Northern Ireland

Efforts to contain Northern Ireland's drug problem like 'sticking plaster over gaping wounds'

A quantity of pills, suspected to be illegal drugs, seized by police on the Ormeau Road in Belfast last month.
A quantity of pills, suspected to be illegal drugs, seized by police on the Ormeau Road in Belfast last month.

THE head of an addiction charity has said the current impact of drug abuse in Belfast is the worst he has ever seen.

With over 20 years experience working in addiction services, Alex Bunting is the director of therapeutic services at Inspire.

“I’ve never seen it as bad in terms of the impact on the city, and I work in the city every day,” he told the Irish News.

“That’s backed up by the statistics, not just in terms of the drug-related deaths but also in the social cost.

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“We see the impact in the courts, the health system and they’re significant and unsustainable.”

Drug-related deaths in Northern Ireland have been steadily increasing over the last decade, with 1,660 recorded between 2011-2021.

From 102 deaths in 2011, an all-time record of 218 was recorded in 2020 and 213 the following year.

While opioids like heroin, Fentanyl and Oxycodone are by far the most commonly mentioned substances on death certificates, there is growing concern about poly drug use – with unpredictable combinations often producing a lethal cocktail.

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Alex Bunting, director of therapeutic services at Inspire.
Alex Bunting, director of therapeutic services at Inspire.

Figures from the Northern Ireland Statistics and Research Agency (NISRA) show men are consistently more prone to drug-related deaths, with 157 in 2021 compared to 56 women.

The most affected age group is consistently 25-34 while the Belfast City Council area always has the highest amount of drug-related deaths (75 out of 213 in 2021).


“It’s a big false economy, to think if we don’t invest to try and change behaviour it isn’t going to cost us a hell of a lot more down the line,” said Mr Bunting.

“Increasing numbers of people injecting opioids like heroin. The big difference that is taking a lot of lives recently is poly drug use.

“People using more than one substance. It’s not uncommon now to work with people who will basically take anything just to blank out life in general and not to have to think about what’s going on.”

He said poverty remained one the big predeterminants, with the cost-of-living crisis likely to drive up drug use and other health issues.

Breaking down the specific drugs involved, opioids were mentioned on the death certificates for 1,026 out of 1,660 drug-related deaths between 2011-21.

In 2021 alone, there were 126 deaths where opioids were a factor – including heroin/morphine (39), Methadone (19), Tramadol (22), Codeine and Dihydrocodeine (32) as well as Oxycodone (7) and Fentanyl (11).

Cocaine was mentioned on 33 death certificates along with amphetamines (7) and MDMA/ecstasy (5).

There was a considerable jump in psychoactive substances (sometimes referred to as legal highs) mentioned on 73 death certificates compared to 51 in 2020.

Benzodiazepines, a term for depressants used to treat anxiety and seizures, including Temazepam and Diazepam, were mentioned on 111 death certificates.

Steadily appearing on more death certificates was the anti-convulsant drug Pregabalin/lyrica, mentioned 71 times in 2021, as well as Gabapentin (12).

The amount of antidepressants mentioned on death certificates (51) also peaked in 2021.

Mr Bunting said Northern Ireland suffers from “a very dysfunctional and disproportionate” impact from prescription medication compared to the rest of Europe.

“There’s a legacy problem there. The Troubles have played a role in terms of certain medications becoming normalised in communities.”

A black market has also emerged for drugs like diazepam and other painkillers like codeine and tramadol, and more recently with drugs like lyrica.

“When lyrica first emerged it was described as relatively safe by pharmaceutical companies and, ultimately, it’s now one of the most sought after prescribed drugs on the market,” said Mr Bunting.

While working well with statutory partners, he said efforts to control the problem were still like “sticking plasters over gaping wounds”.

“The big theme that you get from all of us is that the resources don’t match the need,” he said.

“That’s an issue when people can’t access services like talking therapy when they’re still using substances.

“The mental health strategy is a quarter of a million pounds out of sync, the substance misuse strategy is probably going nowhere fast.

“The lack of a political will to drive them and a lack of resources are having a serious impact on our ability to react.”

While the PSNI and partner agencies also work constantly to intercept drugs reaching Northern Ireland, Mr Bunting said it was likely the overall amount being recovered through seizures was “minimal”.

While stories about the devastating impact of drug-related deaths remain persistent, Mr Bunting said it was under-reported that thousands of people were successfully helped through addiction services.

“They are supported out of their addiction and live normal, happy lives. That does happen and that’s why we’re crying out for more resources because we’re seeing the impact that it can have on peoples’ lives.”