Drug policy expert sceptical about supervised injecting units

Prof David Best also questioned the ongoing reliance on methadone as a treatment

An international drug policy expert has voiced scepticism about the effectiveness of supervised injecting units, one of which is due to open in Dublin in the coming months.

Prof David Best from Sheffield Hallam University has written three books on the subject of recovering from drug use, and he has a continued involvement in recovery studies in Australia where some of the world's first supervised injecting units opened in Sydney in 2001.*

Speaking to The Irish Times during an International Recovery conference in Trinity College Dublin on Friday Prof Best said that while he understands the rationale behind introducing injecting units, they merely encourage prolonged negative behaviour on behalf of addicts.

“I can understand entirely the rationality; this is about reducing the spread of blood-borne viruses and creating a safe environment. I think, however, it becomes a negative factor for people moving on and making that change away to long-term recovery,” he said.

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“It simply creates another facility, and crucially it creates another social network point for [drug] using networks that becomes a barrier to generating recovery space.

“I think there’s still that sense of creating a positive social network about drug use and the drug using activity itself, which is one of the things you want to move people away from if you believe recovery is possible,” he added.

Legislation paving the way for a pilot injecting facility to be opened in Dublin city centre was enacted by the Oireachtas earlier this year.

Supporters of the initiative say it will reduce overdoses as well as drug-related anti-social behaviour on city streets.

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Prof Best was also critical of the reliance on methadone as a long-term treatment option for opioid addicts in Ireland, and he encouraged the provision of suitable and achievable accommodation for people trying to get their lives back on track amid the current housing crisis.

“If there are no jobs, no houses, and no access to community resources, recovery is a shallow and limited experience,” he said.

“There’s a massive risk with high-dose methadone, particularly accompanied by benzodiazepines and a bit of street drinking. You generate about 20 or 30 per cent of people who will be much worse off 5 or 10 years later.

“You can understand the logic of [methadone treatment], but it’s patronising and paternalistic, and ultimately for a lot of people it’s counter-productive.”

Social Democrats co-leader Róisín Shortall began the conference by pointing out that there are almost 10,000 people on prescribed methadone throughout the country, many of whom have been on the drug for over a decade.

The meeting of international drug policy academics took place ahead of the annual Irish Recovery Walk due to take place in Dublin on Saturday afternoon.

The event attempts to raise awareness of the stigma faced by drug addicts, and highlights the stories of those who have successfully come through the recovery process.

* This article was amended on September 10th 2017 to correct an error