Dr. Hugh Gallagher:

Similar to Dr. McGovern, I have been working in addiction services for more than 20 years. I started work in the HSE addiction services. I have also worked in the Prison Service. The training unit in Mountjoy which was a completely drug-free unit. Unfortunately, it no longer exists. It was a fantastic facility where people who detoxed could enter and stay. They could go to work and so on. It is a major deficit within the criminal justice system that such a facility and the services it offered no longer exist.

Within the addiction clinics, I used to write two or three reports every week for courts. My patients were frequently dying back then from HIV, overdose and so forth. Many of them were simply not living very long. That has changed dramatically in the meantime. I might write one medical report a year for a court these days. While my patients are still going to court and prison, generally it is for theft or other reasons to gain the money to buy the drugs presumably in the majority of cases.

The service we offered was largely biological or medical initially. People have spoken about the stigma. When I started in the service, I was trained that if a person was not complying with their treatment, we were supposed to reduce their methadone dose. It was barbaric, inhumane and ridiculous. Unfortunately, that prevailed in some circles and did so for some time afterwards in certain services. We have obviously altered that.

I would like to think I have spearheaded increased choice regarding treatments available for people with addiction, particularly opiate addiction. The availability of injectable buprenorphine is significant and provides recovery in injectable form. It provides many benefits and reduces the stigma of having to attend clinics and so on.

I have worked in the voluntary sector and the private sector. In the voluntary sector the real benefit I saw in terms of presentations with drug problems, particularly in those marginalised communities, was in increasing the psychological interventions, which we had been doing all the time but which were very ineffective in many cases if not combined with social interventions. Social intervention as part of treatment is key to success.

In recent decades, the Icelandic model has been successful in reducing drug use and social problems, as well as increasing participation in sports music and so forth. What has happened in Portugal has also worked. We have prevented the deaths of vast numbers of people through the social interventions we have undertaken.

I work in a part of Dublin where there are crack dealers on every corner.

It is very hard to escape it. It is important to give those people something to do and in any areas Senator Ruane talked about as well. Social interventions both in terms of protecting and assisting those using drugs are what is key to success.