Injection of new psychoactive substance snow blow associated with recently acquired HIV infections among homeless people who inject drugs in Dublin, Ireland, 2015.

In February 2015, an outbreak of recently acquired HIV infections among people who inject drugs (PWID) was identified in Dublin, following similar outbreaks in Greece and Romania in 2011. We compared drug and risk behaviours among 15 HIV cases and 39 controls. Injecting a synthetic cathinone, snow blow, was associated with recent HIV infection (AOR: 49; p=0.003). Prevention and control efforts are underway among PWID in Dublin, but may also be needed elsewhere in Europe.

Prescription drugs with potential for misuse: protocol for a multi-indicator analysis of supply, detection and the associated health burden in Ireland between 2010 and 2020.

INTRODUCTION: There is an increasing concern about the misuse of prescription drugs. Misuse refers to the intentional repurposing of prescribed drugs and/or the use of illicitly sourced prescription drugs, which may be counterfeit or contaminated. Drugs with the greatest potential for misuse are prescription opioids, gabapentinoids, benzodiazepines, Z-drugs and stimulants. OBJECTIVE: The aim of this study is to provide a comprehensive analysis of the supply, patterns of use and health burden associated with prescription drugs with potential for misuse (PDPM) in Ireland between 2010 and 2020. Three inter-related studies will be carried out. The first study will describe trends in supply of PDPM using law enforcement drug seizures data and national prescription records from national community and prison settings. The second study aims to estimate trends in the detection of PDPM across multiple early warning systems using national forensic toxicology data. The third study aims to quantify the health burden associated with PDPM nationally, using epidemiological indicators of drug-poisoning deaths, non-fatal intentional drug overdose presentations to hospitals and drug treatment demand. METHODS AND ANALYSIS: A retrospective observational study design, with repeated cross-sectional analyses, using negative binomial regression models or, where appropriate, joinpoint regression. ETHICS AND DISSEMINATION: The study has received approval from the RCSI Ethics Committee (REC202202020). Results will be disseminated in peer-reviewed journals, scientific and drug policy meetings and with key stakeholders via research briefs.

A cross-section observational study on the seroprevalence of antibodies to COVID-19 in patients receiving opiate agonist treatment.

INTRODUCTION: The HSE National Drug Treatment Centre is an inner city drug treatment centre in Dublin which provides opiate agonist treatment (OAT) to approximately 565 patients, many of whom have complex care needs. OBJECTIVE: This study was conducted to determine seropositivity to the COVID-19 virus in patients attending NDTC, and to establish if patients tested had any clinical symptoms of this disease since March 2020. METHOD: All patients attending for OAT were invited to participate and 103/565 patients agreed. The patients were tested for the presence of serum antibodies to COVID-19 in a single sample collected over a 4-month period (July-October 2020). A questionnaire was administered at the same time as sample taking. RESULTS: Results showed that the majority of patient samples (100; 97%) tested were negative for the presence of antibodies to COVID-19. There were only two confirmed positive results (1.9%) and one equivocal result (1%). None of the approximately 565 attendees at the HSE NDTC presented with serious illness indicative of COVID-19 throughout the three waves of the pandemic, nor were any deaths due to COVID-19 reported. CONCLUSION: These findings indicate (a) possible low level of exposure to COVID-19 among this patient cohort or (b) that those patients who have been exposed have not developed or maintained detectable antibody levels, nor developed symptoms of the disease. Public health measures could explain the low level of COVID-19 in this cohort. The findings are also consistent with the possibility of a protective effect of OAT medications on development of the disease.

Screening of stimulants including designer drugs in urine using a liquid chromatography tandem mass spectrometry system.

A rapid, reproducible and sensitive reversed phase liquid chromatography-mass spectrometry method was developed and validated for the identification and semi-quantitative confirmation of stimulants in urine. The method is capable of separating compounds such as cocaine and metabolites, amphetamines, substituted cathinones and other designer drugs, with a total run time of 11 min. The method was subsequently used to confirm the presence of these stimulants in the urine of patients attending the Drug Treatment Centre Board Ireland over the period in which legislation banning some named cathinones was introduced in Ireland. Substituted cathinones were the predominant drug of choice, outside of cocaine use. Mephedrone was the most widely detected cathinone in 2010, whereas 3,4-methylenedioxypyrrolidinobutyrophenone featured more prevalently in screenings in 2011. The appearance of adverse effects increases during multi-stimulant use related to synergistic pharmacological combinations, and this method has benefits in identifying multi-drug use between next generation designer drugs and commonly used stimulants.