EVERY WEEK, THERE are hundreds of episodes of people injecting drugs publicly in Dublin city centre. This creates problems for everyone.
For the people who inject drugs, doing so publicly is demeaning and increases risks of infection and overdose. I know of many people who do not have their own homes, and have to leave their accommodation every morning and come back every evening. For them, public injecting is an inevitability.
For city centre businesses, public drug taking hinders them in promoting and presenting the capital as a good place to spend time and money.
For the public, including our many tourists, unsafely disposed drug paraphernalia are unsightly and unsafe. Thousands of unsafely disposed needles are picked up every year in the central business district alone.
The problem has not gone unnoticed – An Taoiseach referred to “beds of needles” on our streets in his Dail speech on the issue of homelessness on 10 December 2014. In March 2015, there were media reports on a rise in needle stick injuries among City Council workers. Everyone is agreed that there is a problem, but how do we go about solving it?
Injecting under medical supervision
At the start of March, I spent time in Sydney, Australia, at the Medically Supervised Injecting Centre (MSIC) in Kings Cross. This is a service where people can bring their own (illegally acquired) drugs to inject onsite under medical supervision. The centre has been widely researched and the evidence is clear – it is cost effective, has health benefits for those that use it, does not lead to an increase in local crime or drug use and has contributed to a drop in public injecting and unsafe disposal of sharps.
It also enjoys widespread support from the community. Whilst there I met with police officers, local business people, politicians and a judge. All spoke of the positive effect the MSIC has had on the local area, contributing to a more positive and business friendly environment and improving relationships between different stakeholders in the community. This is what is needed in Dublin, and many of my senior colleagues within city centre NGOs and business groups agree that MSICs should now be implemented to see if the positive impacts achieved elsewhere can be replicated in our own capital.
When I was working with the team of the Sydney MSIC, I witnessed a number of overdoses. We had medical care on hand, and could administer oxygen and opioid antagonists when appropriate. We could also manage the area in which the overdose occurred – there were no needles left on the ground, no discarded syringes, no open packets of citric acid or sterile water – everything was picked up and disposed of safely. We could engage with people and offer support and treatment options. There have been thousands of overdoses at the Sydney MSIC. None have been fatal. In fact, there has never been a fatal overdose at any injecting facility, anywhere in the world.
There are hundreds of fatal overdoses in Ireland annually
In Dublin, I know lots of people like the people I met in the MSIC in Sydney. I know lots of people who have overdosed alone, down a lane, with no-one nearby. I know mothers who no longer have sons because of overdose. There were 350 fatal overdoses in Ireland in 2012, and many more non-fatal overdoses with serious adverse health consequences.
We need to address that, and for the large group of entrenched injecting drug users in Dublin who engage in public injecting, MSICs would help greatly. They are not a panacea – nothing is – but they are an intervention worth trialling in the Irish context, embedded in the existing service landscape.
However, operating an MSIC would currently be illegal. A change in legislation is needed, and Ana Liffey is currently working with the Voluntary Assistance Scheme of the Bar Council to develop draft legislation which, if enacted, would permit, in a regulated manner, the operation of MSICs in Ireland. Sometimes difficult problems require courageous action; and we all agree that the status quo is a difficult problem.
Tony Duffin is the Director of the Ana Liffey Drug Project. See aldp.ie
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