 We're in Dublin City Centre. We're just out the back of the Annaliffy Drug Project. The team I work for would work out and about on the street. So this would be an area that would have quite high drug use, especially around the city centre. Our team expands outside of the city a little bit as well. How would you describe this drug scene? A lot of drug use we'd see would be heroin, so injecting or smoking. Prachocaine, we would see a lot of tablet use, so benzodiazepines. And then there'd be a lot of alcohol use as well. And then from time to time you'd see different drug trends emerging. Crystal meth, GHB, there's a wide variety of drugs around. But yeah, I'd say mainly we'd work with heroin, crack tablets and alcohol use. Who is Annaliffy? Who is Annaliffy? Annaliffy is the spirit of the river nearby, the River Liffey. Annaliffy Drug Project is established in 1982. So that makes us 41 years old now. We are the first agency founded on harm reduction principles in Ireland. I think the reason we have been innovative is our low threshold culture. Our main mission is to engage with people who use drugs and have other complex needs as well and help them find solutions or to reduce the harms that these issues cause. And how we do that is by working with people on an in-reach, on an outreach basis, working with case management in conjunction with them. We don't tell them what they're going to do. We work with them in terms of setting their goals. If they've no interest in becoming drug free, then they want to become more stable. That's the goal for them. That's what we're going to work with on them. If they need to address their housing, that's what we'll work with on them. We also have a fantastic nursing team that are responding to people's physical health and we work with people around, say, dual diagnosis, mental health and addiction issues. We do backpacking needle exchange. We do needle exchange in our mobile outreach vehicle, the Van Aliffey. It's pretty much an ambulance that's been transformed into an harm reduction van. Let's get inside the van. Can you show us around? I'll show you around. Yeah, Peter, so that is basically the Van Aliffey. So it's our harm reduction vehicle. Basically, we'll go out three times a week in different places of Dublin, mainly in the north. We have everything here to provide quick, clean equipment, confidential harm reduction support, needle exchange is one example, but also overdose education. Crack cocaine at the moment is really a big, big problem. We give crack pipes. People are sometimes smoking, drugs, crack or otherwise. We have the naloxone, so we have different type of naloxone. Obviously we have the nasal naloxone and then the intramuscular. So you inject like this. So it's possible that sometimes you may give that also to service users. We train people to use it. If you have someone who's kind of in an emergency situation, who's kind of unwell basically, who may be overdosing or may just have a mental health crisis, whatever. We have a space where we can really do and work with the client around that. Someone can have a picky worker pretty much instantly. You know, you don't have to wait for days. You know, it's just right away we can work with someone and that's what I really like. I think we have very good services. We had in 2022 12,000 cases of people getting treatment for problematic drug use. That was an increase of 12% on the previous year. Availability services is a bit uneven and we now need to kind of make access to services more equitable across the country. I think that's our challenge. HIV is still a risk, obviously, but thankfully due to the level of needle exchange availability, those services help to keep HIV and hepatitis C down. Obviously treatment has improved for hepatitis C. We know that people still inject and we have a considerable problem in Dublin and in other areas of Ireland with injecting and injecting is still a very, very risky behaviour in terms of overdose. How can you respond to the rising number of overdoses? Yes, that's a huge issue for us. So we've just got new data on that. So we have over 400 people have died of overdose. So I think we need to look at the social factors as well as the drug factors. I mean, we can have naloxone as an antidote. Yes, immediately. But what's the antidote for poverty? What's the antidote for homelessness? We need something more than that and that's our challenge. Is a supervised drug consumption room part of that solution? Yes. So we have, again, government has approved this, that we will establish a drug consumption room. We have the legislation passed. We have encountered difficulties in getting local agreement to where we want to locate the service. We want to locate it in the city centre. So we have had some planning issues. But we think we are overdosed now and so we are now progressing to get the supervised ejecting facility open next year in 2024. The drug scene is directly also very, very much linked to the homelessness problem. As you know, there's a huge housing crisis in Dublin and in Analifio we work very, very closely with housing service providers. It's called private emergency accommodation and we work closely with them to provide basically to clients kind of psychosocial support and do referrals and different type of intervention. A lot of our clients are homeless, either slip and rough. So the guys there, they're primarily dealing with those guys, you know, very chaotic clients, are poly-drug users, have an awful lot of mental health issues and have issues also with the criminal justice. So that's their gig. We work for the law engagement assisted recovery team. The lawyer team. So we specifically work with the police called Gaudi in Ireland. So we try to take most of our referrals from the guards. Everyone's needs are unique and addiction brings a lot of complexities. So whether it's mental health problems, physical health problems, homelessness issues with criminality, finances, families and relationships, education workforce, you know, there's a whole host of issues. How would you describe your partnership with the Gaudi? It's a really good walking relationship. We've had really, really positive outcomes. Whether it be through the guards or housing someone, maybe sleeping rough in the tent for a very long time, now they have their own accommodation, it might have somebody else that would have a couple of bench warrants. In Pacific, I remember one person had nine bench warrants and they were hiding around corners. And within a couple of weeks, they were all sort. He was able to source then a decent accommodation. We work with the clients whatever they want to work with. So it might, for some people, it might just be needle exchange, brief interactions, other people might be ready or have a want to go to further treatment, education, employment, you know, mental health issues or physical health issues might be a primary need at that time. So we have the flexibility, I suppose, to meet people physically where they're at and do whatever they want to happen in their lives. I would have come from a community that had a lot of poverty. I've lost a lot of friends. I've lost the brother. I've lost a lot of family members of myself. Myself, I would have had a lot of issues. I would have used a lot of drugs. I would have experienced a lot of trauma. And then that would have led me into the criminal justice system. And I think it's important for people to understand when you get pulled into the criminal justice system, it gets, it's very, very hard to get back out. When we have systems that are based on giving people no voice and punishing them, it will only lead to worse outcomes for themselves, for the family and for everybody else in the community and society as a whole. Don't stigmatise people. Don't criminalise people because it doesn't work. We need to have an approach that's based on love and it's based on listening to people and it's based on hope. The position of the part of the health is very much that we need a health-led approach and that we should deal with it as a health issue. We don't favour punishing people. We favour supporting and giving people access to health service. There is, of course, a very strong piece of advocacy that's been happening in Ireland since 2015, where my colleagues in Citywide and Analyphe and other colleagues had been calling for decriminalisation. I am the chair of Strategic Implementation Group 5, which is under the National Drug Strategy, and that looks at the alternatives to coercive sanctions and we very much support the health diversion programme, which has been designed and is yet to be delivered. The way it will work is, on the first time someone is found in possession, there will be a mandatory referral for an assessment. On the second time, you may be given an adult caution and on the third time, you will go to court. Our problem with that is that is really one chance only and our client group, people with who are problematic drug users, will ultimately end up in court and we don't agree with that. So what we are calling for and have always maintained this is that we need to give people every opportunity. Every single time somebody is found in possession of drugs for personal use, that they are given this referral for an assessment. We are being frustrated because we haven't found yet a mechanism by which the police, if they find somebody in possession of drugs, can refer the person to us. So we have a kind of a gap and we want to overcome that. An opportunity we have now which is positive is that there is a citizens' assembly happening Ireland. This is a structure that was put in place a number of years ago where it gives a space separate to the normal government process to look at issues that are challenging and that can be difficult for the state to deal with. There is a group of 99 random people from the population who are selected to come together to hear from people from across all areas of the drugs issue and to come up with solutions for how we move forward. The people who are the members of the assembly, they are getting to hear about the reality of this issue. Not about what we have had in policy for a long time, the kind of moral judgement approach that people are doing something they shouldn't be doing. It's a bad thing and as a result of them doing a bad thing there are problems and it's making things bad for all of us. So really the assembly is a great opportunity. It's worked for other issues in Ireland in the past where you can get past that moral judgement. People hear the stories of people who are affected by drugs and who use drugs themselves and they start to think differently and say this is not about individuals who are weak or bad, this is about a broader approach in our society, our failure to address underlying issues like poverty and all of the issues goes with it and we need to change our approach now so that we have drug policy that's based on evidence. In light of the citizens assembly at the moment there seems to be a better understanding and a lot more empathy towards our service users or people that use drugs. The engagement and reaction from the 99 citizens that are involved in the assembly has been very enthusiastic, very positive and has given a lot of hope I think to the sector. I do fear that the recommendations will get lost with our policy makers but also government's reaction to previous citizens' assemblies like the one on abortion and same-sex marriage has given me a little bit of optimism that they will also take these recommendations on board. What will happen with the recommendations after this? Yeah, so our drug strategy is finishing, it's coming to an end in early 2025. We'll have the report then, that will be the basis in Parliament, it will be discussed and then we'll be asked to make some responses. So I think our next strategy, our next drug strategy will be very much a citizen strategy because it will be so informed by the citizens assembly. I think it will be a very interesting strategy. I could hear that people were impressed with the health-led approach which is essentially decriminalisation in some formal guise which is probably the health diversion programme, decriminalisation of people who use drugs for personal use and I think that's very exciting and I'm hopeful, you know.