'Heroin, benzos, pills, cocaine ... anything goes, so we need injection centres in the city'
TONY Duffin, the director of the Ana Liffey Drug Project, has travelled to the other side of the world in his quest to bring medically supervised injection centres to Dublin.
The centres, if opened, would allow drug users to inject privately with nurses and medical staff on hand in the case of an overdose.
Such centres exist around the world and Mr Duffin recently spent time in one busy centre in Kings Cross in Sydney. The rules, he says, are strict.
"People are only allowed to inject, because that is the riskiest type of drug taking. People cannot inject others and they are not supplied with drugs," he explained.
Drug use is prolific across Dublin and the problem of open injecting is widespread.
"If you walk down any alleyway in the city you will find evidence of injecting, it's all across the city centre," he says.
"We know that there is a high instance of public injecting in Dublin. It happens when a person has nowhere to go when they feel the need to inject drugs.
"They take the opportunity to duck down an alleyway to inject themselves. Quite often people will be groin injecting and they do that because they develop a little hole in their groin that they can inject right into. It's quick but it's very dangerous - there is a mainline vein there. They do it because of the convenience but it's really problematic."
Dublin is caught in an "injecting culture", the drug worker says.
"Ireland has a poly-drug use problem but Dublin has a very specific problem with injecting. It's an injecting culture.
"Our clients will inject any drugs that they can. They inject drugs like heroin, benzos, they crush up pills and dissolve them with water, they inject cocaine.
"They inject pretty much anything that is being sold through the black market that they can possibly inject."
Depending on their habit and drugs of choice, people who are in the throes of addiction need to shoot up between four and six times a day, if not more, he explains.
The seriousness of the problem is self-evident - across the city the paraphernalia of drug taking can be found.
"There is an increased risk of overdose and an increased risk of blood-borne viruses such as HIV. Those private harms are not good for the person injecting," Mr Duffin says.
"Then you have all the public harms, with needles being discarded for people who live and work in the area - including the risk of needle stick injury.
"For tourists it gives the perception of a city that's not very safe."
Injecting yourself with illegal drugs in the open is a shame-inducing and dangerous experience, Mr Duffin explains.
"There is a lot of shame in public injecting and that shame, that need to get it done in a hurry, can mean that someone can damage their veins quickly," he adds.
Public injection strips people of their dignity and makes it more difficult for health workers and counsellors.
"If you try to ask someone who has just injected about that they might just say no because they are ashamed, but if you are in a medically-supervised injection centre then that barrier is removed," he elaborates.
The benefits of the centres, as Duffin sees them, far outweigh any challenges that will have to be overcome to establish them under Irish law.
"People who are living in areas with drug use in public will see that dramatically reduced. We'll save people's lives, we'll reduce the instances of HIV and get more people through to treatment and rehabilitation," he says.
Mr Duffin acknowledges that creating a legal framework for the centre is a challenge but he points to other jurisdictions that have surmounted this problem. The notion that Dublin's drug problem is worsening is popular but Mr Duffin believes that what has taken hold is a dispersal effect in response to efforts by gardai to clamp down on drugs.
Operations on the northside moved the problem across the Liffey. Operations on the southside pushed the problem along the quays almost to the city centre limits.
"The perception is that it is worse now but whether it's worse or not you have a serious problem," he points out.
"I understand that people may find it difficult to understand why we need to do this, they might feel that we are facilitating drug use.
"Drug use is already happening. We are not talking about making it easier for people to start taking drugs.
"This is designed for people who are well-established drug users with problems," he said.
"It has been done elsewhere and we are at least in a discussion about how we could do it now once we can get it over the line.
"We have the staff and the skills to provide medically-supervised injection centres in the Ana Liffey Project but the problem we have is that it is illegal.
"Do dealers descend on the area? No, because the guards work alongside the service to make sure that doesn't happen."
The evidence is very clear, Mr Duffin says.
"Injection centres achieve what they set out to do and the only downside to them is people's perception of them."