Thursday, 9 March 2017
Misuse of Drugs (Supervised Injecting Facilities) Bill 2017: Second Stage (Resumed)
This is a long-awaited and important Bill. I feel I am in a relay race as part of a relay team. Previous Ministers of State before me have all passed on the baton of the supervised injection facility. I acknowledge the work done by those previous Ministers of State. I also acknowledge the work of the Ana Liffey drugs project through Tony Duffin, who was the first person to mention the words "injection facility" in 2012. I acknowledge that people who have gone before me have done huge work leading to this point this afternoon. As the baton has been passed on, I will probably be the lucky one to bring it across the finishing line.
A number of words have popped out during the debate in the past few days - life saving; compassion; harm reduction; trust; and human beings. All of those words emphasise what the supervised injection centre should be all about. It should be about compassion, saving people's lives, harm reduction and most of all about treating people with respect as human beings and not just as people who for whatever reason end up in addiction and find themselves in such a chronic place that they are willing to inject on any street corner, beside a school, in a park or anywhere else. As public representatives, we have an obligation to facilitate the passage of the Bill as smoothly as we can. Hopefully before the year is out we can have the first supervised injection facility in Dublin.
Deputy Joan Collins spoke about the knowledge she has gained from working with the Canal Communities local drug task force. As we share the same constituency, we have both dealt with the same people. The Bill, as it stands, makes it clear that, like in other countries, An Garda Síochána will support supervised injecting facilities. Many gardaí, particularly those who work in Dublin's inner city and around the Merchants Quay and Ana Liffey drug projects, will know the people going into these centres. They take a pragmatic approach to how they deal with these addicts, which I hope will continue in the context of the supervised injecting centres.
Deputy Maureen O'Sullivan is the only Member who spoke about compassion. This is the most important word that can be used. It can be used lightly sometimes but if it is used with a sense of meaning or purpose, it can make all the difference to people's lives. I first came into the House when the late Tony Gregory was a Member. He represented Summerhill, an area from where my family came and I knew of his work for a long time before I ever went into politics. He was the first person ever in Ireland to raise the problems of drug addiction. He was always ahead of the posse in that regard. Deputy Maureen O'Sullivan knows as well as I do about the history of drug addiction, particularly in Dublin's inner city and poorer areas. It affected people, for whatever reason, who did not get the opportunities in life that other people did, instead finding themselves trapped in addiction and criminal activity. Unfortunately, now more young people are targeted. This is why it is important that we work in these communities to inspire and encourage young people that there is something else in life besides getting involved in crime.
Deputy Gino Kenny spoke about his knowledge of working in his area. I thank him for his support for the Bill. I thank all Deputies for their encouraging and supportive words in respect of this Bill. I note the positive comments of Deputies Jack Chambers and Jonathan O'Brien. They referred to the risks posed by street injecting and the problem of drug abuse. They also addressed the negativity and misconceptions which surround this issue. As I mentioned in my opening statement, and as was echoed by my colleagues, the Minister for Social Protection, Deputy Varadkar, and Deputies O'Connell, Harty and Billy Kelleher, there is international evidence to prove that these centres do not promote drug use, do not cause an increase in drug-related crime and do not draw drug users into an area. However, they do reduce public injecting and drug-related litter.
These centres are an attempt to address problems which already exist in local areas, regardless of whether people choose to recognise that there are such problems. The number of people using a centre will be related to the number of individuals already injecting in public spaces in an area. However, I also understand some of the concerns a number of Members, including Deputy Danny Healy-Rae, raised. International evidence shows that these centres reduce pressure on policing in areas. The legislation does not affect planning permission. International evidence proves there is no honeypot effect in that people are drawn into an area just to inject. The injecting centres will aid the distribution of naloxone, which is a life-saving intervention used for dealing with overdoses. If a person overdoses in a laneway or a park, the chances are he or she may lose his or her life. A supervised injecting centre will allow the distribution of naloxone to prevent such deaths. There have been no deaths from overdoses in any of these centres across the world.
When I visited an injecting facility in Copenhagen before Christmas, I came out of it with a heavy heart because I was saddened by what I saw. As Deputy Maureen O'Sullivan said, it is very difficult to watch people injecting themselves. However, this is reality, not a film or a dream. These are real people who, for whatever reason, find themselves consumed by addiction. They are the people we have to look after. They can no longer be statistics in newspaper reports about how someone else has passed away from an overdose. When I left the centre, I said to one of my colleagues from the Department that I would rather one of my children dying of an illness rather than being addicted to heroin or any other drug. While I know it is a terrible thing to say, that is the reality of this cruel life of addiction. I have met many people in my community whose children and grandchildren have lost their lives to drug addiction and I know of grandparents and other family members who have been left to rear very young children. The funeral of someone who has died from an overdose is disturbing for all involved.
I met service users at the Copenhagen centre before Christmas who had been using drugs on the streets for decades. It was very sad to see, but the message from those people was clear to me, namely, that the centre is saving their lives. It is their lifeline and it provides a sanctuary for them when they have nothing else. The police in the city noted how the centres have actually freed up police and ambulance resources. There are statistics which show that overdose call-outs for ambulances have been reduced by up to 80% of because of these centres.
An injecting centre does not prevent people from choosing to stop taking drugs. Neither does it stop them from engaging with treatment. It provides a chance for people to build up a level of trust with the staff working there. When they are ready, they can then access health and other services and eventually treatment. It offers another chance for these drug users.
This Bill does not provide the location for an injecting centre. However, it is planned that the first centre will be a pilot service. This will be located in Dublin city centre where we know there is a problem with public injecting and the harm it causes to people. However, this pilot cannot be set up as the law currently stands. That is why we need this legislation. I have asked the Health Service Executive, HSE, to set up a working group that will identify the practical issues relating to setting up a pilot service. It includes representatives from the Garda Síochána, the Department of Health, the HSE, Dublin City Council and the service users group, Union for Improved Services Communication and Education, UISCE. The working group will report back to the HSE with recommendations on programme design, consultation, governance structures and the ongoing monitoring and evaluation of the pilot service. The HSE will be undertaking a process of consultation, including with local stakeholders and communities. In other countries, there were apprehensions in the communities where these centres were located at the beginning. If such centres are run well and properly, there is nothing for the wider community to fear.
Any decision on the exact location will be informed by the outcome of this process. In line with the experience in other countries, it is expected that the location will be carefully selected to address the requirements and concerns of service users and the wider community. This pilot service will be evaluated to determine the safety, cost-effectiveness and the benefit of an injecting centre. The results of this pilot project will inform any decisions about future injecting centres.
I agree with suggestions that practical policing is required. The Garda has acknowledged that it has a responsibility to play an appropriate role in ensuring that any injecting centres operate as intended and that the harm-reduction objectives are achieved. The Garda is engaged with, and will continue to be involved with, all steps in the process relating to the opening and running of injecting centres.
I heard a radio interview by chance the other day involving a young garda on the beat being interviewed by a reporter. The garda had come upon a person who was injecting openly in a laneway. I was struck by what the garda said afterwards. He had to arrest the person and he said that, please God, when the injecting facility opens, it may help people like that poor lad who was injecting in the laneway. He said he had no option at the time but to take him in. The success of any injecting centre will be dependent on the engagement and co-operation of the Garda, health care professionals, local stakeholders and the wider community.
To address a matter raised by Deputy Harty about naloxone, a drug used in saving people in the event of an overdose, the HSE ran a very successful naloxone demonstration project in 2015. It helped to prevent five potentially fatal overdoses. Injecting centres will further help to get naloxone to those who need it to prevent further deaths.
The aims of any injecting centre in Ireland will be to reduce the amount of public injecting; to reduce drug related litter and the public health risks that it poses to the wider community; to reduce the number of drug related deaths resulting directly from an overdose on our streets; to enhance the dignity, health and well-being of people who inject drugs and provide them an opportunity to access health and other services; and to enhance the public amenity for the wider community where public injecting currently happens. The evidence is there. It is very strong. The alternative is to continue as we are and that is not working. People are dying on our streets. This Bill is not the solution to our drugs problem but it is a start to help those who are worst affected by drugs and drug addiction. There is a lot of hard work still to be done, but I am encouraged by the support, goodwill and positive comments of so many Deputies from across the House.
I again thank all those who contributed and participated in the debate. I hope the Bill will have a smooth passage to Committee Stage and that it will progress as soon as possible. I emphasise the input of members of all parties and those who are not members of parties in bringing this Bill to the House. I also acknowledge the input of successive Ministers who passed the baton to me.
If the Acting Chairman will indulge me, I would like to read from a poem as it is relevant to this debate. It is a small poem I came across a few years ago. I will read two verses of it as it sums up the people with whom we are dealing in this legislation. I know that the Chair would not normally allow a Member to read from a book but I ask for the Acting Chairman's indulgence in this instance. It is a simple poem about an addict:
In the beginning
I was drawn to the sweet perfume
Of distant desires
Now I know its fire
Burning deep inside
The unquenchable thirst
The brutal hurt.
I know the lonely heart
Not my own
But of those who stand watching
From separate shores,
Who wanted more
For me and now
I've gone too far.
Those verses are basically saying that these people know in their own minds that life has been a turmoil for them and an ultimate goal for them to reach is to be drug free and to begin life anew on a new journey. Another verse of the poem states:
Once filled by painful pride
May You now hide
To life anew
The words "Opening doors" in second last line of that verse signify what we are doing here. I thank all the Deputies in the Chamber and my own party colleagues, and also the Ceann Comhairle and the Acting Chairman for allowing me the time to say those few words.
I had better not sit down without thanking the officials who basically are the brains behind this legislation. The work tirelessly in their office in the Department and they have been truly amazing in recent months in putting the Bill together. I want particularly to thank Eugene and Eamon.