Source: The Journal.ie  (10th March 2018)

The new centre will be operated by Merchants Quay Ireland on Dublin’s south quays.

The local of  the country’s first supervised drug injecting centre was finally confirmed in the middle of last month, after several deadlines for the announcement were missed.

Merchants Quay Ireland, which already offers a range of services for people who are homeless and struggling with addiction issues at its centre on Dublin’s south quays, is expected to host the centre, the HSE confirmed.

The introduction of a pilot supervised injecting centre was one of the commitments in the 2016 Programme for Government, and it was initially anticipated that the facility would open by the end of 2017.

New laws needed to be passed to make the operation of such centres possible in Ireland – that happened last May, and the management and operation of a pilot centre was put out to tender by the HSE in August.

Merchants Quay said in its application that it hoped to have the centre up and running by September of this year, but, after delays to the tendering process, it’s looking unlikely that deadline will be met either.

Meanwhile, concerns have been raised once again in recent weeks over how the new injecting room will be policed.

We spoke to CEO of Merchants Quay Ireland Tony Geoghegan this week to learn more about the plan for the new centre.

An internal project team had already been set up to prepare the new centre, he explained – with staff overseeing areas as diverse as building refurbishment, recruitment and clinical governance.

Merchants Quay is also awaiting news on the setting up of the HSE’s monitoring committee, which will ensure the new facility complies with national healthcare standards.

The next hurdle to be overcome before the centre can put the rest of its setup schedule in place is likely to be in the area of planning, Geoghegan said. It emerged during the tendering process that planning would need to be sought before an injecting room could be opened at an existing building.

“This is a new of-its-type service – and given the media interest in it and the concerns that have been expressed in relation to it, there will be some regulatory challenges,” Geoghegan said.

Where is it? 

Merchants Quay, which was set up in response to the heroin epidemic in Dublin in the 1980s, has been based at the Riverbank Centre – near Christ Church and close to the city centre – for the last six years.

It offers meal services, a drop in and advice clinic and needle exchange at the three-storey building. A Night Café, where people who need shelter for the night can bed down on temporary mats, was opened to deal with the sharp rise in homelessness in the capital in recent years.

The Riverbank also offers a GP, dental service and counselling during daytime hours – and multiple project workers are employed to help service users navigate their options.

Merchants Quay, Geoghegan explained, already has experience operating the kind of support services that are required as part of the legislation underpinning the set-up of the new supervised injecting centre.

The primary aims of the new facility, he said, would be to save lives and to maximise contact with the target group.

Said Geoghegan:

I do think it is sort of a paradox that the State says, on one hand, we acknowledge that you’re taking drugs, it would be better if you weren’t taking drugs at all, but we do recognise that you’re taking drugs so we’ll give you the equipment – and now off you go off onto the street and into unhygienic conditions.

The target group for an injecting room is a specific cohort of chronic drug users that are on the street.

The objective, he said, was to offer privacy and safety to people who have nowhere else to go.

Your primary aim is to maximise your contact with that target group and try and open doors for them, basically, and it’s based on the premise that unless you have contact with people and can build a relationship with them you can’t effect change really – or it’s very difficult to effect change.

No-one has ever died in an injecting room, he stressed.

People have died in the street unfortunately – very regularly. So the primary thing is about saving lives.

What’s the expected effect in the area? 

No-one involved in the set-up of the new centre is expecting the rest of the process to work out without a hitch.

The Dublin Business Alliance – a lobby group made up of the Licensed Vintners Association, the Restaurants Association and the Temple Bar Company – has been vocally opposed to the introduction of supervised injecting rooms so close to the city centre.

“One of the biggest complaints I hear from the business community and the local community would be the visibility of drug taking on the street – people injecting in public, whether over at the City Wall or the Boardwalk or wherever,” Geoghegan said.

By dint of having an injection room here, that would be something you could measure – has the incidence of public injecting in the vicinity decreased?

The new centre, which, it’s estimated, will be used by around 50 people a day, is also likely to have an impact on the level of discarded syringes and other drug paraphernalia littered around that area of the south inner city and further afield.

It’s expected policing will be stepped up in the area too, as the centre prepares to open its doors.

Said Geoghegan:

There is a policing element to this, and my understanding is there will be a strong policing plan with resources to support this initiative – so I hope and I think in that regard that it will be a benefit to the local community.

I do believe there is an inevitable concentration in city centres, people that are homeless and drug users and people that are in the street do get drawn into the city centre – it’s not a phenomenon that’s unique to Dublin.

And I do believe there should be some quid pro quo then – you do need to have a concentration of services where there is a concentration of your target group.

And yes, I recognise that does impact on our neighbours… If we, as the State, are asking people to bear this then there should be resources put in to counterbalance that.

So that is in the form of policing – that there would be enhanced policing in the area.

I would expect that there would be enhanced services from the local authority in terms of street lighting, street cleaning, all those sort of things as well.

And the same from the HSE. I would expect to be able to get coherent pathways into mental health services and into other services – because without those supports it’s not going to really work.

Clients using the centre, which will be based at the Riverbank, will use a separate entry and exit point, he explained.

If someone is using our counselling services or other services they will go in the main door – but if they want to use the injection centre they have to go in another door.

Once inside, the intending drug user will be asked to give a name and to answer some other basic questions (the name given doesn’t have to be a person’s actual one, but service users are asked to give the same name each time they use the facility, so the centre can keep it on record).

In the injection room itself, it’s planned there will be ten booths – including one larger booth for people with mobility issues. There will be a GP on duty 30 hours a week, and the centre will be heavily staffed with nurses and project workers to ensure clients get the interventions they need.

A number of contact rooms will be available off the main post-injection area “in case people want to see the doctor or want to see the nurse or want another intervention”.

How will the new centre be policed? 

There are already over 100 such clinics around the world (the first ‘official’ one was opened in Switzerland in 1986) and most are located in European countries. The pilot Irish injecting centre will be granted a licence to operate for 18 months, and the project will be closely monitored by the HSE throughout that period.

Questions have been raised once again in recent weeks about how gardaí should operate around the new centre – in that it’s taken for granted that people will be carrying amounts of drugs in the area, on their way to inject.

“They can look at the models in other jurisdictions,” Geoghegan said.

“My own view from talking to them is – the gardaí already make a distinction between users and dealers.

“Experienced guards – I often meet them on the street – and when they stop somebody often they’ll send them into us rather than haul them off to the station, because they know that this person is a chronic addict and really arresting them now isn’t going to do anything really.

“Equally through their own intelligence networks they have a suss on who’s dealing and who isn’t, and I think they will try and maximise that information and use it.

We currently have an agreement with the police now that they don’t stop people coming out of our needle exchange and take the injecting equipment off them, which used to happen at one stage when we first set up our needle exchange back in 1991.