Synthetic drugs pose 'emerging threat' across Ireland and Europe
It has documented 'unprecedented imports and seizures' of synthetic cathinones, which are chemically similar to cathinone, a stimulant.
The European Union Drug Agency also flags the 'rising availability' of fake medicines containing highly potent nitazenes — a synthetic opioid that led to overdose outbreaks in Dublin and Cork at the end of 2023 and in several Irish prisons in 2024.
In its European Union Drug Report 2025, the agency highlights a doubling in the strength of cannabis resin over the last decade and the risks posed by high-potency cannabis extracts and edibles, like jellies.
The report said semi-synthetic cannabinoids have 'spread rapidly' in recent years. One of these substances, HHC, has been linked to serious psychological effects, including among schoolchildren in Cork in November 2023.
HHC can be purchased legally in jellies and vapes from stores in Ireland, despite repeated concerns of medical experts. New provisions are being drafted to fill the legislative gap.
The report is also alerting users of the dance drug ecstasy that they are exposing themselves to 'unpredictable health risks', as the content of the active ingredient, MDMA, has 'increased markedly'.
It said the average MDMA content in ecstasy tablets has increased from about 84mg in 2011 to between 138mg and 158mg now, with some tablets containing up to 350mg.
This warning chimes with an alert issued last week by the HSE, which said that one in four ecstasy pills it had tested in 2024 had more than 200mg of MDMA, which, it said, was more than double the typical adult dose.
Issuing the alert as part of its harm reduction strategy for the coming festival season, the HSE said high-strength MDMA pills, powders and crystals in circulation increased the risk of 'getting very sick', including accidental overdose.
The European Union Drug Agency report mentioned the HSE harm reduction campaign at music festivals, which included the testing of samples handed over to surrender bins, enabling live dissemination of rapid risk alerts to potential users.
The agency said that similar to the more extensive trend with cannabis, MDMA had been found in edibles — such as sweets and lollipops — in some countries.
'As with cannabis edibles, these products pose difficulties in regulating dosage and increase the risk of inadvertent consumption, especially a concern if they are consumed by minors,' the report said.
It said seizures of synthetic cathinones had increased from 2.1 tonnes in 2021, to 27 tonnes in 2022 and to 37 tonnes in 2023.
The report said while synthetic cathinones have been shown to have similar effects and potential harms as stimulants like MDMA and amphetamine, they are a broad range of substances, some of which may have 'more severe' effects.
The drug agency said synthetic cannabinoids were widely available online and in shops and include flavoured jellies and vapes.
'Their accessibility and supposed legal status may attract both cannabis users and first-time users, potentially including youth and children,' it said.
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Irish Examiner
5 hours ago
- Irish Examiner
Children waiting up to 13 years for primary care assessment
Children have been waiting as long as 13 years for a primary care assessment within the HSE, as new figures throw a spotlight on just how long waiting lists can go. Previously, the HSE had bracketed all children who had been waiting for longer than one or two years into one overall cohort when detailing the length of time that they were waiting. The new figures, delivered to Social Democrats TD for East Cork Liam Quaide in response to parliamentary questions, show that close to 19,000 children aged up to 17 have been waiting for longer than two years for an initial psychology, occupational therapy (OT), or physiotherapy assessment. For the first time clarity is given as to just how long waiting lists in some parts of the country have extended to, including: A child waiting 13.6 years for a psychology appointment in Dublin North West A patient waiting 9.7 years for an occupational therapy assessment in Dublin North A wait of 8.7 years for an OT assessment in Meath The figures show that of the four disciplines in question psychology is the worst affected. Mr Quaide, a clinical psychologist, said that the crisis in primary care services has 'flown almost entirely under the radar', in contrast with the scrutiny applied to similar issues seen with the HSE's network of Children's Disability Network Teams (CDNTs). 'The core of this crisis is a failure by successive governments to invest in staff over many years. It stems from a political ideology that views the staffing of our essential services purely as a cost, not as an investment,' he said. The HSE said it "recognises the need to address waiting lists, and this is reflected in our commitment to developing the provision of community services through the newly established Health Regions, in line with Sláintecare". A spokesperson said: "This involves a significant restructuring in how services are delivered to ensure that integrated care is provided equitably and efficiently for those who need it. "In 2023, the rate of referral for therapy services grew by 7% nationally, and increased by a further 1% in 2024. The increased referral rate is particularly notable in physiotherapy, psychology and audiology. "Numbers seen in 2024 are comparable with 2023, however, the rate of referral, remains a challenge Children's services by their nature are more complex in presentation and require more attendance compared to services for adults. "It should be noted that when children transfer from specialist disability services to primary care, waiting time is calculated from the date of the original referral. Read More
The Journal
7 hours ago
- The Journal
'It's breaking me': Our readers share the impact of cancer scan delays
NOBODY WANTS TO hear the word cancer, but thankfully as science advances, it is becoming more treatable and people are living longer with the disease. But from diagnostic scans to treatment to surgery to surveillance, people are encountering delays in the Irish healthcare system at every step on their cancer journey. Delays in diagnosis and treatment 'are Ireland's biggest obstacle to improved cancer outcomes', according to Averil Power, CEO of the Irish Cancer Society. The Journal Investigates reported earlier today that hospitals are failing to consistently start treatments including chemotherapy on time. Before ever reaching this step, many people anxiously wait — often for weeks or months — for tests needed to diagnose or monitor their cancer. This is not a small number. Over 300,000 people were waiting on scans in Ireland at the end of March 2025, with a shocking 15% waiting over 18 months. That is the waitlist for all conditions, but it includes tests that are vital for the diagnosis and treatment of cancer, such as urgent and surveillance CT, MRI and ultrasound scans. Readers contacted us from across Ireland to share the physical and psychological impacts these delays are having on their lives. They felt forgotten, holding their breaths, unable to think about their future. Thank you to everyone who got in touch. Here's what you told us. 'I'm in a constant panic by not knowing' Emma Aspell from Dublin, who has two young children, received news she was dreading last week — her cancer was back, and had spread to her lungs. She was diagnosed with breast cancer in 2023 and finished treatments for it in May 2024. Unfortunately, a year on, her surveillance scan wasn't clear and lung cancer was subsequently confirmed. But now she is waiting for a plan. I have been so optimistic. I've had so much fight in me. But my anxiety is winning. Emma said her consultant can't make a plan until she has a biopsy and the wait is three weeks. 'My consultant said he feels for me, but as they need a CT scanner to do a lung biopsy the wait is this long. 'It's breaking me. This could be the difference of life and death for me.' — Investigations like this don't happen without your support… Impactful investigative reporting is powered by people like you. Support The Journal Investigates Advertisement 'The system is so broken' Margaret Higgins said that, after many 'gruelling' months of chemotherapy and radiation, monitoring to see if her cancer has returned is her 'lifeline'. Due to a backlog, her mammogram at a large hospital in Dublin was delayed so she resorted to a private scan. Her next annual check-up was also pushed out by a number of months. 'The system is so broken,' she told The Journal Investigates. 'The staff are killing themselves' but whoever is making funding decisions 'is not doing a good job'. If you haven't got somebody strong to fight for you, you just get left behind. 'When you're not feeling well, you can't fight for your yourself,' Higgins added. Margaret was just one of numerous readers who told us that their mammograms were significantly delayed. Martina Balte, a breast cancer survivor, is waiting for an appointment for her overdue annual mammogram. It was due in May, but she doesn't even have a date. 'I contacted my breast cancer nurse — who couldn't help with an appointment and she told me to do regular breast checks myself while waiting on my appointment.' 'When I was diagnosed at 48, my symptoms were a pain under my arm. When I got my diagnoses of a 5 cm lump, I couldn't feel it. To put the responsibility on me to check for recurrence due to imaging not being available is wrong. 'Cancer survivors live with a fear of recurrence every day. There should be no delays with their appointments, mammograms or scans.' 'You're forever left with 'what if' Muireann Mc Colgan was diagnosed with stage four breast cancer two weeks after her daughter Aobh was born. Getting access to scans continue to be an ongoing issue for her, even after diagnosis. That includes yearly mammograms. But her last appointment was pushed out by five months. 'You feel forgotten about,' she said. The delay made her feel like she didn't matter to the health service 'because she was going to eventually die to the disease'. Muireann Mc Colgan feels forgotten by the health service. Muireann Mc Colgan Muireann Mc Colgan Alongside two other women with breast cancer, Niamh Noonan and Ziva Cussen, she started a campaign — Too Young To Be Heard — calling for improvements across a number of areas of cancer care, especially for young women. The ability to get scans or biopsies on the same day as a BreastCheck appointment is one of their key asks. Muireann said that women who are waiting for tests are 'terrified'. Rather than wait for a place in the public system, she said: 'Honestly, without freaking them out, I just tell them to go private.' She told us that 'the whole thing is a mess'. You're forever left with the 'what if'. What if it been done earlier? What if I had pushed for it? Other issues the campaign group say need to be addressed include lowering the age of public breast cancer screening, immediately referring women with symptoms to specialist clinics regardless of age or family history, as well as financial assistance with treatment and lost earnings. The Health Information and Quality Authority (HIQA) is to examine extending breast cancer screening beyond the current ages of 50-69. This comes as guidance issued in the United States last year recommended it should start at age 40. Niamh Noonan, Ziva Cussen and Muireann Mc Colgan set up Too Young To Be Heard to amplify Irish breast cancer voices. Muireann Mc Colgan Muireann Mc Colgan Related Reads 'It's getting tougher': Hospitals failing to consistently start chemo on time Cancer diagnoses could double by 2045 without urgent action, warns Irish Cancer Society Funding removed from large cancer centre Mater University Hospital diagnoses over a fifth of all breast cancers in Ireland. When asked about delays to mammograms, a spokesperson for the hospital said that it 'is facing significant capacity constraints due to high demand and a lack of funding'. Last year, 'dedicated funding for additional mammography lists was removed, which directly impacted on the unit's ability to meet the demand for services'. The Mater's unit receives about 7,500 referrals every years and also receives patients post diagnosis from the Breastcheck unit. 'A comprehensive business case' for extra staff and resources has been submitted by the hospital. The Dublin hospital said that it 'regrets any inconvenience caused to our patients due to the capacity constraints of the service' and it is 'working to find solutions to the issue'. 'Patients are consistently advised to consult their GP for re-referral if they develop symptoms of concern.' 'Inefficiency in the system' The readers that contacted us attended a wide variety of hospitals, so it is clear that cancer units right across Ireland are impacted by these capacity constraints. One reader who lives in the midlands has been waiting for years to find out if her symptoms are, in fact, cancer. She first had them around three years ago, and between delays and lack of capacity, she only had a biopsy in April. 'It's almost three months since I had the procedure and getting close to three years since I first reported symptoms to my GP and I still have no results. 'I fully understand the pressure on hospital staff, but I also think there is a significant degree of inefficiency in the system.' Other readers recounted their hurt and frustration about the treatment of their relatives who died of cancer. Many cited delays in diagnosis while waiting for PET and CT scans, even as an inpatient or when attending the emergency department with cancer-related symptoms. Kiri, who is based in the south, told us that his wife had to endure this 'hell'. 'Simply in order to get the required MRI scans my wife had to spend four days (of what turned out to be her last two weeks) on a trolley in corridors and later a basement storage room, with lights constantly on, waiting for the scan the doctor had ordered.' Because of the lack of capacity, she had to be admitted as an inpatient to get further tests. Despite her not needing to stay in hospital, she was forced to stay in an overcrowded ward for a further five days away from her family simply to hold her place in the queue. Claire, who contacted us about her mother's care, told us that a follow-up scan wasn't scheduled until she, and her sisters, pushed the hospital for it. When the scan eventually happened, the cancer had regrown. 'From waiting for weeks for scans, further weeks for results and constantly having to follow up ourselves… I am convinced that if we had not been there to advocate for her, her life would have been cut even shorter.' From investigation to consultation in 8 days We also received a positive story from reader Peter Larner living in the midwest. He was diagnosed with bowel cancer following routine screening by the HSE. I received, in a matter of days, a letter with an invitation for more tests. A CT scan was scheduled for the following week and Peter had an appointment with a surgeon a few days after that. He said it took eight days from 'investigation to consultation' and he had surgery within five weeks. This experience was 'hugely positive thanks to the HSE', he told us. Radiographers calling for dedicated units There is a need for dedicated units to prevent delays, according to Liam Downey, president of the Irish Institute of Radiography and Radiation Therapy (IIRRT). Sign up The Journal Investigates is dedicated to lifting the lid on how Ireland works. Our newsletter gives you an inside look at how we do this. Sign up here... Sign up .spinner{transform-origin:center;animation:spinner .75s infinite linear}@keyframes spinner{100%{transform:rotate(360deg)}} You are now signed up 'If you had units that are purely scheduled care… it's more streamlined and better for patients,' he told us. Unscheduled care, such as a trauma patient after a car crash or an ICU patient who needs an urgent scan, mean there is a 'constant balance' between ensuring they can be seen and fitting in outpatient scans. 'They're all coming through one system.' Downey said his members 'are seeing delays to oncology patients needing a scan after radiation or chemotherapy'. 'Trying to meet these timelines is a particular challenge. There isn't capacity there to get them back in.' That is an issue that the Irish Cancer Society's Averil Power also raised. 'Effects on the body can be quite harsh, so you don't want to be giving somebody chemotherapy if it's not working. 'It's really important that people are getting regular scans' to check this, she told The Journal Investigates. As a result of not getting these scans, she said: Patients are starting their treatment later, and also patients are potentially being given treatment that isn't working. That is hugely concerning. As well as more investment in diagnostic capacity the charity is calling for dedicated cancer centres. That is the 'long-term goal' so that 'cancer isn't competing with other diseases' when it comes to scans, treatment slots or surgery. A Department of Health spokesperson told us: 'The Government is fully committed to improving cancer care, ensuring better prevention, maintaining improvements in cancer survival rates, and timely access to treatments.' They said that since 2017, €105 million been invested in the National Cancer Strategy, including €23 million this year. 'This has enabled the recruitment of over 670 staff to our national cancer services, including 200 nursing staff, 100 consultants, and 180 health and social care professionals in designated cancer centres.' In relation to delays in diagnosis of cancer, the spokesperson told us: 'The Department is reviewing utilisation of diagnostics and this will utilise the National Integrated Medical Imaging System (NIMIS) to provide hourly usage data of machines and look at enablers to use machines on evenings and weekends.' IIRRT's Downey told us 'there are huge efforts being put in across the country to increase the capacity'. Radiographers are working on call, evenings and weekends in some places. 'But without the resource behind it, it doesn't actually lead to any increase in volume.' To address this, he said more staff are needed. The IIRRT have submitted a business case on this to the HSE and Department of Health. Though he also warned that even with all units running at full capacity 'we're constantly behind the curve'. 'By the time we increase infrastructure, we are already behind what is needed.' The Journal Investigates Reporter / Editor: Maria Delaney • Main Image Design: Lorcan O'Reilly • Social Media: Cliodhna Travers Investigations like this don't happen without your support... Impactful investigative reporting is powered by people like you. Over 5,000 readers have already supported our mission with a monthly or one-off payment. Join them here: Support The Journal
The Journal
15 hours ago
- The Journal
'It's getting tougher': Hospitals failing to consistently start chemo on time
MORE PEOPLE ARE waiting longer than recommended to start vital cancer treatments in Irish public hospitals. 'It's getting tougher and tougher,' Dr Michael McCarthy, consultant medical oncologist told The Journal Investigates. 'Waiting to start curative treatment could impact the chances of being able to successfully cure cancer, or control it to maximise the quality of somebody's life.' The HSE recommends that once patients are ready for treatments like intravenous chemotherapy and immunotherapy that they should receive them within 15 working days. Hospitals have a target to treat 90% of patients within this time – about 10% can 'have more complex needs that confound or delay treatment', the National Cancer Control Programme (NCCP) told us. But since 2023, all but one of the public hospitals offering these life-saving treatments missed the HSE's monthly target at least once, data obtained by The Journal Investigates through a Freedom of Information (FOI) request revealed. A shocking 10 hospitals missed the target in more than half of the months, where data was returned, between January 2023 and April 2025. That means people can be left waiting many days or weeks more than recommended for their cancer treatment. 'This is not just a delay – it can be life altering,' Averil Power, CEO of the Irish Cancer Society, told The Journal Investigates . It risks disease progression, it worsens survival outcomes and it inflicts deep psychological harm on patients and their families. 'That's why these figures should serve as a wake-up call to Government to provide the investment that's needed in Budget 2026.' A spokesperson for the NCCP said: 'The HSE recognises the critical importance of timely access to cancer treatment and the impact that delays can have on patients and their families.' They added: 'While this target is being met in many instances, it is acknowledged that a number of hospitals continue to experience challenges in consistently achieving this standard.' Hospitals are responsible for ensuring they meet this target, but the NCCP engages at a regional and hospital level to 'enable performance at a system level', including the identification of 'systemic barriers'. The Department of Health told us that 'Government is fully committed to improving cancer care, ensuring better prevention, maintaining improvements in cancer survival rates, and timely access to treatments'. 'Since 2017, funding of €105 million has been invested in the National Cancer Strategy, including €23 million in 2025,' they continued. But for McCarthy, a consultant in Galway University Hospital and chair of the NCCP Medical Oncology Clinical Leads Group, 'the link between demand and resourcing has gone astray'. More and more, after he breaks the news to patients that they have cancer or that their cancer is back, he then has to tell them 'the next treatment slot is in seven weeks'. 'Psychologically, for many people to be waiting that long, is very challenging.' This was echoed by a number of people with cancer who contacted our team. Advertisement There are infrastructure deficits in day wards, according to the National Cancer Control Programme. Alamy Stock Photo Alamy Stock Photo Investigations like this don't happen without your support… Impactful investigative reporting is powered by people like you. Support The Journal Investigates Some hospitals drastically underperforming Nationally, access to chemo and similar treatments, is taking longer. An average of 87% patients received it on time in 2023. This dropped to an average of 85% in 2024 and 84% from January to April this year. This KPI only captures new parenteral systemic therapy in a day ward setting – such as chemotherapy and immunotherapy – so does not include additional cycles of treatment. The lowest performer during that time was Letterkenny University Hospital, which never met the 90% target. Just 12% of cancer patients in Letterkenny were treated within 15 working days in 2024. But 'after significant efforts' last year, 'incremental improvements' were noted since November, according to the NCCP. The figure from January to April stands at an average of 72% treated on time. This stood at 82% in the most recent returned data, from April. Proposals have been made for 'significant investment at Letterkenny University Hospitals', a HSE West and North West spokesperson told us. That includes 'a stand-alone facility to provide ambulatory (non-inpatient) care'. They added: 'The hospital will be making every effort to secure funding and progress this significant capital development… in as expedient a manner as possible.' But three other hospitals continue to drastically underperform – Waterford, St Luke's in Kilkenny and St Luke's in Rathgar. Less than 70% of patients here, on average, started chemo on time between January and April this year. People attending St Luke's in Kilkenny fared worst in more recent times. More and more are waiting longer there each year. The KPI dropped from 84% in 2023 to just 62%, on average, in the first four months of this year. Data for South Infirmary Victoria University Hospital in Cork was not returned to the NCCP since 2023 when 86% of patients, on average, started chemo on time. Power said she was 'particularly alarmed by the regional disparities because where you live should not make a different to your cancer treatment and outcomes. It's shocking to see that it is.' 'The NCCP are aware,' a spokesperson said, 'that there are infrastructure deficits in day wards, some of which are addressed by the Capital Plan 2025.' This plan, they continued, 'outlines that progress will be made in 2025 on the design' of oncology day units at hospitals in Cavan, Tallaght, Kerry and Tullamore. From the FOI's figures, Cavan was the only hospital that always met this KPI since 2023, with 100% of patients receiving treatment on time every month. 'No single solution' A delay of four weeks in getting surgery, chemotherapy or radiotherapy can affect a person's chances of surviving cancer, according to the Irish Cancer Society. Related Reads Cancer diagnoses could double by 2045 without urgent action, warns Irish Cancer Society Martin* from Dublin, who died from cancer in his 50s last year, was one such person impacted in this way, his family told The Journal Investigates . His brother, and best friend, said that after Martin was diagnosed, he was told that chemotherapy was needed before he could have surgery. Because of a long waiting list for treatment in his local public hospital, Martin turned to private care but 'one was as bad as the other', his brother said. It took three months to get a place on the day ward to start treatment. By that time his cancer had spread, his brother told us, and he was no longer suitable for surgery. His whole world fell apart. To improve cancer care, Power said that an extra €20 million is needed for the National Cancer Strategy. This would help to address staffing and infrastructure issues. She warned: 'It will only get worse is the government doesn't provide urgent investment.' The Department of Health told us that 2025 funding 'will support recruitment of 179 additional staff to national cancer screening and treatment services'. The spokesperson also said that capital funding has been used since 2017 'to update cancer infrastructure in chemotherapy wards and lab facilities'. Delivery of cancer services and developments in treatments 'have led to a significant improvement in cancer survivorship', they added. Averil Power of the Irish Cancer Society called for urgent investment in cancer services last week. Andres Poveda Andres Poveda Dr Michael McCarthy told us there is 'no single solution', but tackling three key areas would help reduce delays and improve outcomes. These are infrastructure, staffing and improving workflows in oncology units. The oncology team he is part of has worked hard on the last solution, ensuring treatment slots are used as efficiently as possible – with cancelled slots filled and treatments pre-prepared to reduce the amount of time needed per slot. The Galway team are working on a plan to open on bank holidays, which are 'a disaster', according to McCarthy, as 'you're trying to squash five days of treatments into four'. Working on weekends 'will be trickier again', but he does acknowledge that it will be part of the service in the future. The NCCP told us that 'some hospitals have already started offering services on Saturdays and bank holidays to address local capacity challenges' and is actively monitoring the impact of these initiatives. 'Any decision to implement this approach nationally would need to balance patient access, workforce sustainability and overall system capacity,' the spokesperson added. Delays predicted to get worse Cancer services are set to be under more pressure in the coming years. Last week, in the Irish Cancer Society's pre-budget submission , Power said that 'without urgent action, the number of people getting cancer in Ireland is expected to double by 2045″. The charity's submission showed that people were not only waiting for chemotherapy but also for diagnostic tests, surgery and radiation therapy. We detail how these waits are having a devastating impact on people with cancer in part two of this series McCarthy told The Journal Investigates that delays are 'a problem throughout the country' and it's 'likely to get worse'. 'Demand on our day wards is rising predictably year-on-year. We know that next year there'll probably be about a 10% increase again, and it's likely that rate of increase will continue for the next five to ten years.' Sign up The Journal Investigates is dedicated to lifting the lid on how Ireland works. Our newsletter gives you an inside look at how we do this. Sign up here... Sign up .spinner{transform-origin:center;animation:spinner .75s infinite linear}@keyframes spinner{100%{transform:rotate(360deg)}} You are now signed up Part of this growth is because we have an aging and increasing population. But the main reason demand is increasing is because 'cancer treatments are more effective so people are living for longer', he explained. That means more treatments are needed over the course of their lifetimes. The other driving factor is the increasing complexity of treatments. McCarthy used the example of a new immunotherapy for head and neck cancers, set to be available in Ireland in the coming years. This more effective treatment requires around triple the current number of visits to the day ward. Dr Michael McCarthy says the current struggle to schedule treatment is set to get worse. Ray Ryan (via Dr Michael McCarthy) Ray Ryan (via Dr Michael McCarthy) This is concerning, given it's already 'a struggle' to get people booked for treatment – McCarthy's patients are often allocated a provisional waiting time of seven weeks for chemotherapy or immunotherapy. This struggle is not fully reflected in Galway University Hospital target numbers reported to the HSE, even despite their recent drop. An average of 73% of patients received treatments such as chemotherapy within 15 working days, down from 91% in 2023 and 76% in 2024. The 'only reason' the KPI is even in the 70s is because of the nurses and pharmacists working extremely hard to screen patients so they're ready for treatment and call people with last-minute cancellations, McCarthy said. The other option, if we need to start chemotherapy urgently, is to admit people to our inpatient ward. But, the oncologist said, 'that has consequences for people who need inpatient care', as beds are no longer available for them. A cancer care network for the west and northwest, to include a cancer centre at Galway University Hospital, is set to be delivered in the National Development Plan 2021-2030. The NCCP told us that 'this infrastructure development for the West North West Health Region is expected to improve dayward capacity regionally'. But to properly deal with ongoing delays, McCarthy said that staffing and infrastructure deficits have to be addressed. Though it is clear what is needed, he is not hopeful. 'How bad will it need to get before the resources become available to improve it? Do [patients] need to be waiting eight or nine weeks?' *Name has been changed The Journal Investigates Reporter / Editor: Maria Delaney • Main Image Design: Lorcan O'Reilly • Social Media: Cliodhna Travers Investigations like this don't happen without your support... Impactful investigative reporting is powered by people like you. Over 5,000 readers have already supported our mission with a monthly or one-off payment. Join them here: Support The Journal
