Mr. Tony Duffin:

Deputy Durkan raised the Swiss model, registration and the double dosing. In Switzerland, if we are talking about the same matter, there is diamorphine prescribing and heroin assisted treatment. We are not talking about that here and I would not envisage the double dosing being a problem.

I would agree with Mr. Kennedy on the Health Research Board. We have fantastic statistics from the drug-related death index from 2013 and we hope to have the 2014 statistics as soon as possible.

Obviously, professional accountability will be important. The licensing will take that into account as well. Insurances will need to be in place. People will inject themselves. People will not be injecting other people - that kind of thing will not be happening. The standards that Mr. Kennedy mentioned in his opening statement are in place and will be adapted and expanded upon to include new service provision such as this.

In terms of this issue of recovery and moving away from drug use, first, one cannot rehabilitate somebody who is dead. We have to keep people alive and, ideally, as well as they can be. It is difficult when somebody has HIV, hepatitis C, damaged veins and all sorts of complex health problems to motivate him or her. Such people do not see the point. If we can keep them as healthy as we can while they are in their drug use and keep them alive, then where there is life there is hope. I would strongly advocate that side of things.

The European drug report from the European Monitoring Centre for Drugs and Drug Addiction is clear that one gets people through to treatment and rehabilitation faster than otherwise where one has these services. If we leave people down alleyways, there is little option for intervention and for building a therapeutic relationship.

On the issue of the Temple Bar letter, signed by the Temple Bar Company, the Restaurant Association of Ireland and the Licensed Vintners Association, the Ana Liffey Drug Project and Merchant's Quay Ireland had a seminar last week. We invited a wide range of people, including Deputies and Senators and local stakeholders. Representatives from that group were there. We had a healthy discussion. Profession Catherine Comiskey presented the latest information, which I can share with the committee. I have the presentation here. I hope that people heard what was said because at the presentation Professor Comiskey was very clear about how well these services work and achieve what they are established to achieve.

Deputy O'Connell mentioned attracting people to the area. The evidence is quite clear that when these services are set up it is in an area where there is a problem of public injecting and as a consequence it is already meeting the needs of an established cohort of people and the honeypot effect does not happen. The service works very closely with the Garda to ensure that drug dealing does not take place. We already have drug services in the city centre. I do not really envisage the policing of this to be much different from how we currently police the situation. The difference will be that people within that service will be safer and able to inject themselves with the drugs that they bring to the service.

In response to Senator Ó Ríordáin, it is not just death that is real for people. It is like a war torn city for some people. We do not like to use words such as junkies and zombies. People who use them almost dehumanise the person in order to justify what they do to that group. They are very unwell people. The staff who work for me, such as the nurses, say that when people come in and take off their shirts they can see the scars and vein damage. We know about the referrals made to accident and emergency departments and to hospital where people have chronic illnesses. I know two people in the city who have necrotic legs. The leg is dead, maggots are crawling out of it. They can still walk around because they are addicted to heroin which is the most powerful of pain relievers. When they come in the nurse cleans them up and they go on their way. While the nurse is cleaning them up they swear and abuse the staff because they have mental health issues but those on the team are so good they just keep going. They are incredible. That is the kind of thing we are dealing with. We have a cohort of people who are groin injectors. That is risky behaviour. A study by the Maudsley in the UK on groin injecting found that everybody in that study had deep vein thrombosis. That is a very serious health problem. Unfortunately, I have found people dead and many of my colleagues have. We know people and work closely with them and we care for them. We would not be human if we did not. It is very very sad. It is hard to describe what it is like to come in and find that someone who is significantly younger than me has died prematurely and would probably still be alive if he or she had been in an injecting room at that time because no one has ever died in an injecting service, across the globe. The one that strikes me most is a 21 year old that I and a colleague found some years ago in the bed, her needle still sticking out of her arm, in a homeless hostel. A colleague from Crosscare said at the meeting last week that if there had been an injecting room in that hostel, where people who inject lived, that young woman would probably still be alive. Those things sit with one for a long time and never leave one.