A dangerous mix of heroin is has been linked to recent overdose clusters in Dublin, according to the HSE.
An analysis by Forensic Science Ireland (FSI) found a trace of a Nitazene-type substance "in a brown powder associated with Dublin overdose clusters".
The HSE advises that there is extra risk at this time and strongly recommends people do not try new types of drugs or new batches being sold on the market.
Some 40 drug related overdoses have been reported to the HSE in the last 36 hours.
HSE Clinical Lead on Addiction Services Professor Eamon Keenan said: “We are urging extreme caution following a sharp rise in the number of overdoses related to a powder being sold as heroin in the Dublin region.
“Recent overdoses may be caused by heroin mixed with nitazene, a potent and dangerous synthetic opioid. These pose a substantial risk of overdose, hospitalisation and death.”
'Avoid using alone'
The HSE said “it is safer not to use drugs at all” and people should particularly “avoid new batches of heroin, avoid buying from new suppliers and avoid trying new batches or new types of drugs”.
“Avoid using alone and make a rescue plan, and let someone know you are using and where,” it said.
“Test the dose, start low and go very slow, there is increased risk of overdose at this time.”
The HSE also advised avoid using drugs with “other drugs, including methadone, benzodiazepines or alcohol”.
It also reminded people they can access naloxone from local addiction services and doctors. Naloxone temporarily reverses the effects of opiate-type drugs like heroin