IRELAND’S HEALTH REFERRAL Scheme has come into operation. Under the pilot, some adults found in possession of drugs for personal use for the first time can be referred to health services rather than face prosecution.

Public debate has largely focused on whether the scheme represents progress in drug policy. That is an important question. But there is another issue that receives far less attention: implementation.

In public policy, implementation choices often determine which elements of a reform succeed and which fall short. Eligibility criteria, operational procedures, referral pathways, staff training and data collection may appear to be technical details. In reality, they shape who benefits, who is excluded and whether a policy achieves its objectives. Ireland’s new pilot scheme is a useful example of why that matters.

The government has described the scheme as a health-led pathway intended to support people early, reduce harm and help people make informed choices about their health and wellbeing. Those are worthwhile objectives. The question is whether the implementation choices underpinning the pilot are aligned with them, and whether they will support the people most likely to experience significant drug-related harms.

The published guidance sets out a number of eligibility requirements. To qualify, a person must be over 18, be a first-time drug offender, admit possession of what they believe to be a controlled drug, be assessed as suitable by An Garda Síochána, and be considered likely to benefit from........

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