Drug services in Cork city have noticed "increases in dangerous injecting practices" among drug users, according to new research.
This includes injecting into the groin and neck as well as injecting alone and in the open.
The study said there is also concern around the "growing issue" of visible drug littering and needle stick injury among the non-drug using population.
Researchers said it is against this background that they identified where drug injecting occurs in Cork city and sites of non-fatal and fatal overdoses.
Based on interviews with 51 drug injectors, the study identified 58 fatal overdoses and 47 non-fatal overdoses and mapped possible locations for any future supervised injecting facility (SIF).
Following a landmark government decision in December 2015, a pilot SIF in Dublin city centre was awarded to Merchants Quay Ireland. It is going through a lengthy planning process.
The Cork Local Drugs and Alcohol Task Force and the HSE have expressed interest in examining such a facility in Cork – but the HSE has indicated it will depend on the success, or otherwise, of the Dublin pilot.
The new study was conducted by John Aidan Horan of Arbour House, HSE Addiction Services, Cork and Marie Claire Van Hout, attached to the Public Health Institute of Liverpool John Moores University.
“The aim of the study was to map the location of current injecting practices of people who inject drugs (PWID) in Cork and to document the related high-risk behaviours, ahead of a planned supervised injecting facility,” the report said.
It said that, according to the European Monitoring Centre for Drugs and Drug Addiction, 78 SIFs operate in eight European countries.
It said they are aimed at tackling dangerous injecting practices, including groin and neck injecting, unhygienic and dangerous environments, overdose and blood-borne viruses, such as HIV and Hepatitis C.
The study, published in the journal Heroin Addiction & Related Clinical Problems, said a 2017 cost-benefit analysis estimates that for every US dollar spent on a SIF, $2.33 would be saved.
Almost 60% of those interviewed said they had previously overdosed, with nine out of ten recalling an emergency services response.
The research identified 58 fatal overdoses, 36 of them occurring in private accommodation, 11 in a public building and a further 11 in the open/on the street.
Of the 47 non-fatal overdoses, 20 were in private accommodation, 15 in a public building and 12 on the street.
The study pointed out many homeless people inject in their homeless emergency accommodation, which is classed as private accommodation.
Nine out of ten respondents know of someone who has died from an overdose.
It said the research results emphasise the importance of consulting PWID in locating possible SIF sites.
"The findings are intended to inform SIF location," it said. "Ultimately, the benefits of this mapping study are to inform the new national drugs strategy.
"This could improve treatment for persons who inject drugs and reduce waiting times for those wishing to access treatment."