LAST UPDATE | 19 Sep 2024

THE DEPARTMENT OF Health is being put under pressure by pharmacists and campaigners to remove the need for drug users to have a prescription for naloxone, a life-saving antidote to curb the seriousness of overdoses.

Naloxone temporarily reverses the effects of opioid drugs like heroin, morphine, methadone and synthetic opioids, like nitazenes, if someone overdoses. It has been commonly used during mass overdose events in Ireland in recent months.

The Oireachtas Committee on Drug Use, which is tasked with engaging with stakeholders to assess a Citizens’ Assembly report that recommended drugs be decriminalised earlier this year, met with the Irish Pharmacy Union (IPU) and the Irish College of General Practitioners (ICGP) this morning.

During the hearing, Green Party TD Neasa Hourigan asked the delegates what was being done to progress legislation and action to remove the requirement for a prescription for naloxone.

Leading industry pharmacist Denis O’Driscoll told her and other politicians today that he, colleagues and peers are currently lobbying the Department of Health to “pressure” them towards making the antidote readily available over the counter.

O’Driscoll, who is also the head chemist at Lloyds Pharmacy, the Vice President of the IPU and the chair of the independent Naloxone Advisory Group to the HSE, said that other jurisdictions have chosen to ignore domestic and EU legislation that makes prescriptions for naloxone a requirement.

Denis O'Driscoll told politicians that he and colleagues are lobbying Government to "pressure" them towards making the antidote readily available over the counter. Oireachtas.ie Oireachtas.ie

He believes having the life-saving drug readily available over the counter of a pharmacy would be the “ideal” way to sell the product and added that he would welcome if the HSE made naloxone available in public spaces, similar to public defibrillators.

Naloxone is commonly administered through a nasal spray and supplies have been ramped up this year in areas as the HSE responds to overdose situations in cities and in prisons.

Dr Des Crowley, the Assistant Director of Substance Misuse at the ICGP, and Dr Bernard Kenny, the Director of the same department, explained that naloxone would have “no effect” on someone if they used it on themselves and had not used any drugs.

Dr Des Crowley explained the urgent need for naloxone to be made readily available to the general public. Oireachtas.ie Oireachtas.ie

The ICGP also supported measures to remove the requirement for a prescription for naloxone as Dr Crowley explained that 70% of drug-related deaths are a result of an overdose of opiods and four in ten users are accompanied during overdose incidents.

However, Dr Tom Murray – President of the IPU – said that the main difference between naloxone and defibrillators was that the public welcome defibrillator machine stations but would view naloxone stations as “inviting” drug use into the community.

He said that, from his experience, the presence of naloxone is increased where the chances of overdoses are greater. In January, services in Dublin and Cork stocked-up on the drug as clusters of overdoses began in the cities.

“The first step in preparation for decriminalisation has got to be public education,” Dr Murray told the politicians.

Respective delegates from the IPU and the ICGP supported what they called the “decriminalisation of the individual drug user”, rather than the substances themselves.

Irish pharmacists and GPs this morning said that it will support decriminalisation as they believe prosecution of those with problem-drug habits is a “barrier” to treatment.

They both warned that any implementation strategy should be front loaded with fully-developed policies on funding, framework plans and safeguarding before decriminalisation can begin for it to work effectively.

Sign detailing the importance of Naloxone in Ireland. Daragh Brophy / The Journal Daragh Brophy / The Journal / The Journal

Dr Tom Murray said: “Decriminalisation should only be implemented as the final part of any policy developed, to ensure that all appropriate safeguards and supports are in place and resourced.”

A Citizens’ Assembly on drug use published its final report which said Ireland should move towards decriminalising the possession and use of some currently controlled substances.

The Joint Committee on Drug Use is the second phase of the pathway towards decriminalisation and is tasked with engaging with stakeholders on the report by the Citizens’ Assembly published earlier this year.

TDs and Senators have met just a handful of times since the committee was established in June and no formal decisions or agreements have yet to be made.

A final report by the Committee will determine what steps need to be taken to implement decriminalisation policies, including what commitments must be made in terms of funding, safeguards and framework plans.

A separate report in July did find that there was an “appetite” in Ireland for alternatives to coercive sanctions in drug possession cases, such as favouring addiction service referrals over criminal prosecution. 

It said that funding for drug treatment services that interact with the criminal justice system is stable and available across a wide range of areas in Ireland, but acknowledged that there are some existing services which are forced to rely on alternative funding.

The report also found that knowledge of interventions and alternatives to prosecution have reduced among the judicial system and the public. This has led to fewer people engaging with services such as Dublin Drug Treatment Court.