Ireland’s First Medically Supervised Injection Facility: A Game Changer or a Band-Aid?

Almost a decade after its initial proposal, Ireland’s first Medically Supervised Injection Facility (MSIF) opened at Merchants Quay Ireland (MQI) in December. Six weeks into this 18-month pilot scheme, Prime Time visited the center, gathering insights from drug users, staff, and critics.

Transformative Space for Former Street Users

Brian and Aoife, who previously injected heroin on the streets of Dublin, now visit the MSIF anonymously.

“It’s the act that you do four to six times a day, and every time I’m filth, I’m a junkie, I’m worthless. To have this space, it gives you back that basic humanity and respect,” Aoife told Prime Time.

“This place is…it’s a godsend,” Brian echoed, underscoring the profound impact of the facility.

The opening of the MSIF faced significant opposition, with nearly 100 objections during the planning phase alone. Despite these challenges, the center now offers 56 hours of service per week, divided into two four-hour sessions.

Positive Impacts and Ongoing Assessments

Since its opening in December, the facility has witnessed 233 unique visitors making 836 visits. Staff have treated 15 overdoses within this period, highlighting the need for medically supervised drug use.

Aoife dreams of a cultural shift that embraces users rather than marginalizes them, emphasizing the transformative potential of the MSIF.

Evidence Supporting MSIFs

A 2018 report from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) highlights the benefits of supervised consumption facilities, including:

• Safeguarding public health by reducing drug-related harm
• Promoting safer, hygienic drug use
• Increasing access to health and social services
• Decreasing unwanted public drug use and associated nuisances

The report also notes a lack of evidence suggesting that MSIFs lead to increased drug use or higher injection frequency.

Critical Voices and Alternative Perspectives

Despite its evident benefits, not everyone is supportive of MSIFs. Cieran Perry, an Independent Dublin City Councillor, expresses concern about their role in maintaining addiction rather than addressing it.

“My main concern is that it really is just maintaining people in addiction. It’s not trying to tackle the core problem of tackling addiction,” Cllr Perry claims.

Merchants Quay Ireland (MQI), the charity operating the facility, disputes this perspective, focusing on supporting individuals who are often traumatized and in need of assistance.

CEO Eddie Mullins emphasizes the importance of providing a service to those who require support rather than disapproving of drug use itself.

Addressing Overdoses and Ensuring Safety

A primary aim of the MSIF is to reduce overdose deaths, a critical issue in Ireland where drug fatalities are four times the EU average. In 2020, Ireland recorded 322 drug-induced deaths, compared to the EU average of 22.5 deaths per million people.

Orla Condren, a nurse at MQI, explains that the facility’s medical supervision allows staff to respond quickly to potential overdoses, providing immediate oxygen therapy and naloxone if needed.

The Ongoing Challenge of Drug Paraphernalia

Prime Time’s investigation revealed that, despite the MSIF’s intent to reduce street drug paraphernalia, open drug use remains visible. The presence of numerous syringes and other paraphernalia highlights the gradual nature of change.

MQI CEO Eddie Mullins acknowledges this challenge, noting that reducing litter and open drug use will take time and consistent effort.

The Evolving Landscape of Drug Use

The landscape of drug use in Ireland has shifted since discussions about the MSIF began in 2015. Crack cocaine usage has surged, particularly among young users, leading some to advocate for supervised consumption rooms for smoking drugs as well as injecting them.

According to the Health Research Board, of new cases treated for problem drug use in 2023, 46% were for cocaine, with a 228% increase in cases involving cocaine between 2017 and 2023.

While Eddie Mullins sees the potential for MSIFs to adapt, he does not currently support the idea of providing heroin within the facility.

Managing Drug Dealing Around the Facility

Local businesses expressed concern that the MSIF could create a market for drug dealers rather than reduce drug dealing. However, Eddie Mullins asserts that the facility’s presence is unlikely to exacerbate drug selling.

“This facility, in my view, will not exacerbate in any way drug selling on the street because the people who were using the facility probably had the heroin on them in the first place. They just couldn’t inject it,” Mullins explains.

The Temple Bar Company, a business association, supports providing users with drugs to deter drug dealing in the area.

Conclusion and Future Outlook

While the MSIF is still in its early stages, it has already shown promising impacts on public health and the well-being of individuals with substance use disorders.

The government’s plans to explore mobile MSIFs in areas of need indicate a commitment to expanding these services if they prove successful.

For Aoife, the facility offers hope for a better future: “It might give me and others the space to actually re-evaluate a bit and maybe start thinking about reducing. I’m doing that at the moment.”

The road ahead remains challenging, but the MSIF at MQI represents a significant step towards tackling Ireland’s drug crisis with empathy and comprehensive support.

If you have been affected by the issues raised in this story, you can speak to someone by contacting one of the numbers at rte.ie/ie/helplines.

Conor Wilson and Isabel Perceval’s report on Ireland’s first supervised drug injection centre airs on Prime Time on 13 February on RTÉ One and RTÉ Player.

What do you think about Ireland’s first Medically Supervised Injection Facility? Share your thoughts in the comments below or join the conversation on social media using #MSIFIreland.