Dr. Denis O'Driscoll:

I was involved in setting up the pharmacy needle exchange programme throughout the country, which was a long time ago. When we set it up, the criterion given at the time by the health services was that there were adequate needle exchange services within the greater Dublin region and other regions that had static needle exchange and outreach, such as peripatetic needle exchanges, and pharmacy needle exchanges were the lowest tier of needle exchange. When you walk into a pharmacy, you get a specific needle type and a specific syringe. It is very specific. You do not get, as the Senator suggested, a pick and mix where you can just choose what you want as a user. It is very much a low-entrance mechanism. The whole point of it when I was involved in setting it up was that it would be used only as one part of signposting. It was not intended to be a cold exchange. Patients who came in had to be signposted to services, be that a local GP service that was offering addiction support or a local centre that had a community-based project. The 100 pharmacies that were chosen are based in areas where there was a determined need and a significant waiting time for those who needed to get onto OSD programmes. That is how it was designed at the time.

There are weighings and the demand comes and goes in areas, but equally, it has to be acknowledged that the needle exchange programme in pharmacies has been very adaptive in some locations where there was no demand from, for example, intravenous drug users, IVDUs. There was a huge increase in interest from those who wanted it for Melanotan, for example, so the needle exchange pack was modified to suit them. In recent times, there has been a surge in the number of those who wanted to request it for steroid injecting and, equally, the pack is changing to suit that cohort. We are trying to make it as adaptive as possible. I appreciate that the figure of 100 sounds small in the greater scheme of things but, in fact, 100 pharmacies related to areas where zero needle exchange were being offered by HSE services at the time.