Mr. Gerry McAleenan:

I will address a few of the points. What we are discussing today was known 30 or 40 years ago. A paper written by Gerald Bury in 1979 stated heroin affected the communities which had the least ability to deal with it the worst. Ever since then the problem has involved trying to deal with it.

Deputy Kelleher asked about individual care pathways. Everyone should have an individual care plan, key worker, case management, SMART goals and the totality of their needs named and actioned. That is the approach we take in our work. Within a two-year spectrum, a person can go from being on the streets to being in recovery, off drugs and engaging in daytime programmes, housing and quality-of-life issues.

On decriminalisation and legalisation, we mention in the report the issue of spent convictions. One woman mentioned in the case studies discussed her life. She went to college when she finished using drugs in 2003 and got a degree.

Again, as there was a drug experience and prior convictions, she has lost several jobs. She is drug free for 12 years but it is still an issue that reappears. We advocate along the lines that the spent convictions Bill should address people who are in recovery and enable them after a period, such as five years, to have a conviction quashed. Generally, if a person is drug free for five years, there is more than a 90% chance that he or she will be drug free for the rest of his or her life.

There are other jurisdictions and models and, as I noted, we are involved in a European project. There is a dearth in responses in the countries we are discussing, including ourselves, England, Romania, Cyprus and Italy. This relates to access to learning programmes or work options. If we are talking about recovery and normalising people's lives, these are key elements that redefine how people see themselves. That is important. We have examined other European countries, and Spain, for example, has co-operatives where people can set up and train for the first year before getting a business start-up in the second year and becoming independent in the third year. This exemplifies the social economy options in other countries that are very viable. We have never had a cultural tradition of co-operatives in Ireland. On the Continent, there are approximately 300,000 co-operatives with 60 million people working in them. We are involved with Italy and that country works with a co-operative model.

There may be other models and there are certain models regarding housing. In England, it is very much like a continuum of care. If a person is detoxing, he or she can go to a housing facility and when that person is drug free, he or she goes to another facility in the recovery community with people who are drug free. Those people can move to permanent accommodation afterwards. Deputy O'Sullivan raised the housing issue. There are models we can consider.

There is the question of how to move this forward. We are talking about events on the ground and Professor Barry mentioned a Minister with responsibility for drug issues with respect to the task force in the north inner city. It is relevant across the city. On the ground, the feeling is that the issue is off the political agenda. Having a Minister with responsibility for drug issues is important. The next drugs strategy should be oriented to a recovery paradigm, and again that will send a message to services that we must focus on more integrated qualitative approaches in how we do our work and delivery. We must be more ambitious for service users, focus on outcomes and ensure people are not languishing for years in medication processes. Quality of life issues must be addressed.

The narratives of people in recovery will give us insight and guidance and provide hope, demonstrating that recovery does happen. That is part of the issue on the ground, as people do not believe that recovery happens. When one is stuck in a void for years, all one can see is the recycling of failure. We must promote recovery and demonstrate that success does happen. By addressing stigma, making this more of a public issue and getting people who have gone through it successfully talking about their experiences, we can hope that, in turn, it will infuse the idea and notion in others.

There is an implementation committee and there has been an attempt to try to implement what is laid out through strategies and documents. The big challenge is to get key agencies working together. The HSE does its work well with respect to methadone and the process has plateaued. The required people are in place now. As we heard earlier, we need to work with the likes of the housing bodies because there is a massive homelessness problem. We need to work with the mental health services, with what is now SOLAS and with the education and training boards. There is poor educational attainment and a consequent lack of marketability and progression options. For example, literacy is also a problem. Dyslexia stands out, and we have found it is far more common within our cohort than within the general population. There is a dearth of response, as there is only one project in Dublin dealing with the issue. These are the elements facing us in the implementation area. A small but empowered group of approximately five or six senior people can make these decisions and get these matters progressed. It would be an effective working group.

Mr. Pat Carey, the north-east drugs task force chairman, visited our project before Christmas. He was there for more than three hours and went back over some of what he would have liked to have happened when he was Minister. The housing issue was important to him as he pioneered housing changes and policies, and he said the process had gone in a direction he did not foresee. He does not believe it is conducive to the needs of people. Outcomes in the housing area are very important.

There is an array of clinical services, with counselling offered to people and other interventions concerning mental health needs or any other medical conditions. Detoxification is also offered along with residential treatment. There was a report in 2007 by Dr. Corrigan and Dr. O'Gorman which indicated we should elaborate on the options for bed capacity in the detoxification and residential treatment areas. If we are to make a major change and liberate people from services, there must be options for moving forward. We need more residential beds and detoxification options. The 2007 report is good and comprehensive.

Deputy O'Sullivan spoke eloquently about recovery and that supports the notion of getting this discourse going in the north inner city. That is appreciated. We can see a change, even at task force level, with people looking at outcomes. It may sound trite despite the times we live in but one of the goals for all the projects has been for everyone in the services to have a meal every day. That is the basic level we are talking about when we are starting to work with people. It is about getting them some nourishment, something to do during the day and getting a roof over their heads at night. It is about getting some company and friendship. These are the basic needs we start with and people respond to this, buy in and become inspired.

There is an issue with prisoners and we should be far more effective in dealing with them, planning for their release and having the array of options we are talking about. There are planned releases but there must be work and education options when prisoners are released. They should have other support as well. I spoke about a model involving a recovery coach, which would be a good link or buddy system for people when they emerge from prison.