Maureen O'Sullivan (Dublin Central, Independent)
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Gabhaim mo bhuíochas leis an gCeann Comhairle go bhfuil seans againn an t-ábhar seo a phlé. We know that people get caught up in abusing and misusing drugs and alcohol and many will be come addicted. While there is a wide range of reasons this happens, we can all agree that no one sets out to become an addict or an alcoholic. I would like to see everyone in recovery and very much support the work of the Recovery Academy, but the reality is that there are those who will stay in addiction. We need a wide range of options and services to enable and support stability and recovery. We also need to do more in terms of prevention and education but that is another day's work.

At the request of the Ana Liffey Drug Project, I hosted a meeting in the AV room in Leinster House on having a medically supervised injecting centre. It was difficult to look at someone injecting him or herself but there was no doubt it was done in a clean and safe environment. People who work in these kinds of centres told me they saw a reduction in the use of heroin, the safe disposal of drug paraphernalia, a reduction in the incidence of overdoses and other health issues being addressed. The film showed an older cohort of established drug user. I wonder about the injecting drug users we see shooting up on the streets and their chaotic lives. Will they be able to get to a centre to avail of these services?

I agree that this is a medical as well as a health issue and that medical supervision is required. These centres have been recommended as far back as 2005. The questions relate to the timeframe, because we are under pressure. We must ensure the injecting centre does not come out of the current addiction services budget, which has been pretty much decimated. Location is another issue. I know everyone will say, "Not in my back yard", but there are areas that have an abundance of services allied with private rental accommodation meaning anti-social behaviour and criminality occurs. A mobile unit was suggested and the Ana Liffey Drug Project has also made a suggestion. I acknowledge the role of the Minister of State, Deputy Aodhán Ó Ríordáin, and his availability to task forces, projects and those working in addiction and the launching of reports.

Joe Costello (Dublin Central, Labour)
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I also welcome the opportunity to discuss this issue about medically supervised injection centres. I commend the Minister of State for the way he has handled the matter to date and ask him to clarify further how it will be addressed and delivered. I have just come from the Joint Committee on Health and Children which has been discussing emerging trends and key responses to HIV in Ireland. It has been indicated that there has been a substantial increase in the incidence of HIV in recent years, in particular last year and this year. There is also a younger cohort contracting HIV in various ways, some of which have been identified. There is major concern that intravenous drug addiction and behaviour is one of the contributory factors. There is a strong view that having properly supervised injecting rooms would be effective in addressing this situation. Street injection is particularly dangerous and risky. It is engaged in by marginalised groups, individuals, homeless people and people with various difficulties and it seems it is now taking place to a greater degree than in the past.

We must address the issue in an effective manner. It is time to grasp the nettle and say that this is one way to deal with some of the problems related to drug abuse. It is not a panacea by any means. Resources are needed across the board. Other aspects must also be addressed. However, we can have safe and supervised injecting. The European Monitoring Centre for Drugs and Drug Addiction recently reported that, in areas where it has been introduced, this can be an effective way of reducing HIV and other harmful problems associated with intravenous drug addiction.

Aodhán Ó Ríordáin (Dublin North Central, Labour)
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I thank Deputies Joe Costello and Maureen O'Sullivan for raising this issue. This morning I accompanied Mr. Tony Duffin and other members of the Ana Liffey Drug Project on a walk through the streets north and south of the River Liffey for an hour and a half.

What I came across was particularly shocking. I saw drug paraphernalia, human excrement, the result of a drug user's withdrawal symptoms, blood and various other types of drug litter. What I witnessed today is still very much playing on my mind. I had been on a walk-around previously with Mr. Duffin and was very much taken aback then. I was taken aback again today by what I had witnessed. I will give the official response and we can then discuss the issue in more detail.

I thank the Deputies for raising the issue of the recognised problem of street injecting in Ireland. The establishment of supervised injecting centres has been proposed by the Ana Liffey drugs project. Such centres are essentially drug consumption rooms where drug injection is facilitated in a clinical setting under the supervision of nurses and counsellors. Service users are supplied with clean injecting kits and health care professionals are on hand to make an intervention in the event of a drug overdose. These centres save lives.

Supervised injecting centres seek to attract hard-to-reach populations of chronic injecting drug users. They are particularly effective in reaching out to marginalised groups, namely, those who use drugs on the street or in other risky and unhygienic conditions and those who have remained out of reach of or who are resistant to higher threshold services.

The Minister for Health, Deputy Leo Varadkar, and I have reviewed the evidence on supervised injecting centres and intend to submit a formal proposal to the Government before Christmas. The aim of any supervised injecting centre is to reduce the incidence of public street injecting and the negative impact it has on those who inject, in terms of their dignity, health and ability to access health and social care services, as well as on the wider community and public service providers such as gardaí and ambulance personnel. The aim is also to reduce the number of drug-related deaths resulting directly from overdoses.

No decision has yet been made on the number or location of such facilities. I intend to include additional heads in the Misuse of Drugs (Amendment) Bill to provide for supervised injecting centres. Drafting of the Bill is under way in the Office of the Parliamentary Counsel. The Bill will restore the Government's powers to make regulations to control new drugs. As Deputies will know, these powers were curtailed by the Court of Appeal judgment earlier this year. It is anticipated that the Bill will be published in early 2016 and provide for a legislative unblocking of any impediment to the introduction of medically supervised injecting centres.

I agree with Deputy Joe Costello when he says this is not a panacea. It is not the only response available to us. There are lots of overlapping concerns, including homelessness, isolation, marginalisation and disadvantage. A humane response to the issue of street injecting is to take the small cohort of very vulnerable drug users who are outside any mainstream drug programme off the streets, away from corners, bus shelters, parks and playgrounds and provide them with a safe, secure and compassionate setting where they can inject, as they will do anyway. The aim is to curtail the possibility of their contracting HIV or hepatitis C and to save lives. Nobody anywhere in the world who has injected in a medically supervised injecting centre has died of an overdose. There are 88 such centres across Europe and several in Australia and other parts of the world and they work very effectively.

I expect the legislation to be introduced in the House early next year, after which we will have to talk about management, the way any such centre would be organised, where they would be located and the funding mechanisms which would have to be put in place to run them effectively. I envisage one centre being opened in Dublin city centre initially, but representations are being made to my office to have supervised injecting centres opened in other urban centres, including Cork, Limerick, Waterford and Galway.

Maureen O'Sullivan (Dublin Central, Independent)
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The Minister of State's answer is very welcome. I still believe recovery is the ultimate goal, but, in the meantime, we need innovative strategies to deal with the people concerned, the kernel of which are compassion and dignity. I refer to the issue of detox beds and draw the Minister of State's attention to a winter strategy used in London in the 1990s. Unused office space was taken over and a floor set aside for those who were homeless and had an addiction but who wanted to embark on a detox programme. The project reached a cohort of extremely vulnerable people. The criteria for entry into a detox programme do not suit poly drug users who are homeless and who, in many cases, have mental health issues.

In terms of a timeframe, I hope the Government will not fall before the legislation is passed. This is World Aids Day and this issue is part of that bigger debate. I ask the Minister of State to verify that additional funding will be provided and that the centres will not be funded from the current drugs budget.

Joe Costello (Dublin Central, Labour)
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I am delighted that the Minister of State has stated categorically that he intends, with the Minister for Health, to submit a proposal to the Government before Christmas. That is most welcome and it is great to see some action being taken on the matter. The sooner it happens, the better. It is welcome that a provision for supervised injecting centres will be included in the Misuse of Drugs (Amendment) Bill. The Minister of State is correct in saying there are other areas of the country besides Dublin which would welcome centres of this nature and this should be taken into consideration by the Government. It must, of course, be done with public consultation because there is something of a stigma attached to drug abuse. We must ensure we treat this as a health issue rather than as something that inspires fear in communities. There is important work to be done to reassure people in this respect.

This is a very welcome development. It is certainly not a panacea and we must ensure adequate resources are put in place to make it work and that it will not affect existing resources. This is definitely a step in the right direction.

Aodhán Ó Ríordáin (Dublin North Central, Labour)
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I thank the Deputies for their support. I thank all Members of Dáil Éireann for supporting this initiative. A memo has been sent to all Departments seeking their observations which should be with us by 15 December. Upon their receipt, we will proceed with inserting the relevant section into the Misuse of Drugs (Amendment) Bill which will be presented to the House in the new year.

What I saw this morning shocked me. I saw syringes discarded dangerously on the steps of the Customs House and in alleyways. I also saw blood and human excrement. This is our city and the people concerned are citizens of this republic who are, for their own reasons and because of their vulnerability, forced into a situation where they feel they have no option but to access an area behind a dumpster to engage in this activity. We have to look at this issue from the perspective of the entire community and within it drug users who need dignity and a safe, compassionate place where they can inject heroin in a controlled way in order to take the first step on the road to recovery, safe from contracting HIV or hepatitis C and from the danger of taking an overdose. It is a compassionate response which will be welcomed by the citizens of Dublin and Ireland who are nervous about the unsightly nature of open injecting. The retailers of Dublin city are also pushing for this measure. I do not agree with the suggestion that there should be a mobile clinic because there is a better chance of developing a long-term relationship with a facility if it is located in one fixed spot. However, that is a discussion we must have after the legislation has been passed. Once the Bill has been enacted, we can get into discussions about regulation, funding, control and consultation.

I thank the Deputies for their support and hope to see an historic new section in the Misuse of Drugs (Amendment) Bill in the new year which will provide for an injecting centre in Dublin initially and perhaps, in the coming years, in other parts of the country.