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Aaron McKenna To hell with the NIMBYs, injection centres are a great idea

Injection centres are not just services for addicts.They are services for every decent person who wants needles and users off the streets.

MINISTER AODHÁN Ó Ríordáin has been at the front of the news agenda on a couple of fronts this week, with his proposals to introduce injection centres for drug addicts and even decriminalise certain drug possession marking a dynamic leap forward in Irish government policy making.

The war on drugs hasn’t even been a one-sided contest: It has been a total failure, a rout on every front. Armies are sent in to clear the fields where drugs are produced, and after the fighting and the killing there are other fields yet to conquer.

People try and fight drug cartels and are strung up from bridges en masse. Mules die with bags of drugs in their stomachs, and still more come. Navies and customs officials trumpet massive seizures of various drugs… and still more and more and more comes.

Then, when you finally get to the user we have social care facilities and health programs and revolving door prisons and yet the problem persists and persists. Users forced into the margins see their health decline even further than the drug alone should affect them, as they pick up secondary diseases from dirty needles or take product that is polluted with industrial grade crap.

The war on drugs has been a failure 

The war has been a failure because it has tried to combat human nature with a moral crusade. Softer drugs like marijuana are treated broadly the same as much harder, darker stuff like heroin; despite the fact that the effects of marijuana are comparable to well-legitimised alcohol.

Hard drug users, the moralisers tell us, must undergo their cold turkey or switch to a “more acceptable” drug like methadone, which is possibly one of the most wasteful treatments in our healthcare system in terms of patient outcomes.

We should, of course, work hard to keep people off drugs and help them remove themselves from the cycle of drug abuse and other mental health issues that may play into it. But the simple fact that we are all aware of is that the physical law enforcement war on drugs and the treatments currently offered to addicts are failing.

It is in this context that Minister Ó Ríordáin has brought forward some highly sensible proposals to put aside our moralising in favour of solutions that reduce the harm inflicted by hard drugs. In doing som, he is echoing the United Nations’ own body tasked with fighting the war on drugs, the Office on Drugs and Crime, which in a leaked report in October stated it is coming to the view that hard drugs should be decriminalised.

This has been part of the solution in countries like Portugal, Canada and The Netherlands where heroin is decriminalised.

Taking revenue from the drug cartels 

Fully legalising softer drugs like marijuana, meanwhile, is cutting into the profits of drug cartels more than running gun battles seem to have been able. Since some US states fully legalised and regulated the sale of marijuana, it has led to the brutal Mexican drug cartels losing billions of dollars’ worth of revenue now that the stuff can be “smuggled” from one part of the US to another.

Injection centres are an idea we can all probably see the wisdom in, unless you take a particularly inflexible moralistic line on drug use. Users are going to be injecting no matter what.

It is a fact, it has been a fact for a long time, and it will continue to be. While they’re out on the streets these users are prone to swapping needles, with predictable results for the contraction of diseases like hepatitis and HIV. When they are unsupervised, addicts can overdose. Sometimes they die, sometimes they make it to a hospital and have a long recovery period ahead.

Addicts will often inject in public, where children can see them. They also litter the place, and many public parks have to be closed off regularly so that staff can undertake the risky task of removing used needles. Sometimes people come into contact with them, as with the young boy who sat on a seat on the DART and pricked his finger on a needle.

Injection centres will cost a lot less 

All of these activities have major social impacts and they also cost the taxpayer a bomb. Managing a heroin user is one thing, managing one with HIV costs another stack. There is a cost to running an injection centre, but it’s probably less than the diffused costs of addicts operating on the streets.

Some people cry “But they’re criminals! They should be rounded up!” Rounded up and what, precisely? Be incarcerated indefinitely? An addict shoved into a cell to go cold turkey will simply return to being an addict in a lot of cases once he or she is let out.

Are you going to hang on to them in a prison (at a cost of €45,000 plus a year) forever? Or do you think we should just line them all up against a wall and shoot them? As Joe Stalin once said, “Death solves all problems. No man, no problem.”

As we are, unfortunately for the extreme hard liners, a civilized and sometimes rational society we are unlikely to look to either option. Instead, we need a practical solution such as Minister Ó Ríordáin proposes.

The major issue, as ever with these things, will be where to place such services. My office is in Dún Laoghaire these days, where there is a methadone clinic and various services for addicts and those in recovery. It is truly a shocking sight to see addicts of various kinds wandering around the place on certain days.

I’ve passed people on their haunches hanging onto a bin, defecating themselves in the street, sniffing solvents in doorways and all whilst barely present. I feel nothing but sympathy for guards sent out to deal with this mess. But we come back to a simple issue: If there isn’t services in Dún Laoghaire, there needs to be services somewhere else.

The placement of injection centres will spark a big row. It would be a pity if our parochially driven politics prevented the services from being provided, for they are not just services for addicts: They are services for every decent person who wants needles and users off the streets and away from folks trying to go about their everyday lives.

Read: Want to keep your personal data safe? It could be something you’ll have to pay for>

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47 Comments
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    Mute Niall Mullins
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    Oct 6th 2014, 12:08 PM

    If they spent half as much money on frontline staff and proper services as they do on paying obscene numbers of, completely unnecessary, managers to come up with schemes like this, then it wouldn’t be an issue to begin with.

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    Mute Rory McGuirk
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    Oct 6th 2014, 4:10 PM

    Aye, and maybe if we all complain on the journal something will be done about it. We’re great at criticizing those in power yet we haven’t a single notion of how to change the country for the better .

    29
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    Mute Niall Mullins
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    Oct 6th 2014, 8:55 PM

    Speak for yourself Rory. I’ve joined the Irish Democratic Party and we’re doing all we can to change the face of politics in Ireland. Why don’t you have a look at our website http://www.IrishDemocraticParty.ie, check out our Facebook page or come along to our launch on Oct. 25th in Tullamore. You just might be surprised. Alone we can’t make a difference but together we stand strong.

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    Mute Ger Sweeney
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    Oct 7th 2014, 12:00 AM

    You can’t beat the system… That’s not defeatist is just a sad reality…. Big money and power will be protected by those who have either or both so new parties won’t make any difference… The whole thing is rotten to the core.

    4
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    Mute Charles J. Ahern
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    Oct 7th 2014, 12:09 AM

    Fluoride and EU withdrawal … no thanks.

    2
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    Mute RP McMurphy
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    Oct 6th 2014, 12:40 PM

    Massage the waiting lists, massage the unemployment nos., revise downwardly the need for carers, massage the IW set-up figures, massage the people on low income figures, massage the export figures(upwardly), massage the the message to the people on Budget day…..a country of civil servant masseuses!!

    73
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    Mute Tony Le Blanc
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    Oct 6th 2014, 1:12 PM

    Alas with no ‘happy ending’

    58
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    Mute Tony Tee
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    Oct 6th 2014, 12:04 PM

    Would be absolutely terrific if John would stop seeking media attention, soundbites, drop the Senator gig and concentrate on his patients….and I speak as someone who has experience dealing with the man, appointments at 9pm at night because he is in a RTE sudio or Gove buildings.

    73
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    Mute Norman Hunter
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    Oct 6th 2014, 12:11 PM

    Yes can’t have someone with knowledge highlighting these issues, best to say nothing and carry on.

    108
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    Mute Tony Tee
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    Oct 6th 2014, 12:17 PM

    Saying something is ‘quite plausible’ does not constitute knowledge Norman

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    Mute Norman Hunter
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    Oct 6th 2014, 12:22 PM

    John Crown got the gagging clause removed from Doctors contracts that the HSE wanted, so in my opinion he is justifying his position in the Seanad.

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    Mute Norman Hunter
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    Oct 6th 2014, 12:25 PM

    Did you stop reading after you saw ‘quite plausible’?

    37
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    Mute Denito
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    Oct 6th 2014, 12:29 PM

    No doubt Prof Crowne is spending endless hours in his public clinics seeing new patients and making sure that he, at least, is doing his bit to keep the waiting lists down.

    57
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    Mute Tony Tee
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    Oct 6th 2014, 12:37 PM

    Could have sworn he was a Oncologist…so why is he commenting on abortion?? I’m afraid as someone the man has treated my opinion on the man my opinion, formed via personal experience, will not be swayed

    http://www.independent.ie/irish-news/senator-john-crown-defends-abortion-waiting-list-joke-28812406.html

    18
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    Mute Norman Hunter
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    Oct 6th 2014, 12:45 PM

    So he is not allowed comment on any medical matters outside of his own specialism?

    60
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    Mute Tony Tee
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    Oct 6th 2014, 1:06 PM

    Clearly youve never been hooked up to chemo treatment at 10pm at night because Dr Crowne has had media commitement elsewhere Norman. I have no problem with him making any comments he wants but as I and countelss other cancer patients know it impacts the treatment we receive and he is paid to give us. Do the day job first and they by all means be a Senator, media provider etc in your own time…..

    31
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    Mute Norman Hunter
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    Oct 6th 2014, 1:13 PM

    Your right I haven’t but have been involved with several people who have, and the presence of the oncologist who they are under is not necessary in every case.If you have an issue with John Crown why don’t you switch?genuine question.

    44
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    Mute Tony Tee
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    Oct 6th 2014, 1:17 PM

    I have switched – after not getting my treatment until after 10pm as I was scheduled to meet Dr Crowne first…in that particular instance he had been up from stupid o’clock doing a interview on Newstalks morning show and mixed up my charts – told me I was stage 4 (which means I have no hope) instead of stage 2. If you or I told our employers we wouldn’t be able to do our jobs until 10pm because we had another job elsewhere or had media commitments we would be dealt with very differently I imagine.

    42
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    Mute Norman Hunter
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    Oct 6th 2014, 1:30 PM

    So you’ve switched what’s your issue?
    Why not make a complaint if you feel it is justified to the relevant authorities. Instead of slagging the man on an Internet forum.

    47
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    Mute Tony Tee
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    Oct 6th 2014, 5:24 PM

    Probably because I am perfectly entitled to voice my opinion and I feel like doing so Norman….if you dont like what I am saying there is no need for you to comment either.

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    Mute Norman Hunter
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    Oct 6th 2014, 6:26 PM

    So voice your complaint of Mr Crown in the correct manner instead of the comfort of hiding behind a computer screen.Allow him answer what you have accused him of.

    25
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    Mute Carmel M H (Carm)
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    Oct 6th 2014, 8:57 PM

    Don’t you dare criticize Prof Crown like that. He is one of the few honest people we have in LH. He always said he was going to keep his day job and he is doing so by working himself into the ground. I know the man and I know how hard he works. Remember he takes no salary from LH. He said he would only be a senator for one term so he will work regular hours as a Dr then again. If he had decided to leave his consultants job the waiting lists would be longer and the service poorer. I think we owe this man a great deal of gratitude. If you don’t like his hours then find another consultant.

    35
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    Mute Carmel M H (Carm)
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    Oct 6th 2014, 9:02 PM

    Good on you Norman. You are right. Doubt Prof Crown was the first to ever mix up a chart. Also on mistakes Tony has spelt his surname wrong throughout his rant.

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    Mute Roy Madden
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    Oct 7th 2014, 12:25 AM

    Tony – why haven’t reported him to the IMC yet?
    Or are you just spoofing?

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    Mute Emilio
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    Oct 6th 2014, 3:49 PM

    I know for a fact that Tallaght ENT department had two waiting lists. You’d get on the first list straight away after GP referal. They’d send you a letter stating something like: We have received the referral letter, please don’t bother us for the foreseeable future, because we don’t give a damn about you (the wording was different, but the meaning was confirmed after I rang them).

    Then about 2 years later they will send you a letter with an appointment a few weeks ahead. At that point they’d add you to the official waiting list. Average waiting time of patients ‘a few weeks’. Works every time.

    Chances that after 2 years you are either dead or your condition has remitted or you have chosen to see a doctor privately? About 100%.

    Fantastic. I’m so impressed with the efficiency of this system I almost peed myself when I found out. So simple. So well executed. I am going to try this at work some day.

    43
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    Mute Sheik Yerbouti
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    Oct 6th 2014, 1:09 PM

    Patient Goes ON Long list- Patient OFF long list to private sector- Patient back ON list– but now they are on a smaller list, that is until the other patients moved to private come back to join them on the public list.

    Maybe Tony o Brien could help them by getting them to complete a report for €20,000
    http://www.independent.ie/irish-news/health/hse-adviser-got-20000-for-health-crisis-report-30634326.html

    Although when you get such top-ups,whats €20,000 between friends
    http://www.independent.ie/irish-news/politics/reilly-hse-chief-obrien-can-keep-160k-wage-topup-29817838.html

    28
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    Mute Niall Mullins
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    Oct 6th 2014, 11:36 PM

    I like you Sheik!

    8
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    Mute sid
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    Oct 6th 2014, 1:13 PM

    This has been the case for years. Maybe not have a staff room meeting about how to massage figures but deffo make it part of the system that puts people off lists for any deviance from the official waiting time. I had a situation like that. Eight cancellations over a year period.hopeless service in my own personal experience

    27
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    Mute McGuckin Annette
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    Oct 6th 2014, 5:27 PM

    How can the national director of acute services say with all certainty that current waiting lists are an accurate reflection of how long people are waiting to be seen and treated, if a) he’s no knowledge of the memo and b) the investigation in to the allegations of rigging hasn’t even commenced yet?

    10
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    Mute Gus Sheridan
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    Oct 7th 2014, 12:47 PM

    Just thought how refreshing that all these comments were mentioned on RTE …daydreaming…

    2
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    Mute Deirdre Uí Bhrógáin
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    Oct 7th 2014, 12:24 PM

    i have been told twice in two different hospitals that I would be on a waiting list only when a date could be allocated.

    2
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