- Music
- 02 Feb 16
Dublin's syringe-strewn streets underline the urgent need for the introduction of medically supervised injecting rooms.
One presumes there's a reason for the CCTV camera, which monitors Dublin 2's rubbish-strewn Dawson Lane, but it's clearly not to deter the heroin addicts who use it to shoot-up.
Mushrooms and wild garlic are what the middle-classes normally go foraging for, but in an altogether grittier inner city version, less than 100 metres from the Dáil, the Director of the Ana Liffey Drug Project, Tony Duffin, has helped us find five discarded syringes; the same number of empty wraps, stained yellow by the citric acid they most likely contained; strips of blackened tinfoil; balled up antiseptic wipes; several piles of fresh human excrement, and an upturned wheelie bin to guard against both the elements - it was minus three degrees and sheeting rain last night in the capital - and observing eyes. There's a lemon skin among the detritus too, but it wasn't left by somebody who popped down there for an emergency pancake.
"If people don't have citric acid to cook their heroin up with, they use either a real lemon or one of the Jif ones," Tony Duffin explains. "With real lemon, though, you're prone to fungal infections that can cause blindness."
There is no sugar-coating the effects of addiction with Tony.
"You might notice that there are two types of needle," he explains. "The short ones are for injecting into veins, while the longer ones are for getting into the open sores on the groin that a lot of addicts develop when their veins collapse, and they have to find another way of getting the heroin into their system. Usually when you see a young man hobbling round the inner city on crutches it's from deep vein thrombosis rather than a sports injury."
There's another carpet of needles and discarded paraphernalia at the back of Hawkins House, AKA the Department of Health; and there's one to the side of Kildare Place that has TDs offices directly looking down on it. If the members of Dáil Éireann aren't aware of what's happening on their doorstep, they really ought to go to Specsavers.
"We believe that there are 400 individuals, the majority of them men, publicly injecting in Dublin," Duffin resumes. "The wheelie bin trick's a common one - they don't want to be seen, which means if they're on their own and overdose there's a real danger of them dying there. If they're with somebody, the likelihood is that they're going to share needles or water bottles, which can get contaminated with droplets of blood. Hep C lives outside the body longer than HIV, so that's the more common of the two infections.
"Another trick is to leave your needle on a window-ledge for the next time its needed. The problem being that other addicts know the trick, and will either take it for themselves or use it and put it back. When you're suffering withdrawal, any sense of 'This mightn't be good for me' goes out the window. You do what you do to get your fix."
By now you'll appreciate why Tony Duffin has been one of the loudest voices in the call for the introduction here of medically supervised injecting rooms. Thankfully, the Minister with Responsibility for Drugs, Aodhán Ó Ríordáin, is in total agreement with him.
"He came to us about medically supervised injection facilities, as opposed to the other way around, and has been very consistent in what he's said about them and about other areas of drug policy," Duffin resumes. "The concern had been, 'Will he be able to sell this to others in government?' - but on December 15 the cabinet met, had a thorough discussion and approved the additional heads for inclusion in the Misuse of Drugs (Amendment) Bill. That now paves the way for legislative drafting, and the presentation of the bill to the Dáil and the Seanad for debate. Having lobbied for medically supervised injecting centres since 2012, that was a real red letter day for us."
Duffin is confident that injecting rooms are on their way, regardless of what happens in the upcoming general election.
"I met with the Fianna Fáil spokesperson on health, Billy Kelleher, who was clearly supportive," Tony resumes. "I also gave one of my guided tours this week to the Sinn Féin Lord Mayor of Dublin, Críona Ní Dhálaigh, who's very sympathetic to the idea, as are Sinn Féin as a party. We walked a hundred yards from the Mansion House onto Dawson Lane, and found a classic injecting scenario. Aodhán Ó Ríordáin has made it known that Labour are to go even further by making the decriminalisation of drugs part of their election manifesto."
Asked whether he's had any feedback from law enforcement, the Anna Liffey man reveals that he has. "The Guards I work with understand that addiction is a health issue and that you can't police your way out of this," he says. "They have to enforce the law, but they know that treatment and rehabilitation is the greater part of the solution. We're not saying that the medically supervised centres - and I think it should be more than one, to be honest - are going to stop public injecting altogether, but they will save lives and improve the situation for all of us. The hope is that things will progress quickly, and we'll see the law changed before the summer recess, regardless of who's in power."
Duffin appeared in the pre-recorded introduction to January 11's Claire Byrne Live injecting room debate between Aodhán Ó Ríordáin, and independent Dublin city councillor, Mannix Flynn. Citing fact-based evidence from the likes of Canada and Australia, the Minister insisted that the facilities will save lives and reduce infections. Flynn dismissed the initiative as political smoke and mirrors; the councillor appeared strangely unmoved when a mother suggested that access to an injecting facility might have saved her son, who'd fatally overdosed five years earlier in a toilet.
"As with all new policies, medically supervised injecting centres have their detractors," Duffin acknowledges. "Some are morally opposed to the concept; some believe that scarce resources should be focused elsewhere; some are simply uncomfortable with progress. However, what they all have in common is that none of them addresses the evidence.
"I have yet to see a person or organisation in Ireland put forward a paper, based on the best available international evidence, which says that medically supervised injecting centres are a bad policy choice for Ireland. The reality is that the evidence points to their efficacy, and bodies like the Irish Medical Organisation have called for them to be considered. We need to move beyond anger, bluster and emotion to facts and evidence, and I would welcome anyone who wishes to engage with the debate on this level."
Duffin stresses that injecting centres are not in isolation a solution to Ireland's rampant heroin problem.
"We have a very low number of detox beds, and a difficulty with addicts meeting the criteria needed to occupy them, which also has to change - especially as evidence shows that people are quicker to access treatment through injecting centres," he concludes.
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