE, community drug services, hospital Emergency Departments and the Dublin Fire Brigade, for their swift responses; their collective effort has greatly minimised the harms from the use of synthetic opioids.