Addiction services
Health Promotion Unit
This unit provides drug users with information about the risks associated with drug use and the means to minimize such risks. MQI offers drug users a pathway into treatment and the possibility of living a life without drugs. The main focus is on reducing the harms associated with injecting drug use; fostering the motivation to become abstinent; and giving advice on HIV, hepatitis B virus, and hepatitis C virus infection prevention. In 2018, some 2,742 individuals used the service, an increase of 6% compared with 2017.
In 2018, there were 30,068 visits to the MQI needle exchange in Dublin, a 31% increase over the last five years. For those using the service, heroin continued to be the most commonly used drug. Of concern, MQI noted that 2018 saw a rise in individuals reporting crack cocaine as their primary drug.
Figure 1: MQI county locations in Ireland
Source: MQI annual review (2018)
(1) Dublin; (2) Co. Wicklow; (3) St Francis Farm, Co. Carlow; (4) Cork Prison; (5) Limerick Prison; (6) Co. Offaly; (7) Co. Westmeath; (8) Portlaoise, Co. Laois; (9) Co. Longford; (10) Castlerea Prison, Co. Roscommon; (11) Loughran House, Co. Cavan; (12) Leixlip, Co. Kildare.
Community Engagement Team
The Community Engagement Team works to cultivate and strengthen relationships between MQI and the local community. The team picks up and safely disposes of drug-related litter as well as offering some of the most vulnerable people (those rough sleeping or reluctant to engage with services) street-based advice and referral into the services they need. In 2018, the team, which operates in the area immediately around Merchants Quay in Dublin, conducted over 1,700 patrols.
Family Support Group
MQI offers one-to-one advice and support to family members on the realities of drug use and how they can best cope and provide optimum support to drug users. MQI also runs a Family Support Group (FSG), which meets every week and provides a forum where parents, as well as other close relatives and friends of drug users, are offered support and advice on a range of issues. Participants provide support for each other, and the group is continually open to new members. The weekly FSG is linked to the National Family Support Network, which offers an opportunity to raise issues at a national level. MQI’s FSG in Dublin worked with over 60 individuals throughout 2018.
Community Recovery and Integration Supports
In 2018, the launch occurred of the East Coast Community Recovery and Integration Supports (CRIS) service, provided by MQI and the East Coast Drug and Alcohol Task Force. The service was formally launched in November 2018 by the then Minister for Health Simon Harris TD. CRIS provides supports, including key working, case management, and links with external support, for people experiencing alcohol and/or drug addictions. Demand for this service was immediate after it commenced in September 2018, and by year end MQI had engaged with 44 clients.
Midlands services
Drug and Alcohol Treatment Supports Project
MQI’s Drug and Alcohol Treatment Supports (DATS) team provides a community-based drug and alcohol treatment support service for individuals over 18 years of age and their families in the Midlands area (Counties Longford, Westmeath, Laois, and Offaly). Each county has a dedicated drug and alcohol worker to coordinate the care of individuals and families experiencing problems due to drug and/or alcohol use.
In this region, MQI saw a total of 706 clients in 2018, a 53% increase on 2017. This increase was represented across all age groups, but was particularly evident among the younger cohort aged under 30, where there was a 47% increase. MQI also experienced a 47% increase in the number of women accessing Midlands services in 2018.
In terms of drug use in the Midlands, MQI noted that heroin was by far the most commonly consumed drug among clients accessing services, being used by 47% of clients. Within MQI’s Midlands needle exchange, the total number of sessions increased by 16% in 2018, with a 50% increase in clients who are homeless accessing the needle exchange service compared with 2017.
Rehab and detox treatment services
St Francis Farm Residential Rehab Programme and Detox Services
The St Francis Farm (SFF) Rehabilitation Service offers a 13-bed therapeutic facility with a 14-week rehabilitation programme set on a working farm in Co. Carlow. At SFF, MQI provides a safe environment where service users can explore the reasons for their drug use, adjust to life without drugs, learn effective coping mechanisms, and make positive choices about their future.
The 10-bed residential detoxification service at SFF delivers methadone and combined methadone/benzodiazepine detoxes for both men and women. The detox activity programme includes individual care planning, therapeutic group work, psychoeducational workshops, fitness training, and farm-work activities.
At High Park, Drumcondra, Dublin, MQI operates a 14-week residential programme in a 13-bed facility. The emphasis is on assisting clients to gain insight into the issues that underpin their problematic drug use and on developing practical measures to prevent relapse, remain drug-free, and sustain recovery.
In 2018, the total number of admissions across High Park and SFF was 169, with 110 completing treatment.
Prison-based services
Addiction Counselling Service and Mountjoy Drug Treatment Programme
MQI, in partnership with the Irish Prison Service, delivers a national prison-based Addiction Counselling Service (ACS) aimed at prisoners with drug and alcohol problems in 11 Irish prisons. This service provides structured assessments, one-to-one counselling, therapeutic group work, and multidisciplinary care, in addition to release-planning interventions with clearly defined treatment plans and goals. Services offered include:
- Brief interventions
- Motivational interviewing and motivational enhancement therapy
- A 12-step facilitation programme
- Relapse prevention and overdose reduction
- Cognitive behavioural therapy
- Harm reduction approaches
- Individual care planning and release planning.
A total of 2,149 unique clients were seen in 2018. Of particular concern, MQI observed a drop in residential admissions from prison to treatment, from 83 in 2017 to 53 in 2018, which is a reflection of the increasing difficulty in accessing treatment beds across the country.
Seán Millar
