In May 2017, around six years ago, the president signed legislation to allow for facilities which would provide safe places for people to inject drugs, with staff supervision.
In February 2018, the HSE selected Merchant’s Quay – a day service used by homeless people, which already operates a needle-exchange programme – to pilot the approach and open the first supervised injecting facility.
The hope is that if this were set up, fewer people would have to inject drugs on the streets, and it would prevent overdose deaths and allow health and social care workers to build connections with users to offer treatment options.
After that came four years of planning applications and objections and rejections, before the project finally got the green light in December 2022.
But last week a spokesperson for Merchant’s Quay Ireland said the charity doesn’t know when the supervised injection centre will be opening.
“We are working with the HSE to progress this project,” she said. “I don’t have any timelines for the service to be up and running.”
The HSE didn’t respond before publication to queries sent on Thursday evening about the timeline.
Or to queries about whether the new facility will be matched with more investment in rehabilitation and detox beds to meet the needs of those who may link in through the facility, and say that they want to stop taking drugs.
Back and forth and back again
In July 2019, Dublin City Council refused a planning application for the supervised injection facility following observations from local people, businesses and public representatives saying that the location was unsuitable.
Independent Councillor Cieran Perry submitted an observation saying that the evidence for injection centres from other jurisdictions is mixed and that the supervised injection centre in Sydney has a higher rate of overdose than in the community.
The council planner’s decision said among other things, that opening the centre would lead to an overconcentration of social supports in the area, undermine it as a sustainable neighbourhood and impact on tourism.
It “would undermine the existing local economy, in particular the growing tourism economy, have an injurious impact on the local residential community and its residential amenities, and would hinder the future regeneration of the area”, said the decision.
But proponents of supervised injection centres have argued that they reduce transmission of diseases and overdose risk and mean that there are fewer needles left on the streets.
“These services save people’s lives, they get people through to treatment,” said Tony Duffin, CEO of Ana Liffey Drug Project, in 2018.
Merchants Quay Ireland appealed the council’s decision to refuse planning permission to An Bord Pleanála, which granted planning permission for the facility in December 2019.
The board of management of St Audoen’s National School – which is right beside Merchants Quay – took a judicial review against An Bord Pleanála, arguing that the board’s decision hadn’t addressed the issues it had raised, regarding the impact of the facility on the school.
In 2021, the High Court set aside the granted planning permission, citing An Bord Pleanála’s “failure to properly address the school board’s submissions and to explain the reasons for which they were not accepted”.
Merchant’s Quay Ireland submitted the planning permission application again and in December 2022, An Bord Pleanála again granted permission for the facility to open – for 18 months, as a pilot.
The spokesperson for Merchant’s Quay says she doesn’t think there are any more outstanding planning issues with the project proceeding.
Is it still relevant?
A lot of the open drug use on the streets of Dublin at the moment appears to be people smoking crack, rather than injecting heroin.
The South Inner City Drugs Taskforce has reported that crack cocaine use is at a critical level in the area.
Duffin, CEO of Ana Liffey Drug Project, says that in many other cities, including Lisbon, Athens and New York, supervised injection facilities are paired with spaces for the consumption of other drugs, like crack.
But the legislation introduced here doesn’t allow for the consumption of other drugs so it won’t help to reduce the use of crack on the street.
Duffin says there could also be a major heroin shortage coming soon because in Afghanistan the Taliban is destroying opium crops. Heroin made from Afghan opium makes up 95 percent of the market in Europe, according to a June report by the BBC.
“When there is a heroin drought it’s an opportunity to get some people into treatment,” says Duffin. “However the big risk is that fentanyl enters the drug supply and people overdose.”
Fentanyl is a synthetic opioid, so it isn’t made from poppies. But fentanyl is up to 50 times stronger, according to the Centers for Disease Control and Prevention in the US.
Also, fentanyl is usually not injected.
Moving towards recovery
One major selling point about supervised injection facilities is that staff can use the opportunity to build rapport with drug users and then help those who want to stop taking drugs to do so.
Anti-homelessness campaigner Father Peter McVerry told RTÉ radio recently that every drug user reaches a point in their life when they decide they want to get off drugs.
“And when they get to that point, you have a small window of opportunity to help them, but if they go on a waiting list of three, four months or even longer, they become demoralised,” he said.
So it’s crucial that treatment options are available when people need them, he said, not months down the line.
Irene Crawley, is the manager of Hands on Peer Education (HOPE) a small community-based addictions project in the north inner-city that supports people who want to stop taking drugs.
Crawley says it is good to have methadone programmes and needle exchanges and she supports the opening of supervised injection facilities. “Harm reduction is very important,” she says. Those measures keep people alive.
However, she says it is more difficult to secure treatment options for people who want to stop taking drugs altogether. “Not everyone wishes to become drug-free,” she says. “But for those who do, they should have access to services.”
It is easy to refer someone for methadone treatment because it can be prescribed by a doctor, she says. But for detox beds and beds in rehabilitation centres, there are waiting times of between six weeks to three months, says Crawley.
The housing crisis is a serious barrier to people coming off and staying off drugs, too, she says. The person who wants to be drug-free is often living with others who use drugs. “That can be very, very challenging,” she says.
Also, for those who are homeless, there is a shortage of drug-free beds. In the US there is a lot more “sober-living” accommodation available to people coming out of rehab, says Crawley.
Here in Dublin, “there are very, very few resources to help people move into abstinence,” she says. “If people actually want to break free.”