Merchants Quay Ireland (MQI) is a national voluntary agency providing services for homeless people and those that use drugs. There are 22 MQI locations in 12 counties in the Republic of Ireland (see Figure 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-judgemental and compassionate way. This article highlights services provided by MQI to people who use drugs in Ireland in 2020.1

Harm reduction services

Harm Reduction Service, Riverbank Centre, Dublin

In 2020, some 36,180 clients visited MQI needle exchange and harm reduction services in the Riverbank Centre in Dublin; 3,369 of these clients were unique. When compared with 2019, MQI saw an increase of over 10% in the numbers of clients engaging in the needle exchange service.

Substance use case workers

MQI substance use case workers support people addressing their substance use, including exploring treatment options for detox and rehabilitation. This support is carried out by phone and on a one-to-one basis. In 2020, some 129 clients were supported. Of these 129 clients, 38% were young people aged 18–24 years.

Source: MQI annual review, 2017

(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.

Figure 1: MQI locations in the Republic of Ireland 

Opioid substitution therapy

In 2020, MQI witnessed a steady increase in clients availing of opioid substitution therapy (OST) compared with 2019. The number of people receiving OST in 2020 was 483 unique clients and access to this treatment was believed to be significantly increased due to the reduced waiting times as a result of the Covid-19 pandemic.

Opioid drug reversal with naloxone

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 opioids such as heroin. Throughout 2020, some 263 unique clients were prescribed naloxone, with 318 kits provided. In 2020, some 281 clients also completed training, with 353 sessions provided by staff. In addition, 488 safer injecting interventions were undertaken. 

Community detox

In 2020, some 18 unique clients accessed the MQI Community Detox in the Riverbank Centre, with 14 people accessing benzodiazepine services and four people receiving alcohol detox. People accessing this treatment were supported by a substance use case worker. 

Harm Reduction Outreach Team

MQI has a Harm Reduction Outreach Team that provides harm reduction interventions. Services provided include needle exchange, safer injecting information, and naloxone training. The team also supports clients by referring them to other services such as medical, housing, and mental health. In addition, the team aims to build relationships with clients who are service-resistant and to support them overcome the barriers they face in order to engage with mainstream services. In 2020, this team supported 714 unique clients through 2,744 interventions. 

North East Drug and Alcohol Service

This service provides harm reduction supports to active substance users in the North East region in partnership with a wide range of local agencies. In 2020, one MQI staff member worked three days a week in this service and provided needle exchange, safer injecting advice, signposting, and advocacy interventions to individuals in active addiction. Between January and August 2020, some 24 clients were supported. 

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). Services provided include an outreach-based crisis support service, mobile harm reduction, needle and syringe exchange, rehabilitation, a community employment scheme, aftercare supports, and support for families affected by substance use. In 2020, some 1,298 unique clients were supported through 36,181 interventions. Of these individuals, family support was provided to 119 people, with 1,153 interventions. 

Recovery services 

St Francis Farm and High Park

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 Tullow, 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.

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.

There was a total of 891 referrals to MQI recovery services in 2020. All 891 people referred to the services received ongoing contact and support through phone or video. There were 517 assessments carried out, with 137 admissions and 115 completions during 2020. Covid-19 risk reduction measures resulted in residential capacity being reduced. Groups were brought in together where possible and tested for Covid-19 prior to admission. 

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:

1. Brief interventions
2. Motivational interviewing and motivational enhancement therapy
3. A 12-step facilitation programme
4. Relapse prevention and overdose reduction
5. Harm reduction approaches
6. Individual care planning and release planning.

In 2020, MQI counselling staff saw a total of 1,948 unique clients, with on average 1,187 monthly interventions. 

1 Merchants Quay Ireland (2021) Merchants Quay Ireland annual review 2020. Dublin: Merchants Quay Ireland.  
https://www.drugsandalcohol.ie/34984/