Professor Joe Barry:

My presentation will be shorter. It was important for the joint committee to hear about the reality of addiction from Mr. McAleenan. It sounds simple, but it is hard work that requires dedication across the board.

I thank the committee for giving me the opportunity to speak to it on this topic. I have been involved in the drugs service since the early 1990s. Mr. McAleenan and I are now almost dinosaurs in the service.

In the summer of 2012 I attended the 20th anniversary celebration of Soilse, the symposium that Mr. Gerry McAleenan mentioned. It was a moving and very powerful experience, involving a mix of service users, service providers and community activists as well as those with an interest in the country’s response to our heroin epidemic mostly, although this goes beyond heroin. It was very well attended and inspiring.

Shortly afterwards I was asked by Mr. McAleenan whether I would be interested in contributing to a document with the aim of promoting recovery among drug users in Ireland. I was very happy to do so and we were joined by Mr. Martin Keane from the Health Research Board, who has prepared much of the literature on this, including much of the international literature Mr. McAleenan quoted. Over the course of the following year we worked on the document and spoke to four of the people who had presented their stories at the symposium. We asked if they would be happy to have their stories published in the report. Personal stories make more of an impact than statistics. Mr. McAleenan has alluded to the stigma. People were very brave in standing up in public and talking about their problems and allowing those problems to be in the document before the committee today.

The document was launched in the Mansion House and we had a couple of meetings with the then Minister of State with responsibility for the national drugs strategy, Deputy Alex White. We have since been in contact with Department of Health officials and are hoping to arrange a meeting with the Minister, Deputy Leo Varadkar, subsequent to our attendance here today.

Mr. McAleenan has given the details of the many benefits and we can come back to them during the discussion. However, it will not happen by just wishing it to happen. We prepared the document to try to turn what everybody believes is a good idea into practice. It is a reorientation, obviously. The public health model is still part of the strategy within the HSE, but there is much more scope for recovery if people are given the supports Mr. McAleenan mentioned. There are 10,000 people on methadone and more people can recover if they are given the supports. They are very basic supports; they are not high-flying or technology based. Our document outlines a series of recommendations which we can come back to. We are very keen that members of the committee are aware of the challenges and how we can make recovery a reality.

The document is essentially based on hope. Many people claim that people addicted to opiates have no hope, but that is not true. Of course, opiate addiction causes many problems and kills a number of people in Ireland. About one person dies from an overdose of drugs in Ireland every day. People die, but people can also recover. People want to take control of their lives and many drug users are parents who want to do the best for their children. The recovery model would give them the skills and capacity for parenthood as well as everything else. For any of us who are parents, parenthood is probably the most important activity of our lives.

People will respond positively if offered supports. These supports include access to second-chance education, or maybe even first-chance education for people who have not had it, and literacy training. Obviously the economic recession has not helped drug users and with us, one hopes, coming out of that, there is potential for employment and self-esteem to be restored.

Many drug users are also caught up in the current homelessness crisis. We talk about people who have been squeezed by the recession. Most of the people who are addicted to opiates were squeezed well before 2007. They have had a lifetime of being squeezed and there is a lot to be made up. The community of Dublin's north inner city has been disproportionately affected, but there is enthusiasm.

As Mr. McAleenan mentioned, I was involved in an evaluation of the HSE's recovery model document, The National Drug Rehabilitation Framework. Many of the staff in the drugs services are enthusiastic and are keen to be part of this recovery, but it needs structure and support. This does not apply just to north inner city Dublin. Addiction affects every community in the country, particularly when alcohol is factored in. The principles of recovery apply to alcohol as well as to other substances. There is not as big a difference between alcohol and other drugs as people think. There is polydrug use and benzodiazepines. There has been an explosion in the prescribing of benzodiazepines in this country and it is an increasing cause of death. It is a huge problem and is costing the State a fortune. There are ways of finding money to support things like recovery.

We point out in the document that much of what we are recommending has been the policy of the Department of Health and the national drugs strategy for about ten years. Some excellent documents promoting a way of doing things have been published. We have a bit of a difficulty in Ireland; we are better at writing documents than implementing them. This is about the reality of implementation. The devil is always in the detail. We have the detail here and Mr. McAleenan has given a flavour of it. We hope the members of the committee will take some time to read it in more detail because obviously today is, we hope, the start of a process to push for this to be done in a better way in the future.

The current national drugs strategy is due to end in 2016 and we are aware that discussions are taking place with regard to its successor. We want these principles to become mainstreamed in a more effective way in the new drugs strategy. That is our timescale. We are only three people and Mr. Tom O'Brien from the HSE is very supportive. Obviously Ms Sonia Dillon and all the staff in Soilse work on this every day. They have enormous expertise. We need to disseminate that in other parts of the country. Mr. McAleenan can outline the success stories. There is capacity for more success if we re-orientate. It would be a terrible mistake not to grant recovery a much higher profile in the new strategy.

We urge the committee to support recovery across all Departments. It is not just a health issue. It also affects education and I mentioned homelessness, so it is a housing issue. There is a big problem with a shortage of accommodation. Drug users in recovery are having to be placed in wet hostels and hostels where people are taking drugs. Obviously the public consciousness about housing problems is about people stuck in mortgage arrears, etc. However, there is a continuing housing and accommodation issue among the drug-using community.

What we are suggesting is completely in line with the Government strategy, Healthy Ireland. It is about a multi-sectoral approach because the issue of drugs is not just a medical issue but it is also a social issue. There are issues in Cork and there is also a drugs task force in Cork. There are problems throughout the country. The heroin issue is still concentrated in Dublin with approximately 9,000 of the 10,000 people on methadone in the Dublin area. However, when benzodiazepines, tranquilisers, pills and alcohol are added in, this is a national issue.

I thank the members of the committee for their attention.