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Gervin M, Smith R, Bamford L, Keenan E. 
“Chasing the dragon: experience in Ireland and association with 'Ecstasy'”. 
Addiction. 1998 Apr;93(4):601-3.
In their review, Strang and colleagues also explore three possible influences behind a change in route from injecting to 'chasing' heroin in the United Kingdom and Holland. Results of our pilot study suggest that a fourth influence may be operating in Ireland. Clinically we have been struck by the number of patients reporting, in recent years, that their first experience of heroin was in association with ecstasy use, heroin being used to 'come down' off ecstasy. We therefore explored the frequency of this behaviour in our pilot study. We found that 34% of the group reported that their first experience of any opiate was in the context of 'chasing' to 'come down' from Ecstasy. An additional 25% had used heroin in this way at some point. Cannabis has been reported in the literature as being used to `come down off ecstasy (Solowij et al., 1992), but we could not find any previous reports of heroin use in this context. One poss-ible reason for its use in this context may be due to sedating effects to counter insomnia. Sec-ondly, the tendency of opiates to raise levels of serotonin, which may fall following the initial euphoria after Ecstasy use and may underpin the reported mid-week depression (Curran & Travill 1997), could be compensatory. Based on seizures by the police, ecstasy use appears to have increased substantially in Ireland over the past years, and may have contributed to the increase in the prevalence of heroin smoking by 'chasing'. This association between 'chasing heroin' and 'coming down' off ecstasy in Ireland merits further systematic investigation.
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