The opening of the State’s first medically supervised injection facility this week, almost a decade after being proposed by the government, will mark a “momentous shift in policy in how we treat some of our most marginalised and stigmatised people,” the organisation operating it said.
Eddie Mullins, chief executive of Merchants Quay Ireland (MQI), predicts it will save lives, reduce harm and decrease drug-related litter, including needles and injection barrels on streets.
It will not increase, enable or normalise drug use, which “is unfortunately normal anyway”, Mr Mullins said.
“This is about facing the reality that some of our most marginalised citizens are on our streets injecting drugs in undignified, unsafe, filthy circumstances. This is health-led, health-promoting. And our long-term objective is to support people who are injecting into recovery,” he said.
The facility will be in the basement of the charity’s Riverbank location, accessible from within the premises. It will open seven days a week, including Christmas Day, as an 18-month pilot initially. Opening hours will be arranged to avoid drop-off and collection times of children at a nearby school.
An injection facility was first proposed at cabinet in 2015 by Aodhán Ó Ríordáin, then minister of state with responsibility for the National Drugs Strategy. The Misuse of Drugs (Supervised Injecting Facilities) Act 2017 followed. Beset by delays and objections, notably by a local primary school, the facility was granted planning permission in December 2022, with full HSE support.
“Clients will take a bit of time to trust it,” Mr Mullins said, noting it is “difficult to say” how many would use it.
However, he said feedback so far from people who inject drugs including heroin, crack and crystal meth suggests they are “looking forward to” a safe place.
On entering people will see a nurse, be asked to show the drugs they intend to inject and asked a brief medical history. They will be provided with injection paraphernalia and proceed to one of seven bays around a nurse’s station, to inject. They may need assistance finding a vein but will inject themselves.
“When they have injected, which could take 15 minutes, half an hour, they will go out to an observation room for about 15 minutes, to see if there is any reaction,” Mr Mullins said. Staff are trained in administering the anti-opiate overdose medication Naloxone.
“They can stay longer and can leave at any point. There will be tea and coffee. This will provide space to build up relationships where they can talk about recovery or managing their drug use, homelessness, mental health.”
Accurate figures as to how many active intravenous drug users are in Dublin are not available, though the Ana Liffey addiction project estimated in 2021 about 400. MQI’s harm-reduction service, which provides clean injecting equipment and pipes, supported 3,156 people in 2023.
It will be an injection facility only, meaning drugs cannot be smoked. “At some point the conversation will have to be had: ‘What’s the next stage?’” Mr Mullins said, noting that similar facilities in other jurisdictions have transitioned to be consumption rooms, with smoking areas as well as injection spaces.
Andy O’Hara, coordinator of the drug users’ forum Uisce (Union for Improved Services, Community and Education), said the facility will reduce deaths and stigma experienced by people who inject drugs, many of whom would never get to the point of total abstinence.
“The majority of people we work with, it is their understanding that they have no value, no voice and no power. That leads to more harmful drug use and more deaths,” Mr O’Hara said.
“The safer injecting facility gives us an opportunity to say to people who use drugs, ‘You matter. You have value.’”
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