Background
In 2022, the HSE, in partnership with Merchants Quay Ireland, collected 165 used syringes from the Dublin and Midlands regions during September and October. Residual drugs were extracted from these syringes and the data obtained were used to compare drug trends from the two regions.

The Syringe Analysis Programme is the first of its kind in Ireland and enables the HSE to identify temporal and geographical trends annually as part of its emerging drug trend monitoring. Analysis of 235 drugs and metabolites was performed using liquid chromatography–mass spectrometry.

These analyses spanned a wide range of substances, such as opiates (including new synthetic opioids), benzodiazepines, amphetamines, cocaine, new psychoactive substances (NPS), Z-drugs, gabapentinoids, ketamine, and various cutting agents. In 2023, the HSE published a report1 detailing the findings from the 2022 analysis programme; it also compared 2022 programme results to findings from a syringe analysis programme conducted in 2021. The main findings are discussed below.

Results
As expected, heroin was the most common drug identified over the two-year period (see Tables 1 and 2). Cocaine was the second most common drug detected in syringes (71.0% Dublin and 50.8% Midlands); however, there was a reduction in the presence of cocaine in Dublin and Midlands syringes when compared with 2021 findings (86.5% Dublin and 89.1% Midlands). Overall, there were reductions observed in a number of drugs; notably, there were significant reductions in the presence of cathinones (11.3% to 1% in Dublin and 23.6% to 0% in Midlands); methamphetamine (32.6% to 0% in Dublin and 18.2% to 0% in Midlands); and pregabalin (24.7% to 3% in Dublin and 34.5% to 15.4% in Midlands).

The only documented increases since the 2021 study were the presence of ecstasy and the injecting of flurazepam both in the Dublin and Midlands regions.

There was also less variety in the types of drugs identified in the 2022 study compared with 2021. This could be due to shifts in injecting practices or that the samples obtained did not capture a diverse enough user population.

Table 1: Dublin region syringe analysis comparison, 2021–2022

Source: McNamara et al. (2023)1

Table 2: Midlands region syringe analysis comparison, 2021–2022

Source: McNamara et al. (2023)1

Comparison of results

The report authors noted that while applying the same methodology with the same services in the Dublin and Midlands regions for both years, there was difficulty in obtaining diverse and representative syringe samples for the 2022 programme. This was due to new deposit points in hostel accommodation where people discard syringes and also as a result of drug market shifts, with increases in crack cocaine smoking among service users. Based on these changes, there are some early indications of a reduction in injecting practices by some individuals. As a result, the 2022 results are based on fewer numbers of people who inject drugs and may not accurately reflect the drug trends among the wider community. The project was set to be expanded in 2023 to help gain greater market insights, with the HSE partnering with a number of services in Tallaght and Clondalkin to capture trends within Dublin but which are outside the city centre.

1    McNamara S, Killeen N, Eagleton M and Keenan E (2023) HSE emerging drug trend monitoring: year 2 results from the Syringe Analysis Programme 2022. The identification of injecting trends in the Dublin and Midland Region through the application of syringe analysis methodology. Dublin: Health Service Executive. Available from:
https://www.drugsandalcohol.ie/40165/