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Can medically supervised injecting centres help Dublin tackle its drug problem?

Tackling drug abuse is a live issue in every major city across the world. In recent years, how to deal with vulnerable addicts has become central to that debate.

In 2012, an academic research paper found that seven Irish people in every 1,000 were heroin users, giving the country the highest prevalence of use of the drug in the EU. Since 2014, there has also been a worrying spike in the number of cases of HIV among drug users in the capital.

It’s against that background that Aodhán Ó Ríordáin, the minister responsible for the state’s national drugs strategy, has voiced his support for medically supervised injection centres (MSICs) in urban areas.

The principle is a simple one: injecting centres advocate a “harm reduction” approach to drug use. They do not promote drug taking, but they do provide a legal, hygienic and safe environment for addicts to use drugs. They have medically trained staff onsite, and provide access to drugs education as well as health and social services.

The first official such facility was founded in Bern, Switzerland in the 1980s, and today, across the globe, 90 of them are now in operation. Only three of these – one in King’s Cross, Sydney, and two in Vancouver – are outside Europe. The rest are located across cities in Switzerland, Germany, the Netherlands, Norway, Spain and Luxembourg.

The proposals for Ireland’s first MSIC were released earlier this month. They’re the work of the Ana Liffey Drug Project, a national charity for substance users.

Public opinion is divided on the concept, with some believing an MSIC would encourage drug use. But Ó Ríordáin is confident of the benefits. Last month, he described injecting centres as “the lesser of two evils”, arguing that they would get drug taking off the streets, while also limiting personal risk factors such as overdose and disease transmission via infected needles. Another broadly accepted benefit of such facilities is that they provide a referral gateway to rehabilitation and social services to those who might not otherwise access them.

So just how successful have the existing centres – mainly set up in the 1990s and early 2000s – been? While concrete evidence is scarce, there are some promising signs.

The MSIC set up in 2001 in Sydney’s Kings Cross claims that, over a ten year period, it has dealt with 4,400 drug overdoses on site without a single fatality. There has also been an “80 per cent reduction” in ambulance call-outs to this inner city area. In Vancouver, the Insite injecting centre saw more than 400 admissions to its adjacent detox facility in 2012, with 49 per cent completing the programme.

Meanwhile, the neutral European Monitoring Centre for Drugs and Drug Addiction has this to say in its 2015 European Drug Report:

“…the benefits of providing supervised drug consumption facilities may include improvements in safe, hygienic drug use, especially among regular clients, increased access to health and social services, and reduced public drug use and associated nuisance.”

It added that there was no evidence suggested that creating such facilities increased either the frequency or incidence of drug uses, concluding:

“These services facilitate rather than delay treatment entry and do not result in higher rates of local drug-related crime.”

How effective an MSIC in Ireland’s capital might be remains to be seen. But for a city such as Dublin, it just might be an effective and helpful tool in an uphill battle.
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