Injection Rooms On The Horizon

"It'd save lives, help get people into treatments, take pressure off A&E departments and benefit the neighbourhoods they're in, because there won't be people shooting up and overdosing down alleyways."
Tony Duffin is highlighting the benefits of the heroin consumption rooms that the Minister with Responsibility for Drug Strategy, Aodhán Ó Ríordáin, told Hot Press in June he wants introduced here as a matter of urgency.
The Director of Dublin’s Ana Liffey Drug Project knows what he’s talking about. He recently went on a fact-finding mission to the Sydney Medically Supervised Injecting Centre, the facility the Minister has cited as an example of what’s required in Ireland.
“I’ve been in Dublin since 2000 and worked with a lot of good ministers, Eoin Ryan and Pat Carey among them, but Aodhán Ó Ríordáin is definitely the most progressive,” Duffin reflects. “A lot of people have supported the idea of medically supervised injection centres, but he’s gone further, talking about things like decriminalisation that work and are evidence-based. What’s happened in the past is that politics have crept in, people get nervous about approaches and the evidence goes out of the window. This time, hopefully it’ll be different.”
Unless Aodhán Ó Ríordáin played possum at the job interview, Enda, Joan, Leo and the others must have known what they were getting when the member for Dublin North-Central was handed the portfolio.
“Broadly speaking his fellow ministers seem supportive of him,” agrees Duffin who goes on to detail the contact he’s had with the Minister: “At the recent Mansion House conference, I met and debriefed him on medically supervised injection centres one to one. He came along to the meeting where the Voluntary Assistance Scheme of the Bar Council presented the draft legislation they’ve drawn up for us. He got a copy, which I know he’s read from cover to cover. The other day I sat down in my office with the Minister and showed him the 15-minute lobbying and training video the Sydney Medically Supervised Injecting Centre have compiled. The Lord Mayor of Sydney’s in it talking about the reductions in criminal problems and unsafe needle disposals. I don’t want to put words into the Minister’s mouth but you could see that he was very affected by it.”
Tony Duffin went on his fact-finding mission to Sydney in March. He spent two weeks on the staff-floor, working directly with clients.
“It’s on the main drag directly across the street from King’s Cross Train Station,” he resumes. “There are strip clubs and prostitution, but essentially it’s a retail area. The centre has a shop front; you go into reception and, if you haven’t already, you register your details. There’s a quick assessment and then you can go through to the injection rooms. It’s a very clean, clinical space with eight booths that can accommodate up to 16 people.
“We intervened and saved people’s lives,” he adds. “If you see someone sitting there who’s starting to nod off, you put an oximeter on them and see how much oxygen is in their bloodstream. If it goes below 90, you pump more into them until it returns to normal. That’s all you’ve to dofor most people, but some drop completely and you have to use naloxone and pump oxygen and literally try to get them back. Those people would have been down alleyways and on their own and possibly could’ve died.”
Aodhán Ó Ríordáin acknowledged in his Hot Press interview that there’s likely to be plenty of NIMBY opposition to safe injecting rooms.
“While I was in Sydney I met with police officers, politicians and business owners and without fail everyone said it was better having medically supervised injection centres and even talk about it being their medically supervised injection centre,” Duffin resumes. “The fear is of a honey pot effect and being ‘overrun by addicts’, but there’s very strong evidence to prove that isn’t the case.
“In the 15 years the Sydney centre’s been open, they’ve never had a death and have intervened in 4,500 overdoses. One of the stats that stands out is that they’ve seen an 80% reduction in ambulance call- outs. Drug abusers are often referred to as ‘super utilisers of A&E’ – there’s an average one overdose a day in Ireland – which is an expensive service. If there are less intravenous drug users presenting to A&E you’re obviously saving money.”
While clients in Sydney are free to inject and leave with no questions asked, they’re gently encouraged to access the counselling and other free services offered by the centre.
“If we leave people to inject themselves down the alleyways of Dublin, you’re leaving them to their own devices and the risk of overdose and blood borne viruses is increased. There’s a lot of shame attached to injecting in public, which is a barrier in itself. Remove that barrier and people are far more likely to want to go the treatment and rehabilitation route. They’ll talk to you about having had enough and wanting to get off it.”
Described by addiction specialist GP Dr. Garrett McGovern as being “off the Richter Scale”, the recent surge in new HIV cases in Dublin reinforces the need for safe injecting rooms.
“People think they’re buying and injecting methamphetamine, but it’s actually psychoactive substances like mephedrone, which are linked to risky sexual behaviours. They’re also being injected to give a more pronounced high, so we need to be giving out both condoms and clean needles.”
Before Tony Duffin and his Ana Liffey colleagues can think about setting up their own medically supervised injection centre, a change in the present drug possession laws will be required.
“My understanding is that it could happen before Christmas, which is phenomenal,” he enthuses. “I’ve had behind closed doors discussions with the Gardaí and they support what we’re talking about because it makes sense. It’s time for action; people are contracting HIV and Hepatitis C, they’re overdosing and they’re dying. We’re not going to get the centres themselves in the lifetime of this Dáil, but with the Minister so committed, I’m hopeful we’ll get the legislation that will pave the way for their introduction.”