IRELAND’S FIRST MEDICALLY supervised injection facility (MSIF) will finally open its doors in the coming days, almost a decade after it was approved by the then-Fine Gael/Labour government.
The facility, which cost about €5 million, will provide a safe space for people to inject drugs using sterile equipment under the supervision of a nurse, as well as counselling and other support services.
The MSIF is designed to reduce the health risks associated with intravenous drug use, including overdose and the transmission of conditions such as HIV and Hepatitis C through people sharing or reusing needles.
The centre will open as an 18-month pilot initially. The opening hours are still being finalised but it will operate for 56 hours each week across all seven days.
Supervised injection facilities – which have been in operation in countries such as Portugal, Australia and Canada for years – are proven to reduce drug overdoses.
The Dublin MSIF was first proposed at Cabinet nine years ago, almost to the day, by then-Drugs Minister Aodhán Ó Ríordáin. On 15 December 2015, the Government approved the Misuse of Drugs (Amendment) Bill 2015 to allow for supervised injecting facilities.
The Bill passed through the Seanad on 10 May 2017, but the proposal was delayed due to planning objections - notably by a local primary school. Permission for construction was eventually granted in December 2022.
Building work on the facility began in June and the centre will open within the next week at Merchants Quay Ireland’s building in Dublin city centre.
Construction work at the site is almost complete but was ongoing when The Journal visited the centre on Monday. Eddie Mullins, CEO of MQI, said it will be a “mad dash” to the finish line, but the centre will open in the coming days.
The exact date is not being publicly disclosed to ensure service users’ privacy, but the centre will be open over the Christmas period including Christmas Day.
Mullins told The Journal it’s been a “long” wait to get to this point, but staff and service users are delighted to finally be at this stage.
When a person attends the MSIF, a case worker will speak to them to assess how they are and what support they need.
“We’ll also ask them to show the drugs they have. We want to be very clear – we won’t supply drugs in the centre, obviously – but we also don’t want the centre to be used as an area for dealing in drugs,” Mullins explained.
“So if a person has no drugs coming in, then they’re actually coming to try and score drugs. They’ll have to present the drugs when they come in.”
Once the person has been assessed and signs a consent form, they will be escorted to one of seven booths where they can inject their drugs. Two nurses will be on hand to supervise this process, which typically takes between 15 and 30 minutes.
The person will then be brought to an aftercare area where they will be observed for a minimum of 15 minutes to ensure they are ok post-consumption. Medical intervention will be delivered if needed.
Mullins said Dublin’s inner city has been “ravaged by addiction and drug use over many, many years”. He said most people “have a genuine sympathy for people in addiction”, but some have “legitimate concerns” about the impact of opening an MSIF.
One of the biggest concerns, he said, was “the fear that it would attract more people into the community”. However, he noted the so-called “honeypot syndrome” – when an MSIF attracts more drug users to an area – hasn’t occurred in other countries.
Mullins said he expects most of the people who will use the new facility will be those who already engage with MQI’s services.
He said the main thing that struck him from speaking to clients over the past few weeks is that a lot of people told him they are “treated like lepers”.
‘We have been treated like lepers’ – and they use the term ‘lepers’ in biblical terms – being pushed to one side.
“They can’t believe that they will have a facility, a medical facility, that will treat them with dignity and respect and a lack of judgement. So that’s a big step forward.”
Mullins said “there’s so much more to do” but the very fact the centre is finally opening shows that society is moving in the right direction, albeit “very slowly”.
A big part of getting the project over the line has been monthly stakeholder meetings where local people and businesses can discuss their concerns with MQI, the HSE, Dublin City Council and An Garda Síochána.
Mullins said there is, rightly, a public outcry over the level of road deaths in Ireland every year. As of yesterday, 167 people have been killed on Irish roads this year.
In 2021, the last year for which we have figures, 354 people died related to a drug overdose.
Mullins noted that fatal road traffic accidents are “always very emotional”, adding “there’s a real impact on society”. He said more than double that number of people die due to overdoses, but there is not the same level of media coverage or public reaction.
I don’t mean to be preachy or patronising as I say this, but we shouldn’t value one life over another. Three hundred and fifty four deaths is a horrendous figure to contemplate.
Mullins said harm reduction measures like medically supervised injection facilities, consumption rooms and needle exchanges are “proactive, positive medical interventions” that support people who take drugs and have the power to save lives.
Speaking about the new facility, Professor Eamon Keenan, the HSE’s National Clinical Lead in Addiction Services, said the MSIF “will enhance the harm reduction response for people who inject drugs” and “could be the first step on the road to recovery for someone presenting to the service”.
He said the MSIF “will also play a key role in addressing the issue of drug-related litter in public spaces and reducing the pressure on emergency services by preventing overdose deaths”.
Referring to the recent emergence of new and more potent synthetic opioids in the Irish market, Keenan said: “It is more important than ever to progress such a facility to support people who inject drugs.”
The opening of the MSIF is part of the government’s strategy to introduce a health-led response to drug and alcohol use in Ireland.
At the start of this year, the Citizens’ Assembly on Drug Use published its final report which recommended the decriminalisation of possession of drugs for personal use.
The government was still considering the report’s recommendations prior to the general election last month. During the campaign, the leaders of both Fianna Fáil and Fine Gael indicated they did not support the full decriminalisation of all drugs.
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