Frequently Asked Questions

What is a Medically Supervised Injecting Facility (MSIF)?

An MSIF is a clean, safe, medically supervised service for people who inject drugs. As a compassionate, person-centred healthcare environment, which respects the dignity of service users, the MSIF is a vital first step in reducing harm and supporting a person towards recovery.

What is the latest update on the MSIF?

In December 2019, An Bord Pleanála granted planning permission to MQI for the reconfiguration of our Riverbank Centre to provide for a medically supervised injecting facility (MSIF). Leave to apply for a Judicial Review of the decision by An Bord Pleanála was granted by the High Court in February 2020.

This Judicial Review took place in June 2021 and in November 2021, Judge Simons overturned the planning permission decision and ordered that the matter be remitted back to An Bord Pleanála for further consideration.

MQI, while disappointed, remains committed to the opening of an MSIF as part of a health-led approach to addiction. There is a clear need for this facility as it saves lives.

MQI will engage with An Bord Pleanála in the hope that a new Grant of Planning Permission will be issued next year, which will be acceptable to all parties.

Why do we need the MSIF now?

Ireland has a significant and growing drug issue. In addition, there is an acute housing crisis. Both of these challenges are at their most severe in Dublin. Unfortunately, the issues of drugs and homelessness have become enmeshed with the result that more vulnerable people are visible on our streets. One of the consequences of this interplay between drugs and homelessness is that public injection and drug litter have become an increasingly common occurrence. Alongside this, Ireland continues to have one of the highest rates of drug-related deaths in Europe. The MSIF aims to reduce drug-related deaths, reduce the risk of disease transmission, and connect the most vulnerable and marginalised people with treatment and healthcare services. In addition, research from MSIFs internationally shows a decrease in public injecting and drug-related litter.

Why the Riverbank Centre? Are there too many services for people who use drugs in Dublin 8?

One of the main goals of this facility is to provide an opportunity for health interventions in a marginalised community. At Merchants Quay Ireland, we already provide a wide range of primary health care services and our best hope of effective intervention is by having these services all in one place, alongside the Medically Supervised Injecting Facility.

Has there been an MSIF built before?

The first MSIF opened in Switzerland in 1986, and to date, there are over 100 similar facilities around the world. The MSIF at Merchants Quay Ireland will be a pilot project, and as such, the first in Ireland.

What will the governance structure for the MSIF be?

There will be several levels of governance.

Merchants Quay Ireland will establish an Operational Governance Committee, to oversee the management of the facility from a practical day-to-day point of view, providing for communication, consultation, and cooperation regarding operational matters. Merchants Quay Ireland will also establish a Medical Clinical Governance Committee to address clinical governance issues in line with best medical and social care practice.  Alongside these, a Monitoring Oversight Committee will be established. This committee will be chaired by Dr Eamon Keenan, National Clinical Lead, HSE Addiction Services on behalf of the HSE, and its membership will include representatives from the Gardaí, local authority and other experts.

Who is funding the MSIF?

The MSIF will be fully funded by the HSE.

Will the MSIF be run by Merchants Quay Ireland or the HSE?

The MSIF will be licensed by the Minister for Health, but operationally run by Merchants Quay Ireland. It is an 18-month pilot project, which will be closely monitored and evaluated at the 6-month point.

Will you be supplying drugs to use?

No.

What drugs will people be using at the centre?

The MSIF is specifically for people who are injecting drugs. No smoking or other drug-taking will be permitted.  Current drug trends indicate that people who will use the MSIF are most likely to inject opiates (e.g. heroin) and/or cocaine.

Does access to an MSIF encourage or normalise drug use?

No. The service does not promote drug use. The service seeks to reduce harm and drug-related overdose deaths and connect people with treatment services and other health and social services.

What will the opening hours be?

It is planned that the MSIF will be open 6 am-10 am, 2.30 pm-5.30 pm, and 7 pm-9.30 pm on Monday to Friday. On Saturday and Sunday, the planned opening hours will be 6 am-10 am and 3.30 pm-9 pm.

What other services do you have at Merchants Quay Ireland?

At our Riverbank Centre, we provide a wide range of homeless, primary healthcare, and drug services. Our drop-in, Night Café (as it is currently located) and extended day services offer meals, crisis support, information, advice and assistance to people who are homeless and rough sleepers. Our primary healthcare facility includes a GP service, nursing, mental health services, dental services, chiropody, and counselling. At Riverbank, we also have a Health Promotion Unit (HPU), which provides people who use drugs with information about the risks associated with drug use and the means to minimise such risks. We also offer people who use drugs a pathway into treatment and the possibility of living life without drugs.

Can someone who is a first-time drug user access this service?

In line with current MQI practice and policy, first-time drug users will be admitted to the MSIF subject to a robust assessment and induction process. They will also be offered a safer injecting information intervention and linked with the full range of drug treatment services.

Will people who are pregnant be allowed to access the MSIF?

Pregnant people who are injecting drug users are a very vulnerable group and will require specific support.  This group will not be excluded from the service, and we will have a dedicated staff member with expertise in this area. We will obviously be reviewing this prior to opening and ensuring that our own practice is in line with current Irish legislation and international best practices. We, of course, are aware of our responsibilities under the Children First Act 2015 and will act in accordance with these.

87% of drug MSIFs internationally do allow pregnant people to use their services[i]. We will also be seeking guidance from the HSE, TUSLA as well as discussions with MSIFs internationally.

[i] Belackova, V., Salmon, A. M., Schatz, E., Jauncey, M. (2017). Online census of Drug Consumption Rooms (DCRs) as a setting to address HCV: current practice and future capacity, Amsterdam, Sydney: International Network of Drug Consumption Rooms, Correlation Network, Uniting Medically Supervised Injecting Centre p18

Will children be allowed in the facility?

No.

Why is the HSE investing money in an MSIF, which could be invested in more detox and rehab beds?

This isn’t an ‘either or’ situation. In Ireland, there are two people dying every day from a drug-related cause. People can only be rehabilitated if they are alive, and the MSIF is proven to save lives. It is a vital first step in engaging hard-to-reach, often excluded, injecting drug users in the continuum of drug treatment and healthcare services. Furthermore, by promoting safer injecting practices, the MSIF reduces the risk of harm to people when they are at their most vulnerable.

Merchants Quay Ireland currently provides 10 medically supervised residential detox beds and 26 residential drug-free rehabilitation beds. We would like to see more investment in those services. However, we believe there also is an urgent need to reduce the number of overdoses in Ireland, as well as address the significant health risks that result from unsafe injecting.

Will service users be charged to access the MSIF?

No.

How many people will be at the MSIF at one time – in the queue, in the waiting room, in use, in the observation?

The MSIF will have space for approx. 30 clients in the queue area, 15 in the assessment/waiting area, 7 in the Injection room and 20 in Aftercare. We estimate that around 60-100 clients will access the MSIF each day.

What happens to people once they leave the MSIF? Where will they go?

People who use the MSIF are able to use the other MQI services including our drop-in and holistic support services. Our Community Engagement team will work proactively with clients and the local community to mitigate against loitering and anti-social behaviour in the local area.

What about the primary school beside MQI – how will it impact the children there?

We fully appreciate the concerns raised by staff and parents of children at St. Audeon’s National School. No one wants children exposed to the sight of drug use and drug litter. We believe that the MSIF can provide an effective response to the concerns raised. Research from MSIFs abroad has shown a reduction in public injecting and drug litter. We are keen to maintain a dialogue with St. Audoen’s, as we are with all those living, working or studying in the Merchant’s Quay area, to ensure that the MSIF benefits everyone.

Does this mean that there will be more drug dealers and drug litter in the area?

The evidence from other countries shows that MSIFs do not increase drug use, drug dealing, or crime in the areas in which they are located. This is largely because they are located in areas where injecting is already occurring in public spaces.

One of the aims of the MSIF is to reduce the level of drug litter in the area currently, and international experience suggests this will be one outcome of the service. In Sydney, public injecting and injection-related litter was reduced by half following the opening of the MSIF, while in Barcelona the area surrounding the MSIF saw a fourfold decrease in the number of unsafely disposed syringes being collected in the vicinity.

How can I get in touch with MQI about the MSIF?

Merchants Quay Ireland will work to ensure that a dialogue is maintained with businesses and residents in the area. We do not anticipate any increase in anti-social or illegal behaviour. In line with our commitment as part of securing the MSIF licence, we will be establishing a Community Consultation Committee, which will provide local businesses and residents with the opportunity to give feedback on the impact of our services. We are also expanding our Community Engagement Team. The Team currently work weekdays 7 am to 7 pm and can be reached on 086 17441404.

When is the MSIF expected to open?

In December 2019, An Bord Pleanála granted planning permission to MQI for the reconfiguration of our Riverbank Centre to provide for a medically supervised injecting facility (MSIF). Leave to apply for a Judicial Review of the decision by An Bord Pleanála was granted by the High Court in February 2020.

This Judicial Review took place in June 2021 and in November 2021, Judge Simons overturned the planning permission decision and ordered that the matter be remitted back to An Bord Pleanála for further consideration.

MQI, while disappointed, remains committed to the opening of an MSIF as part of a health-led approach to addiction. There is a clear need for this facility as it saves lives.

MQI will engage with An Bord Pleanála in the hope that a new Grant of Planning Permission will be issued next year, which will be acceptable to all parties.

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