Merchants Quay Ireland (MQI) is a national voluntary agency providing services for homeless people and drug users. There are 22 MQI locations in 12 counties in the Republic of Ireland (see Figure 1). In September 2018, MQI published its annual review for 2017.1 MQI aims to offer accessible, high-quality and effective services to people dealing with homelessness and addiction in order to meet their complex needs in a non-judgmental and compassionate way. This article highlights services provided by MQI to drug users in Ireland in 2017.

Drug 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 2017, some 2,583 individuals used the service (an increase of 3% on 2016), of which 443 were new clients.

As part of the MQI health promotion remit, a total of 2,691 safer injecting workshops were undertaken with injecting drug users in 2017, an increase of 26% on 2016. There were 25,358 needle exchange visits, an increase of 3% on 2016.

Naloxone provision

Along with partners in the Health Service Executive, the National Family Support Network and the Ana Liffey Drug Project, MQI was front and centre in the national rollout of the Naloxone Demonstration Project in 2015. Naloxone is an antidote for opioid overdose that reverses the depressant effects of opiates such as heroin. To date, more than 400 drug users have been prescribed naloxone, and an external evaluation concluded that the scheme was a success. Work on this initiative is ongoing and MQI hopes that eventually all opiate drug users in Ireland will have access to this life-saving drug.

Community benzodiazepine detoxification

In response to a need identified in 2017, MQI undertook to facilitate community benzodiazepine detoxifications in collaboration with Granby MQI GP Services. A total of 45 clients accessed this programme in 2017. MQI notes that many of these clients have since moved on to become drug-free, have gained employment, and/or have accessed education programmes in addition to accessing residential rehabilitation programmes.

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 (who are rough sleeping or reluctant to engage with services) street-based advice and referral into the services they need. A total of 11,951 items of drug-related litter were disposed of by this team in 2017.

Drug Rehabilitation Scheme – Riverbank Centre, Dublin

As part of their Community Employment Scheme, MQI provides a stabilisation programme which seeks to establish a regular pattern of discipline and daily attendance in order to help clients stabilise and reduce their drug use and prepare them for mainstream training and employment. In 2017, some 26 individuals participated in the programme; most were aged between 18 and 39 years of age. Links with the Education and Training Boards facilitate the accredited educational component for this programme, which helps people gain momentum into education and employment.

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 40 individuals throughout 2017.

Midlands services

Drug and Alcohol Treatment Supports Project

The 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 2017, the team based in the Midlands provided support to 460 people, with a total of 4,906 interventions carried out.

Drug Rehabilitation Scheme – Athlone

Supported by Athlone Community Taskforce; the Adult Education Centre; the Probation Service; Longford and Westmeath Education and Training Board; and South Westmeath Employment, Education and Training Services, this programme allows clients to participate in activities and educational qualifications at an appropriate level on the National Framework of Qualifications. The scheme also provided individuals with addiction and other rehabilitation supports, for example, crisis intervention supports, group work, and key working. In 2017, some 22 participants were engaged on this programme.

Rehab and detox treatment services

St Francis Farm Rehabilitation 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. There were 52 clients admitted to the SFF Rehabilitation Service during 2017, of whom 27 completed the programme.

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. There were 65 clients admitted for detox service during 2017, of whom 56 completed the programme.

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. 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. 

In 2017, some 2,547 prisoners accessed the ACS and the MQI team delivered 10,252 one-to-one counselling sessions. The MQI ACS also coordinated and contributed to the delivery of a structured, multiagency eight-week Detox and Drug Treatment Programme (DTP) in the Mountjoy Prison Medical Unit. During 2017, the DTP assisted 44 prisoners in detoxing from methadone and benzodiazepines.