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Dublin: 7 °C Sunday 18 November, 2018
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What can Irish cities learn from the response to drug use in New Orleans?

There is an increasing recognition by police services that drug use is not a policing matter, but requires a health led response, writes Tony Duffin

Tony Duffin Ana Liffey Drug Project

NEW ORLEANS IS a party town with lots of things for tourists and locals to do.

In central parts of both Dublin and New Orleans people overindulge in substances and this can create behaviours that become a policing problem.

Like in Dublin, the most commonly used drugs are alcohol, cannabis, heroin and crack cocaine.

I recently traveled to New Orleans as part of a delegation from the Ana Liffey Drug Project based in Dublin to learn about their drug policies and to share the learning from our work on informing drug policy in Ireland.

It was a hot humid morning when we called into the air-conditioned reception of the New Orleans Police Department, where Commander Nicholas Gernon explained how the police have partnered with their colleagues at the health department and implemented the Law Enforcement Assisted Diversion (LEAD) programme.

LEAD is a collaborative law enforcement and public health response to drug use, mental illness and other health issues experienced by people on the streets of the French Quarter of New Orleans.

Bourbon Surfing

In New Orleans the act of ‘Bourbon Surfing’ is when people who are street homeless or drug or alcohol dependant, start walking from one end of Bourbon Street to the other, drinking beer out of discarded plastic cups; checking trash cans for leftover liquor; and drinking any other booze they can find.

By the time the person reaches the other end of Bourbon Street, one of the main areas for socialising in the city, they are often highly intoxicated and their behaviour can become a matter for the police.

While we don’t have ‘Bourbon Surfing’ in Dublin, we do have a significant number of intoxicated people with complex and multiple health needs who come to the attention of An Garda Siochana due to behaviours that are a direct consequence of their drug or alcohol dependency.

Gernon explained that the diversion programme is based on the LEAD Seattle model, which is focused on “working with our most frequent flyers”. That means people who repeatedly come to the attention of the police for low-level crimes, where that behaviour is health-related, including addiction, mental illness and homelessness.

Before the programme was introduced, processing this small group of people through the criminal justice system was costing the taxpayer a lot of money and was leaving the underlying causes unaddressed. That meant that the targeted group of people were often found in a health-related crisis, which required expensive emergency care.

Said Gernon

Ambulances are the most expensive cabs and hospitals are the most expensive Airbnb.

Under the diversion programme, police officers exercise discretionary authority to divert individuals to community-based, harm-reduction interventions for law violations

Gernon explained that a key goal is to reduce incarceration for low-level crimes among the target group. Instead providing people with an opportunity to improve their situation. Problematic drug use is a chronic, relapsing condition and LEAD recognises this. 

Funded by the police, the programme employs three social workers and two support workers, through an NGO called Odyssey House. The workers currently support 14 men and one woman.

A case conference takes place every three weeks between the police and the health workers involved. Gernon emphasised the importance of providing social housing with supports and the provision of accessible treatment for people.

Nicholas Gernon, New Orleans Police Department, with Dawn Russell and Tony Duffin of the Anna Liffey Drug Project Source: Tony Duffin

Law Enforcement and Public Health

We also visited Odyssey House to visit their detoxification and rehabilitation facilities. Lee Riesman, Project Coordinator of the Overdose Prevention Programme there explained that there are 174 overdose deaths every day in the United States.

In 2018 the number of overdose deaths surpassed the number of homicides recorded as the cause of death, she said. 

It’s hard to imagine that number of people dying each day, but we were given a tangible example when Emily Loska, Outreach Coordinator, told us that on average three people known to Odyssey House die from overdose each week.

Odyssey House provides an accessible free residential detoxification service for people funded via Medicaid. While beds are limited, we were impressed that people are accepted as they present, no matter what drug or combination of drugs they are taking – unlike in Ireland where people often have to reduce their use of certain drugs to become ‘treatment ready’.

That stipulation can result in the most vulnerable people, who are unable meet such entry criteria, being unable to access residential detoxification.

Finally, we visited the Crescent Care needle and syringe programme. Alison Gaye, who leads the Harm Reduction services walked us through downtown New Orleans, to get to the building where the needle and syringe programme is based. 

Gaye showed us the range of injecting equipment and explained the service she delivers to people. Her services are in demand but funding is very tight. Much of the equipment we provide in Ireland, she doesn’t have – due to funding restrictions.

The trip gave me hope, knowing that our similar minded, new-found, friends were there working collaboratively to keep people alive, well and out of prison.

All jurisdictions have deficits in drug services – to greater or lesser degrees. New Orleans has accessible residential detoxification while Dublin has well-developed harm reduction services.

One thing that strikes me though is the increasing recognition by police services that drug use is not a policing matter, but requires a health led response.

Many jurisdictions have mistakenly criminalised the use of drugs and are now attempting to reverse engineer health led responses to drug use via the criminal justice system. An example is the drug courts which have a poor evidence base in terms of outcomes.

This simply does not make sense. The only real way forward is to decriminalise the people who use drugs and instead give them an opportunity to change their lives. 

This would save lives and save taxpayers money.

Tony Duffin is the CEO of Ana Liffey Drug Project a ‘Low Threshold – Harm Reduction’ Service, established in 1982 and currently working in Dublin and the Mid-west Region of Ireland.  For more information about the Ana Liffey visit aldp.ie. You can watch the TEDx talk ‘Making the case for Supervised Injecting Facilities’ by Tony Duffin here.

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About the author:

Tony Duffin  / Ana Liffey Drug Project

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