Oireachtas Joint and Select Committees
Thursday, 3 October 2024
Committee on Drugs Use
A Health-Led Approach: Discussion (Resumed)
9:30 am
Dr. Richard Healy:
I will speak to the question about central clinical care. I understand there are resource issues and that certain areas may think they need these clinics. This really speaks to the topic today of a health-led response because I hope that does not lead to more of these centralised clinics. They are open for four hours per day. They are beyond capacity. They are obviously going to be a magnet for people who will sell street tablets and this, that and the other outside them. In other countries, they are open 18 hours per day and people can collect their methadone at 6 o'clock in the morning and go to work. I really hope this health-led response does not entail one of the solutions being to open loads more of these huge clinics all over the place.
Individualised care with a GP is just so much better. A person is literally a number in these clinics. A lot of the things I spoke about in my opening statement, such as it involving a urine test and nothing else, is because they are so under-resourced. The training is poor in these clinics as well. It is not up with the international evidence base. There is no evidence behind it whatsoever. It is a test and that is all.
Deputy Gould's story about his nephew is really sad. It is most likely linked to exactly what we are talking about here. If he had that individualised care, he would have been asked those important questions we talk about. In these clinics, because of limited resources, we end up with these uniform care models and the assumption that everybody who presents at these clinics has the same problems. As we know, addiction is so complex and so many different things come into it. Individualised care is the way forward. I hope that is taken into consideration in this health-led response we are speaking about today.
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