IRELAND IS AT a pivotal moment in its approach to drug policy, the head of Dublin’s new North Inner City Drugs and Alcohol Task Force has said.
Dr Austin O’Carroll was recently announced as the new chairperson of the reestablished task force. He has been a GP in Dublin’s inner-city since 1997 and has extensive experience in treating people impacted by addiction.
In an interview with The Journal, O’Carroll said the coming months will be crucial in terms of forming a health-led approach to drug use and addiction, as recommended by the recent Citizens’ Assembly, and making life-saving medication more widely available.
The NICDATF has been reestablished at a time when service providers and authorities in Dublin are bracing themselves for an increase in opioid use, as well as a renewed effort to deal with open drug dealing and intimidation.
Areas in the north inner city have long been “traumatised” by poverty and addiction, O’Carroll told us. He said it’s vital that people with lived experience of addiction are on the new task force to give their insights on what communities need.
“I’m a big fan of user involvement and developing user voice. The best way to address stigma is to get the voice of people who are ex-service users or present service users to explain what they need.
“I want to develop services, but also harness the existing community services.
“I do think we can work together with existing services to improve the ability to work with young people to avoid drugs, but also to work on the effect of drug use on families and to give them the support they need.
Everyone knows there is an issue with the visibility of selling drugs and the issue of intimidation in areas of poverty.
The task force was originally set up in 1997 to help areas heavily impacted by heroin use. It comprised community organisations, health boards, gardaí and relevant government departments.
In summer 2021, the Department of Health suspended the task force following a dispute over the appointment of a new chairperson. Following the publication last year of a review into “governance issues”, efforts have been made to get a new iteration up and running.
O’Carroll wasn’t involved in the previous task force but said he has engaged with former members and recognises the “huge work” they did.
The new task force is at an early stage – it’s in the process of setting up as an independent company and new members will be added in the coming weeks. Representatives of statutory agencies, local councillors and service providers will join the group, as well as at least two people with lived experience of addiction.
Once all members are in place, the task force will develop a three-year strategy. The group will oversee approximately €2.25 million in public funding for drug services in Dublin 1, 2 and 7, and also be expected to address any gaps in service provision.
Overdoses and opioids
O’Carroll said the availability of naloxone, a medication that temporarily reverses the effects of opioids, was vital in preventing deaths during a recent spike in overdoses in Dublin and Cork.
Naloxone is a prescription-only medication that is used as an antidote to temporarily reverse the effects of opioid drugs like heroin, morphine, methadone and synthetic opioids if someone overdoses.
The overdoses in recent months were caused by nitazene, a powerful synthetic opioid, which has similar effects to heroin but is much more potent. Many drug users unwittingly took nitazene, believing they had bought heroin.
O’Carroll said naloxone is “really effective” and undoubtedly saved lives during the spate of overdoses before Christmas.
“I commend the HSE and everyone involved in [rolling out the naloxone programme], they’ve done a really good job.
But I still think we need to explore means of making naloxone more widely available, including exploring the use of vending machines.
Vending machines where people can access naloxone are used in the United States in response to the massive opioid crisis there. Ireland is not at that point but any avenues that could save more lives are worth considering, O’Carroll noted.
In January the Department of Health announced that naloxone services would be extended due to the success of the programme in 2023.
O’Carroll said it’s only a matter of time before more opioids are sold here, telling us: “They’re going to arrive again, there’s no doubt.”
The Journal previously reported that the HSE, gardaí and other organisations are working behind the scenes in preparation for opioid use becoming more prevalent in Ireland.
A global heroin shortage is expected this year after the Taliban banned poppy cultivation; the vast majority of the world’s heroin comes from Afghanistan.
Countries like Myanmar have increased their poppy cultivation in a bid to capitalise on the ban, but an increase in the production and sale of synthetic opioids like nitazene is also likely.
Over €32 million worth of synthetic drugs were seized at Cork Port last month.
Citizens’ Assembly
The Citizens’ Assembly on Drug Use recently recommended that the country should adopt a health-led approach to drugs and decriminalise personal use, prompting a wider conversation on the topic.
Among its 36 recommendations is a proposal that people should be referred to health and addiction services where appropriate, rather than criminalised.
O’Carroll, who spoke at the assembly, has long-advocated for a health-led approach to drug use and addiction. He said the group’s recommendations are clear and it’s now up to the Government to act on them.
“We have the evidence, [a health-led approach] would reduce deaths,” he said, adding that the long-awaited supervised injection facility needs to open in the city as a “priority”.
The facility was first signed off on by the then-Government in 2015, but has been beset by planning issues and complaints over the last nine years. It’s on track to finally open this September, providing there are no more delays.
An Oireachtas Committee is expected to be set up in the coming weeks to examine the Citizens’ Assembly’s recommendations.
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