Professor Joe Barry:

It was introduced because of HIV. As Deputy O'Sullivan said, we have had heroin in Ireland since the late 1970s. In the 1980s the response to the problem was to tell people if they came off drugs, they would receive help, but that did not work. Perhaps the approach was not well resourced, but there was chaos, riots, shootings and protests. A structured drug service shifts drug users from dealing exclusively with a criminal environment and dealers to working with social care professionals, nurses, doctors and counsellors. It involves a shift in emphasis to recovery. One will not do everything in one day. We would like this issue to be taken on board and to have a genuine implementation plan. That would make a significant difference.

In terms of measuring outcomes and the register, which Deputy Byrne mentioned, there is a register of people on methadone and it has been recommended in numerous reports that there should be data linkage to follow, with appropriate privacy protections. That has not happened, and not just in the drugs area. I do some work with the HSE and I am quite often asked to answer parliamentary questions. We receive questions on the success of a programme or what is happening. It is very difficult to measure some outcomes if one has no way of following someone on a longitudinal basis.

The Health Identifiers Act is not enough. There needs to be a next stage, which is a step that has long been advocated outside of the Oireachtas. If we want to measure outcomes in the health services generally, the next stage of the legislation needs to be commenced. The only information available is on cancer, and the national cancer registry can measure outcomes and survival rates because it is a good register which is appropriately staffed and confidential. We need something like that for drugs services.

I refer to legalisation, decriminalisation and considering things in another way. Legalisation and decriminalisation are different. I do not think drugs should be a criminal issue, but that is not to say that I would support legalisation. Members may remember head shops opening in 2009. People who had never thought of taking drugs took them when they were legal. The world is made up of two types of people, those who are risk takers and those who are risk averse. We would have a much larger problem with pills than we currently have with other substances if we legalised them. Decriminalisation is different.

Mr. McAleenan will discuss recovery academies. In terms of an all-Ireland approach, we currently have 14 local drugs task forces in the Dublin area, including Bray, and Pat Carey is the chair of one. I have worked on this issue for 20 years and it has been a genuine cross-party initiative. We have had Ministers and Ministers of State from three parties involved. It helps to have a focus because it is not just about medicine and clinical matters but a much wider issue encompassing homelessness and so on.

We have ten regional drugs task forces. In each part of the country there is a structure of people who are trying to help, but that is not enough. There is a framework and more of a consensus, which is not absolute, among those working in the area that we need to do things differently. We all need a wake-up call, which is what this is about.

Mental health was mentioned, which is a major issue. The dual diagnosis rate is about 30%. Some 30% of those who use opiates have mental health issues. The Vision for Change document excludes addiction, which is crazy and needs to change.