Merchant’s Quay Ireland – Leading the way out of addiction

Martin Cusack

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Photo: Janet Wippell (Flickr)

The recurring problems of homelessness and addiction have become increasingly visible on the streets of our cities over the last decade. With the link between crime and addiction long established, the work of experienced and dedicated rehabilitation staff is invaluable in combating these issues. Staff at dedicated centres such as Merchants Quay Ireland in Dublin have long played an important role in this battle.

The poorest and most vulnerable in our society are always most at risk in times such as these, and Merchant’s Quay provides a place where addicts and the homeless can engage with staff, get a hot meal and a shower, and avail of free medical services which can be vital to their day-to-day survival. They will also find staff who are capable of giving them the guidance and advice that they need to address their problems and find a route out of poverty or addiction and towards realising their potential in life.

Merchants Quay Ireland(MQI) have been based at Winetavern Street in Dublin 8 since 1989. While their headquarters are still located in the old Franciscan friary, this autumn will see the long-awaited opening of their new Riverbank Open Access Center, which allows MQI to bring all of their frontline services under one roof. In the past, staff were forced to improvise with what they had in sometimes cramped conditions at Winetavern Street.

However, they can now reap the benefit of vastly-improved new facilities and a much greater capacity which will allow them to maintain their essential services to the homeless and addict populations.

I spoke to Tony Geoghegan of MQI about the central role played by Merchants Quay in battling the problem of addiction:

Q: The profile of addiction is changing in today’s Ireland…. why has prescription drug addiction emerged as such a major problem over recent years?

TG: I think that obviously cost is one reason. In the past there was a large black market in methadone, mainly because any GP could prescribe it, but since the late 90s the prescription of methadone began to be regulated – this had the effect of curtailing the black market supply of methadone. Consequently, there was an increase in other drug use. Other than that affordability and cost is the main reason. Heroin is still sold in bags, usually at 20 Euros per bag, whereas prescription tablets go for anything as low as 50 cents or a Euro per tablet.

Tony Geoghegan, Merchant's Quay Ireland
Tony Geoghegan, Merchant’s Quay Ireland       Photo: Martin Cusack

Q: How will the new Riverbank Open Access Centre help you to improve the services you offer to the homeless and the addict population?

TG: Well, in terms of capacity it means we can deal with more people, which is very important since the numbers, particularly on the homeless side, have increased in recent times. Previously, when we provided meals we would have to do it in a number of sittings because we would have to try to move people on to make way for others who had been waiting. Now with the extra capacity we don’t have to do that nearly as much anymore. Our current philosophy is that unless you are able to engage with people you can’t expect any change, so we don’t just want people to come in and out of the building without engaging with them in some way. We do that through some of the low-threshold services that we provide here.

Q: At Merchant’s Quay you take a holistic approach to addiction treatment. Can you describe how you take an individual from initial engagement through the rehabilitation process?

TG: Well as you’d have seen on your tour of our crisis centre, we have people here who are at various different stages of their addiction. Quite a few people, or most of them, are currently active drug users who attend the centre every day. Some people are still in what I’d call a “honeymoon” period as regards their addiction, where they’re still using drugs and still feel as if they are in control of their addiction….so it’s very important to engage with people at all stages along the way because certainly drug use has the potential for huge harm to the individual. So by providing safer and cleaner injecting conditions here we are helping to minimise that harm as well as helping in prevention of Hepatitis and HIV and other diseases.

It’s important that everyone who comes to the centre seeking treatment has a chance to come out the other end without having contracted HIV or anything else that could impact on their lives, or even curtail their lives. So that’s our rationale here, we try to engage with people because you can’t effect change without that initial contact. At first it’s about minimising the harm that they do to themselves, and consequently their families and others.We have to accept people no matter where they are at in their lives and engage with them on that level, so that a rapport can be built up. Consequently,when they do reach a crisis point in their lives they are already engaged with you and you are able to put them on a pathway to help them move forward with their lives and move away from drugs. It is also important to say that drug addiction is not a life sentence. We have seen many people here who have become caughtup in drugs and they have been able to come out the other end and get on with life without drugs.

Q: In Portugal, the decriminalisation of drugs proved to have positive effects on society, reducing crime and improving the health of addicts etc. Could decriminalisation work here?

TG: I think it has started to happen in its own way, for instance we have the needle exchange programme here at the centre which is, obviously, sponsored by the state. We’re also involved in rehabilitation in the Irish prison service. We’re contracted to provide addiction counselling services across the 13 prisons in the state, so I think that if the root cause of someone’s criminal offending is addiction – then unless the addiction issue is addressed you really aren’t addressing the offending behaviour and the root cause of that behaviour.

Obviously there are many links between drugs and crime and for a politician to back something like that would be a gamble….after all, there wouldn’t be many votes in it for them. Overall, we have to be pragmatic, certainly the National Drug Strategy is trying to be more pragmatic by making needle exchange services available, as well as methadone programmes. The alcohol and drug strategies have been joined together now and they are looking at curtailing advertising of alcohol and the linking of alcohol and sports….so overall I think that the government does recognise the correct way forward.

 

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Martin Cusack