Merchants Quay Ireland (MQI) is a national voluntary agency providing services for homeless people and those who use drugs. There are 27 MQI locations in 14 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 to meet their complex needs in a non-judgemental and compassionate way. This article highlights services provided by MQI to people who used drugs in Ireland in 2023.1

Figure 1: MQI locations in the Republic of Ireland

Source: MQI annual review 2022, p. 40 

The 14 counties are Dublin, Wicklow, Carlow, Cork, Limerick, Offaly, Westmeath, Laois, Louth, Longford, Roscommon, Cavan, Monaghan, Kildare.

Harm reduction services

The aim of harm reduction is to minimise the risks stemming from sharing drug paraphernalia. In 2023, a total of 3,156 people were provided with 25,905 health-led interventions. This number includes needle exchange in the MQI Riverbank Centre.

Community detoxification and opioid substitution therapy

In 2023, MQI increased from one to three the number of addiction case workers at the Riverbank Centre. Addiction case workers work closely with the mental health team to provide a dual diagnosis support structure for clients facing both addiction and mental health problems. The addiction team carried out 1,197 addiction interventions with clients in 2023, ranging from offering support to clients on opioid substitution therapy (OST) and ensuring robust care planning, to community detox; 18 alcohol and 14 benzodiazepine detoxes were completed with clients in the community during 2023. Three detoxes were also carried out with clients who
self-reported polysubstance misuse.

Community engagement

A Community Engagement Team operates in the neighbourhood around Riverbank, Dublin in order to strengthen relationships with the local community and stakeholders, and proactively engage with clients and people sleeping rough in the area. The team also responds to calls and queries from the general public in relation to the local area, as well as collecting drug litter. The team carried out 816 patrols in 2023, and engaged with 525 residents and local businesses while collecting 4,809 items of drug litter.

Counselling service

The addiction counselling service in MQI’s Riverbank Centre offers holistic support to individuals who are dealing with substance misuse and homelessness. A counsellor offers one-to-one assistance for mental health and life issues such as depression, anxiety, low mood, bereavement, mental ill health, and family and relationship issues. In 2023, a total of 360 counselling sessions were provided to clients.

Midlands services

Drug and Alcohol Treatment Supports

MQI’s Drug and Alcohol Treatment Supports team provides a community-based drug and alcohol treatment support service for individuals aged over 18 years, 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 support, as well as support for families affected by substance use. In 2023, this service provided 4,791 interventions to 415 individuals. In addition, 13,954 needles were distributed as part of the mobile needle exchange programme. Seventy new clients were referred to the family support specialist last year.

Recovery services

St Francis Farm residential detoxification and rehabilitation

Located in Tullow, Co Carlow, the St Francis Farm (SFF) Detox Unit offers 24-hour medically supervised residential detoxification and individually tailored treatment plans for men and women aged over 18 years. The new purpose-built detox unit can accommodate up to 10 residents at any one time. In 2023, there were 319 referrals to the detoxification unit, an increase of 35% on 2022. The number invited for assessment was 239 and out of these, 195 clients attended for assessment. Overall, during 2023, there were 49 admissions to the detox unit, which again represented an increase from 2022 of 37%. These admissions were a combination of clients detoxifying from the following substances: methadone and benzodiazepine, methadone only, benzodiazepines only, and suboxone. The report noted that completion rates from the detox unit were extremely strong in 2023, at 84% (41 clients). Out of this group, 27 participants progressed to the SFF rehabilitation facility.

The rehabilitation programme offers one-to-one support and care planning, group work, self-esteem seminars, assertiveness training, anger management, art work and relapse prevention training. Service users also receive education in first aid, overdose prevention, life skills, and budgeting. There were 177 referrals into the rehabilitation programme during 2023 that met the programme criteria. A total of 85 people were invited for assessment and 80 people took up the offer. Overall, there were 49 admissions to the rehabilitation unit (a 23% increase on 2022), 27 of whom were admitted directly from the detox unit. The unit achieved an overall bed occupancy rate of 77% during the year. Of the 48 clients discharged during 2023, 33 successfully completed the entire programme (69%, which was consistent with the 2022 achievement of 67.5%). 

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 aimed at prisoners with drug and alcohol problems in 12 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 2023, counselling supports were provided to 2,035 people and these individuals were provided with a total of 14,947 interventions. MQI also relaunched the Treatment and Recovery Programme in Mountjoy Prison in 2023. This programme aims to support people who have become drug-free in prison. In 2023, there were five programmes delivered, with a completion rate of 85%. 

Medically Supervised Injecting Facility

Following a tendering process, MQI was selected by the HSE as the preferred provider to operate Ireland’s first medically supervised injecting facility. Located in the Riverbank Building on Merchant’s Quay in Dublin, where other healthcare and harm reduction services are currently provided, the facility opened in December 2024 and will initially run as an 18-month pilot, subject to independent evaluations at 6-month and 18-month periods.

1         Merchants Quay Ireland (2024) Merchants Quay Ireland Annual Review 2023. Dublin: Merchants Quay Ireland. Available from: https://www.drugsandalcohol.ie/41841/