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 13 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 2021.1

Source: Merchants Quay Ireland annual review 2021, p. 36

The 13 counties are Dublin, Wicklow, Carlow, Cork, Limerick, Offaly, Westmeath, Laois, Longford, Roscommon, Cavan, Monaghan, Kildare.

Figure 1: MQI locations in the Republic of Ireland

Harm reduction services

The aim of harm reduction is to minimise the risks stemming from sharing drug-use paraphernalia. In 2021, MQI facilitated 49,448 interventions in its needle exchange and harm reduction services; 4,777 of these clients were unique. When compared with 2020, MQI saw an increase of 27% 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 2021, some 145 clients were supported. Of these 145 clients, 34% were young people aged 18–24 years.

Community Detox and opioid substitution therapy

In 2021, some 80 unique clients accessed the Community Detox service in Riverbank, Dublin, with 65 clients accessing benzodiazepine detox and 15 clients alcohol detox; 185 clients accessed opioid substitution therapy (OST). In 2020, MQI had witnessed a steady increase in clients availing of 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.

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 2021, this team supported 1,092 unique individuals through 6,642 interventions.

Hepatitis C treatment

The hepatitis C worker is the member of the MQI team who liaises with the primary healthcare team to ensure clients who use drugs intravenously are screened for blood-borne viruses. This worker advocates for testing; if a client is positive, a general practitioner refers the client to a specialist nurse. The hepatitis C worker continues to regularly check in with clients in these situations, ensuring that they are attending appointments and receiving care where required. In 2021, some 59 unique clients engaged with the worker, with 383 visits in total.

East Coast services

A community-based drug and alcohol treatment support service is provided for the East Coast region and South Dublin. In 2021, some 209 unique individuals accessed the service and 2,973 interventions were provided. In addition to the client interventions, the team provided 1,402 phone calls to support people enquiring about the service.

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 and aftercare supports, and support for families affected by substance use. In 2021, some 702 unique individuals were supported through 11,538 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, make positive choices about their future, and gain hands-on experience in animal care and vegetable production. In 2021, there were 167 referrals, 90 assessments, 47 admissions, and 39 completions. The 10-bed residential detoxification service at SFF delivers methadone and combined methadone/benzodiazepine detoxes for both men and women. In 2021, there were 302 people referred to SFF detox. Of the 157 people who completed assessments, 42 were admitted, and 40 individuals completed the programme.

At High Park in 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 2021, the service received 304 referrals. Of this number, 250 people completed assessments, 52 were admitted, and 37 individuals completed 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.

In 2021, MQI counselling staff saw a total of 1,930 unique clients. In addition, MQI continued to operate a national phoneline where prisoners could access phone support, averaging 33 calls per day.

1    Merchants Quay Ireland (2022) Merchants Quay Ireland annual review 2021. Dublin: Merchants Quay Ireland. Available from: https://www.drugsandalcohol.ie/37321/