Innovation through Crisis

HIV, AIDS and services for injecting drug users in Mountjoy prison in Dublin in the mid-1990’s

Janet Weston

Researching the history of HIV and AIDS has meant learning about a great many of the dilemmas and difficulties that faced policy makers and service providers in the 1980s and 1990s.  One of the themes that stands out is the importance of bold individuals and new ways of thinking in tackling the very knotty problems of HIV and prisons.

Services for injecting drug users in Mountjoy prison

My conversations and interviews have recently highlighted a perfect example of this. In the mid-1990s, as Ireland was getting to grips with HIV and AIDS, services for injecting drug users in Dublin were undergoing something of a transformation. Clinics had multiplied, and no longer relied on promoting abstinence. Instead, they were offering clean needles, methadone, and a great deal of information and support to help reduce the spread of HIV and other infections too. But, many service providers knew that things were different for heroin users in Mountjoy.  Services there were extremely limited, injecting drug use took place with shared and dirty equipment, and prison officers were frequently hostile to any calls for change.

Education to benefit prisoners

Inspired by the peer education movement for drug users established in the Netherlands, individuals working in addiction services in Ireland joined with colleagues across Europe to develop methods of peer education that would benefit prisons. This saw former prisoners who were drug users receiving training, so that they had accurate information about risks and practical solutions, and could go on to educate their peers. It also saw prison officers receiving a similar education, and most importantly, these two groups were brought together to educate each other. This was not easy: each side began with strong views of the other. Through dialogue and debate, and with the help of the project facilitators, former prisoners and serving officers came to know each other better.

Respect and trust between prison officers and inmates

This had a significant impact upon the prison officers in particular. Armed with a new appreciation of the realities of heroin addiction, prison officers could rethink their approach in Mountjoy and take steps to improve the safety of staff and inmates alike. One officer remarked at the time that they would now do one specific thing very differently. In the past, if they came upon an inmate injecting, they would rush to intervene. Having spoken with injecting drug users, they realised that this was both potentially dangerous and pointless – the inmate would be in an emotional state, there would be a needle in the picture, and in the long run, it would not stop them from injecting. A more measured approach, rather than rushing in straight away, would be safer and help to build very valuable respect and trust.

The effects of this education project were, of course, limited: small numbers of officers could only do so much, and structural change remained a long way off.  And yet, in terms of gradual attitudinal shifts and individual lives, this innovative approach to tackling HIV and drug use was undoubtedly transformative.

Image: ‘Home’ (2000) a public memorial monument to those lost to heroin. The sculpture is sited at the junction of Buckingham and Sean McDermott Street in Dublin, a place once well know for open drug dealing. The memorial was created by artists; Leo Higgins, Michael Quane, Jackie McKenna, Louise Walsh, Brian Connolly and Annette Hennessy  in collaboration with relatives of those who have died.  Photograph taken by William Murphy sourced on Creative Commons.

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