It is the small hours outside a popular suburban nightspot and Bill McCann, a sometime bar manager and facilitator with alcohol.ie, which has worked behind the scenes with the bar, club and hotel industry for more than 20 years, has been called to the venue to help in the management of the hordes of young people who arrive and leave in various states of inebriation.

A CCTV video shows groups of young women, on what looks like a mixture of MDMA and alcohol, some of them drifting in and out of consciousness. Inside the club, small bags which once contained cocaine are found. And on the ground outside, a sea of nitrous oxide nozzles – at popular R&B nights ‘whippets’, as it is known, has become the street drug du jour.

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As alcohol abuse steadily falls among young people, synthetic drug use is on the rise in Ireland. The numbers of Irish people aged 15-64 who have used an illicit drug in their lifetime has increased to a large extent over the past 15 years – from 19pc in 2003 to 31pc in 2016, the most recent year surveyed.

In 2017, Taoiseach Leo Varadkar said: “Rates of drug use in Ireland have risen significantly over the past decade, with the greatest increases among younger people.”

This rise has been driven by a number of factors, including the street cred of taking drugs as opposed to drinking; the increased sophistication of dealership networks, aided by social media, particularly Instagram; and the cost factor – McCann notes that most synthetic drugs are relatively cheap to produce, and therefore give greater “bang for the buck”.

The increased availability and use of these drugs have to some extent blindsided the HSE and addiction services, which have been geared to more traditional substance-abuse issues.

At least 18 people have been discharged from Irish hospitals in the last three years having overdosed on ‘chemsex’ drug gamma-hydroxybutyrate, more commonly known as G, or GHB, according to hospital in-patient inquiry figures.

These figures only include inpatient and day patient figures however, and it is thought the vast majority of overdoses present in casualty.According to the HSE, this drug has been associated with ‘chemsex’ within the MSM (men who have sex with men) population but, anecdotally, the drug is now believed to have spread to the broader bar scene.

One Dublin venue was shut down because of the use of GHB on its premises. “It was like Studio 54 back in the day in New York”, he recalls. “It was completely mental, clothes off, full on. Some people took GHB themselves, others were spiked by it, and the bar was eventually closed down for the night. The dosing with GHB has to be very precise, and frequently when people are partying they’re not able to do this – if you’re 0.05ml off on your measuring, you can go from feeling good to being completely unconscious.”

The drug is sometimes referred to as liquid ecstasy due to its effects, but has a completely different chemical structure – it has a similar composition to industrial floor cleaner and in the class of drugs known as hypnotics or downers.

A particular danger has been noted in recent years from PMA (Para-Methoxyamphetamine) and PMMA (Para-Methoxymethamphetamine), stimulants with hallucinogenic effects similar to MDMA. These are both toxic at much lower levels than MDMA and, because they take longer to take effect, users are more susceptible to piling one dose on top of another and eventually overdosing.

Warnings about PMA/PMMA first emerged in 2012 after a number of deaths in Cork. Between December 2013 and May 2014, at least six people in Ireland had PMA/PMMA in their system when they died. There have been around 35 deaths from the drug in Northern Ireland alone. “The base ingredients for all these drugs come from places like Moldova or south-east Asia, and then they come to a central holding country for us, which is normally Holland”, McCann explains. “A lot of MDMA a few years ago had very little MDMA in it at all, but now it’s back to full strength. PMMA is a new kind of designer drug, which is even cheaper. Basically when you overdose, you burn from the inside out.”

The real overall issue is what McCann calls poly-drug use – people who mix alcohol and drugs together. Alcohol greatly increases the toxicity of drugs like GHB and MDMA.

“Staff who work these venues have to be knowledgeable about what the different kinds of highs look like,” McCann says. “We work with the National Drugs Unit and gardai and we train bar staff in first aid. The landscape is always changing, its important we all keep on top of it.”

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