Mr. Mark Kennedy:

Deputy Durkan asked where did we got the information on the number of drug deaths and how the information is broken down or classified. The Health Research Board has provided the information for the past ten or 11 years. Each year the data has shown that there are 600 drug deaths of which 300 to 350 are overdose related deaths. The data is broken down into age, gender and the substances used or the groups of substances used.

The big offenders are alcohol, methadone, opiates and benzodiazepines in combination. That information is gathered from the coroner's data.

I was asked the countries that are up at the top in terms of drug deaths - it would be a terrible way to look at it. We know what works in terms of preventing drug deaths. Certainly, having a national overdose prevention strategy, which would be multifaceted and would include measures such as injecting rooms and the provision of naloxone in the context of a multi-agency multi-disciplinary care plan for each individual, is something that works. There is no one thing that can be applied to all people.

In terms of trying to put a human face on it, those who I would know who have recovered and come through their own journeys with drug use all have a particular thing that worked for them. Sometimes it was getting a job. Sometimes it was getting into college or getting an education. Sometimes methadone helped them. There was family support involved. There can be dozens and dozens of contributing factors. We would see people who are in our services for many years and they do not show an inclination to change, but there often is a window which opens up. Generally, people do not want to be in this chaotic drug fuelled life, but a window opens and they say, "Look, that's it. I want to go in and detox.", or "I want to address my drug use." For us, as services, it is about being able to jump on that, seize that opportunity and be able to put options in front of people very quickly. From the evidence available, this medically supervised injecting centre is well positioned to do just that. There is this concept of the teachable moment where a person may overdose and medical staff can intervene to save the person's life and are then able to say: "Look, you nearly died. Here are the treatment options that would be available to you."

In terms of professional accountability, another point that Deputy Durkan raised, services in Ireland that are commissioned now come with a service level agreement. Often these are policed by agencies, such as the local authority or the HSE. Any provider that would apply or be granted a licence would have to sign up to a service level agreement. This would insist on compliance with all of the legislation, including safety legislation, ensuring that there are competent professional staff delivering the services, that the governance is in place, and that the service would be open to audit and would be accountable for its outcomes. Deputy O'Rourke asked when would be the appropriate time to audit such a service. The Sydney injecting room was audited after only one year and there was considerable evidence on the efficacy of the service that was being provided.

In terms of setting up an injecting room, it would need to involve all of the local stakeholders. That would include: community groups, such as the Temple Bar group mentioned earlier, where everybody would have a say because everybody, I suppose, has his or her own priorities in terms of what he or she would want from an injecting service. Primarily, they are about saving lives but they would have to consider the justice, community and other stakeholders that would be party to such a service.

Finally, in terms of the human face of this on which Senator Ó Ríordáin asked that we might speak, it is shocking seeing an overdose and seeing somebody there dead, cold, laid out. It is a cold experience. It is shocking for the staff team which may have been working with that person for many years. For us, it would be seen as a failure. There is a grief associated with that. There is a grief that one must process with the staff team to get them back on their feet.

One has got to talk to the family. This is very difficult. One is trying to arrange the care and support for the family after the death. I have spoken to mothers for whom after many years the grief is just as alive. It never ends. Particularly when we are talking about issues like injecting rooms, one sees mothers looking at one knowing that they are wondering if that had been around when their sons died if they would they still be here today, and that is very difficult.

It is devastating. One sees it in partners of drug users, and partners' sons and daughters. It just never ends. If one has 300 to 350 people die each year in this country, that is on average one person every day. That grief just ripples through a family.