Mr. Aaron O'Connell:

Go raibh míle maith agaibh as ucht an deis chun labhairt libh inniu. The link between drug and alcohol use, homelessness and prison populations is well established. Any attempt to address the issue requires a highly integrated approach based on an agreed strategy that provides cross-departmental and cross-sectoral supports and services. While work with prisoners may well have a criminal justice element, it should also include a public health response across all sites and provisions. In addressing the drug and alcohol issue through treatment, particularly in prisons, it is important that options for support are clearly outlined and available to all prisoners in all prisons. For example, the drug free option available in Mountjoy Prison should be expanded to include other prisons and options.

In terms of the continuum of care and supports stable accommodations is a key element in recovery from drug and alcohol addictions and for mental health. This is also the case for people who are exiting prison. It is important, therefore, to join the dots in all this because pre-release requires a holistic assessment of a person's support needs. Pre-release programmes must be followed through in the community post-release. This applies to methadone programmes as well as housing, housing stability and the supports associated with this. Former prisoners are particularly at risk of overdose if they are intravenous drug users when they are decanted from prisons. For this reason, a continuum of care must be provided that offers supports and plans that include an accommodation option.

It is also important to continue to innovate in terms of our responses. The diversion programmes, for example, the drug treatment courts, must be expanded to include alcohol, which remains one of the largest addiction issues faced by the country. This needs to be reflected in future strategies and plans. We must also be practical, which means harm reduction must be a core part of policy and practice. We need to open up options for people to address where they are in their addiction cycle and create opportunities to ensure that when they are ready and are given encouragement, support options and alternative routes are available to them. I refer to positive activities that cut into negative aspects of their day. There is no point in asking someone to behave differently if a positive alternative to the negative issue being addressed is not provided.

Medically supervised injection centres must be an option. We welcome Cabinet approval for recent legislation on such centres as a forward looking response to a complex issue. Harm reduction is key, particularly for intravenous drug users but also for everyone else. If we can support people to reduce harm to themselves in terms of what, how and when they use drugs and address discarding, which can be a major issue for communities, we will keep everybody safe and open up options to work with people. If I may put it this way, we cannot work with a dead addict. For this reason, we need to open up options to work with a vulnerable cohort of the group of people who have addictions.

Another element of the response is to consider the innovative idea of heroin prescription as provided for under the Swiss model. I say this because supply is one of the key aspects of the heroin issue, which means demand must be tackled. One way of doing this is to intervene in the market that supplies heroin. If one removes people from that aspect of supply, it will have a major impact in terms of supporting them in terms of what and when they use.

Another key element will be the decriminalisation of drugs, particularly for personal use. This is important for a number of reasons as it shifts the focus from users to the suppliers and dealers. Viewed from a public health perspective, nothing is gained by deploying scarce Garda resources to working with addicts whose issues are in the area of health. Decriminalisation would allow the Garda to deploy its resources more effectively on the interdiction process by focusing on the supply chain of suppliers and dealers.

In short, we must take a long-term view and adopt an integrated, cross-departmental approach that includes the health service, the Departments of Social Protection, Justice and Equality, Housing, Housing, Planning, Community and Local Government, and Education and Skills. We must join the dots. Housing stability, with requisite supports, is the key to recovery.