CHILLY RECEPTION FOR DUBLIN'S DRUG TREATMENT

Plans to expand drugs treatment services in Dublin are being seriously
undermined by a groundswell of local opposition, writes Joe Humphreys

For years the biggest obstacle to the provision of drug treatment services
was either official neglect or a lack of funding. Now it seems it is the
"not-in-my-backyard" attitude.

Disputes with residents' and business groups have effectively brought the
Eastern Health Board's treatment expansion plan to a standstill.

While the number of drug treatment places almost doubled between 1996 and
1998 from 1,861 to 3,610, only 128 new places have been created in the past
six months. More worryingly, after a decline in the number of people on
waiting-lists from 560 to 455, the numbers have since risen to 478 (143
women and 335 men).

The increase in local resistance has coincided with an attempt to move
services away from overstretched city-centre clinics to the suburbs.
Persuading residents in often affluent areas that, first, they have a drugs
problem in their midst and, second, it needs dealing with is proving a
difficult task, with the hardest battles being fought in south Dublin.

Plans to establish a clinic on the grounds of the EHB's health centre at Old
County Road, Crumlin, have been blocked by South Dublin County Council after
strenuous lobbying from residents' groups.

Providing a comprehensive range of services from methadone maintenance to
education and family support, it would be Dublin's 10th addiction centre
and, excluding the city area, only the second in south Dublin.

The area's other such centre, Dun Laoghaire, is meanwhile embroiled in its
own controversy. Businesses located near the Patrick Street clinic are
calling for its closure, citing an increase in "street-fighting,
drugs-trading, assaults and shoplifting".

Meanwhile, attempts to establish satellite clinics - 36 of which are
operating in Dublin - which would be linked to the Dun Laoghaire addiction
centre have been thwarted.

Having dropped plans to develop three clinics at Shankill, Ballybrack and
Loughlinstown after local opposition, the health board has opted for a
single facility at St Columcille's Hospital, only to find itself embroiled
in another dispute with residents threatening "direct action" to stop the
development.

The health board has attempted to ease fears by making security a priority
at clinics and emphasising the strictness of its monitoring policy.
Supervised urine samples are taken every day from patients who are allowed
to drink the heroin-substitute methadone only in the presence of medical
staff at the clinic.

The EHB also argues that the services can help to reduce crime rates and
unsociable behaviour, creating a "win-win" situation for the local community.

Such claims are supported by Garda figures, with Dun Laoghaire recording a
10 per cent drop in crime in the first year after the clinic opened, in
April 1997, and a 20 per cent drop the following year. Insp Liam Mulcahy, of
Dun Laoghaire station, says: "The drug clinic has made a definite
contribution towards reducing crime, especially larceny."

However, Mr Vincent MacDowell, chairman of the Dun Laoghaire Business
Association, says this does not tally with the experience of local
shopkeepers. "There has been an increase in fighting in the street, an
increase in dealing." The health board's security assurances, he adds, are
"absolute balderdash. Security is a farce". Mr MacDowell, a Green Party
councillor who owns a pet and craft shop in Patrick Street, says his
objection is not out of self interest. "What we are trying to put across is
that the clinic should be located in a more discreet area, not in the middle
of the commercial heart of the town."

He claims that more than 140 patients are being treated at the centre in
contravention of an agreement to cap the numbers at 100. According to the
health board, the total is just 96.

The board has also agreed to close the facility at weekends, acceding to a
demand of the association, even though it detracts from the quality of
treatment offered. Dun Laoghaire is the only addiction centre operating on a
five-day basis, requiring patients to administer "takeaway" doses of
methadone themselves for the other two days.

However, the local chamber of commerce does concur with the association. Its
president, Mr Tom Nolan, says most people acknowledge the need for the
clinic, although he says it should be used only by local addicts and contain
a broader range of rehabilitation services.

If there is a problem with excessive numbers of people attending the unit,
it is partly due to local opposition elsewhere. At least 27 Dun Laoghaire
patients are due to be moved to the proposed Loughlinstown clinic along with
25 new patients currently on waiting lists.

The row over this satellite clinic reached new heights in the run-up to the
local elections last month when a local Fianna Fail councillor, Mr Larry
Bulter, who favours the plan, was targeted by the Loughlinstown Action
Group. After accusing the group of "pushing" the other three-clinic
proposal, Mr Bulter found himself the subject of angry protests at polling
stations.

In a letter to the EHB recently, the group warned that if it decided to go
ahead "and visit this plague on this community, it will be revisited back on
them twofold". It suggested it would lobby "on a daily basis anyone within
the EHB and the political parties who we feel is responsible for locating,
operating or supporting this action", making it "a 24-hour issue for all
involved".

A spokesman for the health board says it gives "very careful consideration"
to such local concerns, adding that in most cases opposition can be overcome.

The Cork Street addiction centre, for example, had a torturous birth but is
now regarded as an integral part of the community.

Mr Charlie Hammond, chairman of the local residents' association, says: "All
the fears we had of dealers hanging about and people shooting up outside,
thankfully, have not materialised." Instead, there has been a noticeable
decrease in crime.

The EHB spokesman says it would like to have more co-operation than conflict
with local communities and "to introduce these services in as pleasant a way
as possible". However, "at the end of the day, we have an obligation to
provide the services and we will do so".

This was all the more urgent, he says, as "if there are 500 people on the
waiting-lists you can take it there are probably double or treble that
number out there who need treatment."