Ireland Takes Steps Toward First Drug Consumption Room

Insite medically supervised injection centre

Insite medically supervised injection center, Vancouver

Momentum is growing toward Ireland's first ever medically supervised injecting center (MSIC) being put in place in what would be a vital addition to harm reduction services in the country.

The Ana Liffey Drug Project (ALDP) has been working in collaboration with the Voluntary Assistance Scheme at the Bar Council of Ireland since last summer on legislation that would make the opening of an MSIC permissible in the capital Dublin. It is currently illegal under the 1977 Misuse of Drugs Act.

ALDP Director Tony Duffin told TalkingDrugs via email that he hopes to have draft legislation ready by the end of March this year, adding that the ALDP is “actively engaging with people, including politicians, around the proposed legislation, and the climate [for an MSIC] now is certainly more receptive than it was a number of years ago." 

MSICs are professional healthcare facilities that provide drug users with a space to use in safer, more hygienic conditions. Switzerland opened the world's first such center in 1986, and has been followed by other countries including the Netherlands, Spain, Canada, Australia and Denmark. Not only do these centers help tackle the rate of HIV and other blood-borne viruses among injecting drug users (IDUs) -- from 1993-2006 new cases of HIV among IDUs in Switzerland fell from 498 to 61 -- they virtually eliminate the risk of fatal overdose; in Canada's MSIC in Vancouver (opened in 2003), there has never been an overdose death, for example. 

As part of its two-year strategic plan (2015-17) the ALDP is also looking to secure the introduction of a Low Threshold Residential Stabilization Service (LTRSS) to ensure that the issue of problematic drug use is tackled on all fronts. One person dies per day from an overdose in Ireland, the third highest level of overdose deaths per capita in Europe.

As Duffin noted: "Drug use is not going to go away -- it's a problem to be managed, not solved."

Evidence is what the ALDP is counting on to push its goals forward, with Duffin pointing out that, “The provision of an MSIC is an evidence-based intervention which will help address some of issues Dublin faces -- public injecting and unsafe disposal -- and I think there’s a growing recognition of this”.

After coming through a particularly difficult period in terms of funding, partly as a result of the economic downturn, the ALDP is currently “in the process of developing a dedicated fundraising function” that, according to its director, should allow the progress of both LTRSS and MSIC thanks to the amenability of both to receiving funding from different sources. 

Regardless of the legislative and economic implications behind the opening of a medically supervised injecting center, what remains is the skepticism among Dubliners. Despite some mixed reactions to the MSIC proposal, Duffin is confident that the time is ripe for change:

“I believe there’s been a shift in recent times towards thinking it’s a good idea. A number of the business groups in the city center are lending support, which is significant. Politicians and statutory stakeholders are also open to progressing the issue. There’s always a natural amount of skepticism when people first hear the idea, because it’s not intuitive. However, we should establish services on evidence, not intuition, and the evidence behind MSICs as something which could help in Dublin is strong."

These are still early days, but the first steps the ALDP has taken toward improving Irish harm reduction programs and the lives of people suffering from problematic use offer strong signs of encouragement.