Medically supervised injecting facility ‘a leap of faith’ for Dublin community

This is the twilight zone that the country’s first ever medically supervised injecting centre will operate in when it starts this week.

As detailed in the panel, it has been a long — and difficult — journey.

“When a person comes in, they’ll have to present the drugs they have, they can’t come in without the drugs,” the CEO of Merchants Quay Ireland, Eddie Mullins, says.

The building in question is the basement of the Merchants Quay Ireland offices in the Riverbank Centre on Dublin’s South Quays.

This is where the country’s first drug injecting centre is located.

Here, users can come in and inject their drugs — mainly heroin — in a safer environment under medical supervision of qualified nurses. Advice and clean equipment will be available and, if there is an overdose or other reaction, the nurses are on hand.

Drug workers are also there to support users and other assistance — whether mental health or accommodation — is available.

The aim is to bring street level, and highly public, drug use into a safer and more dignified environment.

The basement provides a legal bubble to protect both the users and the operators.

But outside, the laws of the land remain.

“There is no change to the legislation outside,” Mr Mullins says.

The law is still the law, it is still illegal to carry drugs

There had been discussion in previous years that more clarity would be needed — or, at least, desired — on how gardaí were to police the laws outside the centre.

However, that clarity does not appear to have been hammered out.

“I suppose we have an enduring relationship with the guards,” Mr Mullins says.

“They have great knowledge and understanding of the clients, and they’re not targeting vulnerable people.

“They’re trying to support them, but it will be a challenge for the guards because the law is the law.”

‘Dark corner of the city’

He says it will be largely a continuation of current practices, adding: “People who use our services every day — for needles or for crack pipes — are carrying drugs when they go in, and they’re carrying drugs when they leave. The only difference now is that they consume their heroin or cocaine on the facility.

“Before they would have left our facility, gone around the corner, and injected in a dark corner of the city.

“It’s very much a cooperation piece with the guards and ourselves. At the moment we know that, currently, people are taking drugs — and in a really dangerous, unsafe, undignified, unsanitary condition — and this is simply an opportunity to provide a bit of dignity with respect and a bit of a health-led approach to people who inject drugs.”

He says both Merchants Quay Ireland and gardaí are aware of the possibility of increased drug dealing nearby.

“I’m not convinced that the injection facility will increase the level of dealing,” he says. “It’s probably going to spook some the dealers.”

Mr Mullins says the benefit of the pilot, which has an initial lifespan of 18 months, is that it will be continually assessed with a formal HSE-led expert review after six months.

The deputy head of clinical services at  Merchants Quay Ireland, Orla Condren, shows off the equipment in the facility. Picture: Moya Nolan

“It will be a robust assessment, and I could see a series of regulations potentially coming from this to make it more certain that it currently is.”

He said the local chief superintendent and superintendent were taking a “pragmatic, practical approach” and were showing “great leadership”.

This model, which has been operating in many European cities and beyond for years, has attracted the interest of authorities in Cork and Limerick.

As far back as December 2016, the Cork Local Drugs and Alcohol Task Force has called for such a centre in the city.

The slow implementation of the pilot has meant that the original parameters of it — set down in legislation –— are now too narrow.

No longer is the problem of street drug use just centred around heroin injection. It has now morphed into a parallel, and greater, crack cocaine phenomenon.

One of the difficulties is that drug trends have changed, and crack cocaine is a very big problem

“For services like Merchants Quay, crack is the most consumed drug at the moment, no question, and [the new centre] can’t facilitate smoking — this is just an injection centre,” Mr Mullins says. 

Figures from their needle exchange/crack pipe service illustrate the growth in crack use, with the number of crack pipe kits given out rising from 11,204 in 2020 to 18,997 in 2024.

“We would now be saying that we need a facility that provides an opportunity for people who take other drugs, who are smoking drugs,” Mr Mullins says.

“We have looked at Lisbon as a good example. It started as a supervised injection facility, and now it is a consumption and supervised injection facility. They run side by side. You can’t do both in the one room. So, in Lisbon, one is the injection and the other two are consumption rooms [for smoking drugs].

“I think we’ve taken the big step with the medically supervised facility. So now it’s about modifying that — introducing legislation to allow it to become a consumption room or a consumption room in another part of the city. We certainly should be looking at that.”

Eddie Mullins is aware that there are still ‘fundamental objections’ from the local community to the facility. Picture: Moya Nolan

Mr Mullins feels that they have a better relationship with the local community, including St Audoen’s National School, than before.

“They still have fundamental objections,” he says.

“Their focus has been about the children. They know this area has been ravaged by addiction, and they are not opposed to helping people. Their opposition was about ‘is this going to make it an even bigger problem?’.

“Now, there’s an approach of ‘lets see what the outcomes are and, if there are issues, let us address them’.”

Mr Mullins, a former prison governor, took over as CEO in August 2023 from Paula Byrne — who had been there since October 2018. She in turn replaced Tony Geoghegan, who had been at the helm for almost 30 years. Both of them did a lot of the hard work to make the pilot to reality.

The pilot will operate seven days a week, between 8.30am-7pm (closing in the middle of day) from Monday to Friday and between 10-5pm on Saturday and Sunday.

“We don’t believe it will run at capacity, it will take time for clients to build up some trust in it,” Mr Mullins says.

Some clients will be reluctant, scared, or nervous

He says for everyone — clients, gardaí, and the local community — it is a bit of stepping into the unknown.

“It’s a leap of faith.”

Long and winding road for injecting centre

• In 2005, Ireland’s National Advisory Committee on Drugs recommends injecting rooms be considered — particularly for homeless heroin users — suggesting they might allow more hygienic practices and reduce overdoses;
• A 2010 report by the European Drugs Agency says consumption rooms improve drug users’ access to health and social care and reduced public drug use.
• It said there were over 90 such rooms across the world;
• In 2012, the Ana Liffey Drug Project begins campaigning for a supervised injecting centre (SIC);
• May 2015: Aodhán Ó Ríordáin, the minister of state in the departments of health and justice, tells the Irish Examiner and Dublin radio that he wants to bring in a supervised injecting centre;
• December 2015: Mr Ó Ríordáin says he would be introducing a Misuse of Drugs Bill, containing provisions for a supervised injecting centre;
• December 2016: Cabinet formally backs a pilot centre in Dublin city centre;
• February 2017: Misuse of Drugs (Supervised Injecting Facilities) Bill 2017 passes;
• August 2017: Government publishes tender for the pilot to run for 18 months, with review after six months, and operate by means of a licence granted by the Department of Health;
• November 2017: HSE is due to choose the successful bidder for the pilot facility on November 1, but announces it will not be made until December.
• It remains unclear if planning permission will be needed at this point;
• February 2018: Merchants Quay Ireland (MQI) is awarded the contract by the Department of Health to run a pilot medically supervised injecting facility (MSIF).
• It emerges that planning permission will have to be sought;
• July 2019: Dublin City Council refuses planning permission for the proposed facility — a 387sq m basement — at its main offices at Riverbank, along the south quays;
• December 2019: An Bord Pleanála’s overturns the council decision. The board’s own inspector acknowledges the high level of opposition and the high level of complaints that public drug use, anti-social behaviour, and criminal behaviour is occurring daily around Merchants Quay Ireland’s existing facility;
• February 2020: St Audoen’s National School, Cook St, brings a High Court challenge to the board’s permission;
• July 2021: High Court halts the facility and directs the case back to An Bord Pleanála for reconsideration. The court says the board has not engaged adequately with the school’s concerns;
• December 2022: An Bord Pleanála grants planning permission for the pilot facility;
• 2023: HSE has to renegotiate building contract and secure budget;
• December 2024: The facility starts.