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Injecting reality into drugs debate

06 Nov 2015

Dara Gantly applauds Minister Aodhán Ó Ríordáin’s call for a cultural shift in drug treatment.

It’s not every day that a lecture at the London School of Economics (LSE) makes headline news this side of the water. But when an Irish Minister of State uses the opportunity to state that the introduction of medically supervised injection centre for intravenous drug users would be one of his key aims for his remaining time in office, then expect us journalists to take note (see news report).

Speaking at the LSE’s IDEAS Forum earlier this week (November 2), Minister of State with responsibility for the National Drugs Strategy, Aodhán Ó Ríordáin, said a supervised injecting centre would not be a “free for all” for those who wanted to use drugs, but would be based on models operating elsewhere in Europe and in Sydney. Such a facility would be a clinical, controlled environment aimed at engaging a hard-to-reach population of drug user, where defined pathways could be provided to higher threshold treatment services such as medical and social interventions and counselling services.

The Minister has been clear in his desire to shift away from the ‘war on drugs’ mentality and implement an evidence-based, progressive drug policy here in Ireland. He has spoken openly of his support for these injecting centres and has started a dialogue on decriminalisation. Personally, the Minister is in favour of a decriminalisation model, but it must be one that “suits the Irish context and be evidence based”. That may well prove a bridge too far for some.

In the second part of the event in London, eminent experts Prof John Strang of King’s College London and Prof Virginia Berridge of the London School of Hygiene and Tropical Medicine led discussions on shifting the drug policy debate in the UK.

Britain has been reluctant to integrate new public health models, such as medically supervised injecting centres and heroin-assisted treatment into its national response to drugs. This is despite an ever growing body of evidence around their efficacy in minimising the impact and costs of drug use on society, including preventing HIV transmission, overdose deaths, crime and other social harms.

Leading up to the 2016 United Nations General Assembly Special Session on Drugs, the LSE has established itself as the leading voice by highlighting the failures of global drug policies over the past 40 years and examining alternative policy routes. In 2014, the LSE IDEAS International Drug Policy Project (IDPP) published its ‘Ending the Drug Wars’ report, which concluded: “It is time to end the ‘war on drugs’ and massively redirect resources towards effective evidence-based policies underpinned by rigorous economic analysis.”

Commenting on this week’s event, IDPP Coordinator and TCD graduate Dr John Collins said that the recent leak of a UN Office on Drugs and Crime (UNODC) document, which explicitly highlighted the ineffectiveness of, and the damage caused by, criminalising people who used drugs, showed the timeliness of a workshop aimed at charting new drug strategies in Ireland and the UK.

Pic: Getty Images

“In Ireland we’ve seen the emergence of a mature and evidence-oriented discussion that avoids much of the rhetoric and scaremongering that characterised the rush to repressive policies in the past. The creation of medically supervised injecting centres would be a step forward for Irish drug policies,” said the Dublin-born expert.

There is indeed growing support for a more liberal approach to drug misuse. You may recall that back in May, draft legislation for the introduction of medically supervised injection units was presented to Minister Ó Ríordáin by the Bar Council of Ireland’s pro bono programme, the Voluntary Assistance Scheme (VAS).

Since 2012, the Ana Liffey Drug Project has been lobbying for the introduction of injecting centres where they are needed in Ireland. It says medically supervised injection centres are already used in more than 90 countries around the world, and have been proven to assist in the reduction of crime, anti-social behaviour and public injecting.

Its Director Tony Duffin was also in London this week for the LSE conference, and welcomed the interest being shown in this area by the Minister and the international drug policy community. However, he was conscious that a General Election was looming back in Ireland. “In this regard, I call on all parties and independents to prioritise addressing Ireland’s drug problems by committing to implementing empathic, evidenced and effective drug policies like medically supervised injecting centres.”

Minister Ó Ríordáin is to be commended for bringing this issue to the top of Ireland’s drug policy agenda. But it is something that you might expect from a former teacher and principal working in Dublin’s North Inner City. He is obviously acutely aware of the devastating consequences of drug abuse for those using drugs, their families and the wider community as a whole.

The Minister accepts that Ireland has a problem with street injecting, particularly in Dublin. Looking out from IMT’s offices in Dublin 8, we have to agree. These drug users are indeed at increased risk of overdose and blood-borne disease infections, and the general public is also at risk owing to the unsafe disposal of syringes.

I don’t think many people would view a medically supervised injecting centre as being the answer to the drug problem, but it could form part of a suite of harm-reduction measures. Certainly the drug users themselves and the public at large deserve this issue to be addressed by our politicians in a compassionate and sensitive way.


Click here to view the full article which appeared in Irish Medical Times: Opinion