Mr. Enda Kelly:

The Deputy has raised a very interesting question. We have spent a lot of time with our international colleagues looking on the drugs in prison issue. The Deputy is correct that there has been a big shift from the drugs of choice in previous years, namely, hashish, marijuana, heroin and so on. Nowadays, people do not know what they are taking. They may be told that what they are being given is ecstasy, a benzodiazepine or a roche but that may not be the case. When people take these drugs the onset of acute psychosis is so rapid it causes a massive management problem for the person in the prison environment or the clinical environment outside of the prison.

In terms of how we as clinicians respond to this, all the international evidence is to treat symptomatically. For example, one should try to keep them cool because they overheat and their temperatures spike and to try to keep them in a safe environment. We are finding that once the psychosis passes, these people have amnesia. They often are missing up to a week of their lives where they cannot remember what happened.

Responding to the drugs people are taking is a huge challenge. We work closely with the State Laboratory in terms of trying to analyse what we find when people take these drugs. The State Laboratory and all laboratories across Europe are having trouble keeping up with the chemical formulations that are being put out there. We are very much working in the dark, which underlines the need for the dual diagnosis service. We need to get comorbidity tackled. There are a lot of people with mental health problems not only in prisons but across the whole country. There are not silos of mental health on one side and drug addiction on the other, these are married inextricably. The Irish Prison Service has committed in the national drugs strategy to work with the HSE to take a lead on developing dual diagnosis because we are a service that can initiate that help and treatment as soon as a person presents to us.