Oireachtas Joint and Select Committees
Thursday, 13 June 2024
Committee on Drugs Use
Citizens' Assembly on Drugs Use: Discussion
9:30 am
Michael McNamara (Clare, Independent)
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I wish to advise members and everyone else present, including the witnesses, about parliamentary privilege. Parliamentary privilege is considered to apply to the utterances of members participating online in a committee hearing when their participation is from the parliamentary precincts.
There can be no assurances in respect of participation online from outside the parliamentary precincts and members should be mindful of this when they are contributing.
I welcome everyone to this first public meeting of the committee. The remit of the committee is to provide a reasoned response to all 36 recommendations made by the Citizens’ Assembly on Drugs Use within a seven-month timeframe. We hope to engage with a wide range of stakeholders before providing the reasoned response. The committee has held some private meetings to agree a work programme and has agreed to work in modules. It is hoped to complete two modules before the summer recess. Members of the committee are committed to working together and with all those who engage with it to examine the issues raised by the citizens' assembly and in its report.
Drug use is a complex and important issue, as we are all aware. As Cathaoirleach, I will fulfil my duties as set out under Standing Orders, which include allocating time fairly to members to put questions while ensuring witnesses have sufficient time to reply and that contributions are relevant to the matter under discussion.
The purpose of today's meeting is to engage with the Citizens' Assembly on Drugs Use, which considered this issue over a long period. We are joined by Mr. Paul Reid, chair of the citizens' assembly, Mr. Cathal O’Regan, secretary to the citizens' assembly, Professor Jo-Hanna Ivers and Mr. Brian Galvin, who were members of the advisory support group, and Ms Céire Moynihan and Mr. Graham O'Neill, who were members of the citizens' assembly. I apologise for keeping them waiting. We were attending to housekeeping matters. No disrespect was intended by the delay and I hope none was taken.
I invite Mr. Reid to give his opening statement on behalf of the assembly.
Mr. Paul Reid:
On behalf of the members of the Citizens' Assembly on Drugs Use, I thank the Chairperson and members for the invitation to meet the committee. Our delegation comprises several people who were closely involved in the work of the citizens' assembly. The Citizens' Assembly on Drugs Use has been an example of deliberative democracy at its best. Our terms of reference asked us to consider the legislative, policy and operational changes the State could make to significantly reduce the harmful impacts of illicit drugs on individuals, families, communities and wider society. I am pleased to report we have completed our mission in full and on schedule. Before the committee today is the end result, a two-volume report that sets out what I believe to be the most thorough and far-reaching examination of drug use undertaken in the history of the State. The report reflects the reality that the causes and consequences of drug use are multifaceted and it emphasises the need for the State to respond to these challenges with urgency and ambition.
The citizens' assembly recommendations support specific measures for implementation including, for example, a decriminalised model, pivoting from a reliance on a criminal justice response to a comprehensive health-led response. We have described this as an Irish model for the Irish problem of illicit drug use. Other measures include strengthened political oversight and accountability, through the establishment of a dedicated Cabinet committee on drugs, chaired by the Taoiseach; the prioritisation of supports for marginalised groups and disadvantaged communities; enhanced funding including additional and new sources of funding; a greater focus on prevention and recovery; greater support for families and children impacted by drug use; strengthened services including the expansion of harm reduction measures and treatment and recovery services, both in prison and at community level; and supply reduction, supporting the continued efforts of An Garda Síochána while strengthening the response to drug-related intimidation and violence by organised crime gangs.
The report documents many important contributions to the citizens' assembly made by expert practitioners, stakeholders and, importantly, service users and people with lived or living experience of drug use. We learned that while drug use is prevalent in all parts of the country and among all socioeconomic groups, we can clearly tell that vulnerable groups and disadvantaged communities suffer disproportionately. We learned how addiction and dependency can destroy lives. We heard that organised crime gangs are influencing drug-related intimidation and violence in cities, town and villages throughout Ireland and are luring vulnerable young people into criminality at an early age. We heard also about the limitations of the State's response, which has not substantively evolved in several decades. We were stunned by the length of time it takes to introduce even modest changes in this area. The assembly members were frustrated and disappointed that even the most modest proposals for our health diversion programme, signalled in the 2017 national drugs strategy and in the current programme for Government, have still not been implemented. This would have been at least a starting point for a health-led approach. We were concerned by the inadequate provision of drug services in community settings and the prison system. We heard how shame and stigma compound the harms experienced by individuals and families affected by drug use. Time and again, we heard that simply criminalising people is no way to deal with the drug problem.
In response, the citizens' assembly has recommended a comprehensive package of 36 measures. These aim to ensure the State and stakeholders will respond urgently, effectively and decisively to a full range of issues. We firmly believe all 36 recommendations need to be adopted. Tackling issues in isolation will simply not work. We fully respect the role of the Oireachtas committee now in the next phase of this process, but we call for urgency from the Government and believe our recommendations could and should be implemented in full. We are acutely aware that for tens of thousands of people in this country who are affected by drug use, the clock is ticking. People's lives and futures are on the line. There is no time to waste. We believe this report offers a new paradigm. We have, I hope, broadened the national conversation about drugs from a narrow focus on debates about legalisation and decriminalisation.
The assembly comprised 100 members, 99 of whom had been randomly selected from the general public and me, as independent chair. Our demographic profile perfectly mirrored wider Irish society by age, gender and location. The group was also diverse in socioeconomic profile, nationality and disability status. Importantly, our members held diverse perspectives on drug use, with people from all walks of life coming from various levels of experience of drugs and addiction. Irrespective of their backgrounds and personal experience, each and every member made an invaluable contribution and ensured the assembly was informed by a wide spectrum of opinions, reflective of Irish society generally. We had six weekend meetings, heard from 130 presenters and had more than 15 hours of questions and answers and 250 hours of round-table deliberations. We also received almost 800 public submissions. We heard from eminent experts at international, EU and national level. We grounded our deliberations in empirical evidence, including from the Health Research Board and the European Monitoring Centre for Drugs and Drug Addiction. Most important, we included practitioners, service providers and people with lived and living experience.
Despite the diverse profile of our members, there was a strong consensus of support for most of our recommendations. Of the 36 recommendations, 31 were supported by more than 90% of members, while another four were supported by more than 80%. The only issue that revealed a significant divergence in perspectives related to the possession of cannabis for personal use. Even then, there was a strong consensus the status quo is not working and that we need to adopt a new approach.
If I may, I will briefly summarise our recommendations. Recommendations Nos. 1 to 6, inclusive, focus on the need for urgent, decisive action by the State and for drugs policy to be prioritised by the Government. Among other things, they call for a dedicated Cabinet committee on drugs, chaired by An Taoiseach.
Recommendations Nos. 7 to 10, inclusive, focus on a whole-of-government, whole-of-society response to drug use, with a new national drugs strategy built on partnership between the State and stakeholders.
Recommendations Nos. 11 to 14, inclusive, focus on policy on services for people with underlying drug problems who are engaged with the criminal justice system. They call for more community-based and residential drug services to give the Judiciary greater options to divert people away from convictions and custodial sentences towards appropriate help. They also call for more drug treatment services within the prison system.
Recommendations Nos. 15 and 16 focus on improving service delivery and targeted services for vulnerable and marginalised groups.
Recommendation No. 17 relates to how the State should deal with the possession of drugs for personal use. The assembly has recommended a comprehensive health-led approach, informed by international examples, including Portugal and Austria. While the possession of controlled drugs would remain illegal and prohibited by law, anybody found in possession of drugs for personal use would, first and foremost, be afforded extensive opportunities to engage with the health-led services.
Recommendations Nos. 18 to 21, inclusive, focus on the funding of services and include a recommendation to examine potential novel sources of funding.
Recommendations Nos. 22 and 23 focus on workforce development and providing trauma-informed training to key personnel.
Recommendation No. 24 calls for a continued focus on the efforts of law enforcement to reduce the supply of drugs, working at international, EU, national and local level.
Recommendation No. 26 calls for a zero-tolerance approach to drug-related intimidation and violence and a continued strategic focus on tackling this issue at a community level.
Recommendations Nos. 27 and 28 focus on prevention, emphasising the need for Ireland to improve its approach to primary, secondary and tertiary prevention.
Recommendation No. 29 calls for a public health communication strategy focusing on reducing shame and stigmatisation, drug prevention, risk mitigation and advertising drug services.
Recommendation No. 30 calls for a systemic approach to recovery with funding for evidence-based innovation in the provision of residential and community-based recovery services.
Recommendation No. 31 calls for a strategy to enhance resilience, mental health, well-being and prevention capital across the population, including therapeutic supports for children and young people.
Recommendations Nos. 32 and 33 focus on improving the State's response to drug use through innovation, evidence and data.
Recommendation No. 34 refers to the submissions received by the citizens' assembly to the Department of Health in the context of the work in preparing the next iteration of the national drugs strategy.
Recommendation No. 36 refers onwards to the appropriate regulatory authorities submissions received by the citizens' assembly which relate to the potential therapeutic benefits of cannabis and plant-based psychedelic substances.
Recommendation No. 36 calls for more widespread use and rapid adoption of evidence-based approaches to harm reduction.
We believe that the citizens' assembly has been the most comprehensive, inclusive, transparent and informed examination of illicit drug use that has ever taken place in the State. This is why I urge the Oireachtas and the Government to embrace this new paradigm. With the right ambition, resourcing, leadership, strategic direction and determination, we can fundamentally transform how Ireland deals with drugs now and into the future.
Michael McNamara (Clare, Independent)
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Thank you very much, Mr. Reid. Before I invite members to ask questions, I want to ask one brief question and then I will ask Senator Ruane, who is the Leas-Chathaoirleach, to chair the meeting.
Mr. Reid, you rightly pointed out that the make up of the assembly reflects the national demographic in terms of age, gender, etc. This is a brief procedural question. How was that achieved and who carried out the selection process?
Mr. Paul Reid:
The process is administered by the secretariat, headed by Mr. Cathal O'Regan. In essence, it is what is called a stratified, random selection process. Some 20,000 letters issued out to the public. Of those, we got fewer than 2,000 responses back. From those, we basically used the CSO data and identified the population mix that reflected the CSO data. It will reflect geography, regional distribution and, as best it can, socioeconomic background, nationality and disability. We had a really good mix, with 12 nationalities represented in the assembly.
Michael McNamara (Clare, Independent)
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In terms of the people originally written to, of whom a proportion replied, from what database were they selected?
Mr. Cathal O'Regan:
It is a database provided by An Post called GeoDirectory. It is the most comprehensive database of all households in the country. Essentially, every household in the country is in the mix to be selected as one of the 20,000. Out of the 2.3 million we get a random selection of 20,000 that reflects the population distribution around the country. From that 20,000 the applicants are whittled down to 99.
Michael McNamara (Clare, Independent)
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Thank you. I invite Senator Ruane to take the Chair. I want to reassure everyone that I mean no disrespect. I just have to go to another meeting, and I apologise for this. Thank you all very much for coming here today and for the information you have provided.
Lynn Ruane (Independent)
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I will go straight to questions from the members and first up is Senator Mary Fitzpatrick.
Mary Fitzpatrick (Fianna Fail)
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I thank the witnesses for being here today and for all the work they have done to get us this far. The citizens' assembly has done incredible work. This is an incredibly important issue for us as an Oireachtas committee and for society more generally. When you see the statistics that 20% of our young people use drugs, that Ireland has the second highest rate of MDMA use, and when we see the carnage this is wreaking in our communities, we as an Oireachtas committee have a very serious responsibility to build on the work the citizens' assembly undertook. I sincerely thank the assembly for that piece of work. It is long overdue and we have to move forward. It would be completely unacceptable and negligent of us not to respond comprehensively to the recommendations. The fact there are 36 recommendations indicates the enormousness of the task. There is no point in us doing this piecemeal. It has to be comprehensive and holistic. The citizens' assembly, rightly I think, took a person-centred, victim-first and health-led approach to its workings. The recommendations all reflect that.
When I read all the documents, the depressing part was the enormous amount of effort that has already gone in, which I acknowledge, by people who work in this space, such as those in our health service, the drugs task forces, community services, An Garda Síochána and others who work with victims of drugs, the addicts, their families and their communities. It is really depressing to think we are this far on, with the hundreds of millions of euro that are being spent and the human effort that is going into trying to defeat this. I approach our task with real caution and concern. It is a once-in-a-lifetime opportunity that we have as an Oireachtas committee to get this right. It will require very strong recommendations, and those recommendations will have to have not just an all-of-government but an all-of-State approach to it. They will have to be recommendations we can get communities throughout the country to buy into voluntarily and then all of the State's resources applied to making them happen.
I have a lot of questions and I have only a couple of minutes. As these meetings progress, we will come back and forth, so we would appreciate if we can come back to the assembly, even offline, with questions and queries. That would be very useful. In making our recommendations, our guiding principle has to be to try to do no more harm than is already being done and to enhance the potential for drug reduction, damage reduction, the increase of recovery and to support communities and individuals to recover, rehabilitate and be stronger and more resilient.
We will deal with the whole health side of it at another meeting. For my understanding, how did the assembly set the agenda for its meetings? How were topics determined? Were they determined by the assembly? Will the witnesses explain that to me?
Mr. Paul Reid:
I agree with the Senator that the statistics give great cause for concern. If we look at 2020 data again, republished by the Health Research Board, HRB, Ireland ranks as the worst in the EU for drug-induced deaths. We are a complete outlier in terms of our response.
On the 36 recommendations, we were very anxious that the whole debate did not just harp on the one issue of criminalisation versus decriminalisation versus legalisation. It is much bigger and that is why we reach out much further. I think the previous assembly on biodiversity had 170 recommendations so we tried to keep things as tight and as focused as we could.
Regarding the structure of the meetings and the agenda, we looked at the seven months of work we had. In the six assembly meetings we put a structure around us which was, first, a steering group comprising six of the assembly members. Two of the assembly members are here and can talk about that. They looked at what they felt was suitable for the agenda. Separately, we had an advisory steering group. This had people, including Ms Jo-Hanna Ivers, who is here with us today, with very different public views on reducing the harm caused by drugs. Some people were more liberal and others were stricter to the point of being perceived by some as being prohibitionist. We had a broad spectrum of views there.
Third, we had a legal advisory group working with us to give us a bit more depth about the complex issues. Some people talk about legalisation but they actually mean decriminalisation and others talk about decriminalisation when they mean legalisation.
We wanted to get a better grounding, so they advised us on the process. Finally, we took feedback at the end of each assembly meeting about the agenda and whether people would like to see any other items on it. Setting the agenda was quite comprehensive and the secretariat worked with people. If appropriate, when we get a chance I will ask one of my colleagues, Ms Moynihan or Mr. O'Neill, to give their perspective on how we shaped it.
Mr. Graham O'Neill:
I was part of the steering group that was a point of contact for assembly members. We met for two or three meetings before the assembly meetings took place and had an input into how it was arranged and how the day went, including on matters as menial the time given to certain speakers, breaks, etc. The assembly members had the option of going to the six steering group members and voice their concerns as well. As members of the assembly we had an input into how the meetings took place and the speakers. We were also given advance agendas.
Mr. Cathal O'Regan:
The agenda for each of the six meetings flowed initially from the terms of reference the Oireachtas set. There are detailed terms of reference in the motion establishing the citizens' assembly and everything derived from that. That provided us with an overarching work programme, how to schedule in a limited time and fit everything into six meetings, which really only included five substantive meetings because the final meeting was all about voting. Fitting everything into five meetings was quite an order. We came up with a draft work programme, which said we would start in the first meeting by focusing on these issues and work our way down through the rest. That was given to the members and members gave us feedback about issues they felt needed to be resequenced or reprioritised. Therefore, the final work programme was effectively based on input from the members and then as Mr. Reid and Mr. O'Neill explained, the advisory group and steering group also gave inputs to help us to finesse the individual meeting programmes for each meeting.
Mark Ward (Dublin Mid West, Sinn Fein)
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First, I commend the members of the citizens' assembly, the chairperson and everyone who was involved and gave expertise to the project. It was a worthwhile exercise and the fact we are here today is testament to that. I spoke to Mr. Reid previously about my professional background, which is working in front-line addiction and recovery services across Dublin. I have seen services have to change and adapt to the circumstances in their area over the years not being supported by Government policy or by the HSE and that has always been a barrier. I am from north Clondalkin and am proud of the area, but my community, including my parents, neighbours and other members of the community, had to fight tooth and nail for everything that is in the area. I am talking about the most basic services, such as schools, transport and at one stage we even had to fight tooth and nail for the local shop. It is an area that is disproportionately affected by addiction, but it is also disproportionately affected by poverty, and poverty underpins a lot of areas that are affected by trauma, which leads to high levels of addiction and adverse drug use.
I have seen too many of my peers and family members succumb to a life of addiction over the years. Some people do not have an alternative. That was there and that was their way. Addiction and drug use are escapism. That is why is called getting out of your head. It is getting out of whatever is going on, whether that is poverty or trauma. It is escapism and continuous drug use can lead to problematic drug use, which can lead to addiction.
One of the biggest scourges in my community and other communities like mine is drug debt intimidation. People are afraid to ask An Garda Síochána for fear of reprisals. Families can often not pay back exaggerated drug debts to unscrupulous drug dealers. I say "exaggerated" because what they say is owed is a ten times multiple. Parents or young people are often put in a situation where they have to do things they would not normally do to get the money to pay back these unscrupulous dealers. That is where the intimidation aspect comes in.
I am aware of the DRIVE project. I linked in with it before. We have a partial one in my area of Clondalkin. I am interested in what other solutions and barriers were discussed at the citizens' assembly in relation to drug debt intimidation. It relates to recommendation 26. Will the witnesses start with that?
Mr. Paul Reid:
I will make a few comments and then defer to some of my colleagues who are practitioners in this area. I am glad the Deputy raised the issue of social deprivation early in the debate because it became clear to us very early in great depth. Like the Deputy, I come from an area that has high levels of social deprivation, Finglas west, and I have witnessed many of the issues of drugs and the intimidation, violence and harm that go with them. The issue of trauma jumped out at us very early. The lived experience described by people was of going through early life trauma and using drugs to numb the pain or the issue. They then got criminal convictions, ended up in prison and then in a vicious cycle. That is the cycle we are anxious to break with our recommendations, the vicious cycle of criminality where there were other issues to be addressed.
I am familiar with the DRIVE project. Its members presented to us and I was with them at another of their presentations. I am very impressed by it. I will pass to Dr. Ivers who is a practitioner in the area of recovery and addiction to respond on the Deputy's issues and we will then get to recommendation 26 specifically.
Dr. Jo-Hanna Ivers:
To clarify, prior to academia I worked in front-line services for seven years and all my research is translational so I deal with communities a lot, but I feel like a bit of a fraud calling myself a practitioner today.
The programme represented other community-based services that deal with young people around building up supports for intimidation. I acknowledge what the Deputy said about the notion that every community is under pressure to scrap for services and trying to fight to fill this comprehensive response to address people's drug use; in other words, trying to find houses for people in the middle of a housing crisis, trying to get them into education when our numbers have never been higher or trying to get them a job in a market that calls for so much skill. The pressure we are putting our health system and communities under has to stop. The Deputy is right that poverty is the driver of addiction. We have acknowledged that as far back as the Rabbitte report, which was really good, but our solution is focused on treatment. If people are addicted because they are in poverty and we treat the addiction, we are doing nothing about the poverty. Ultimately it is about building up community supports, putting resources back in communities and driving such things as Mr. Reid mentioned, where we have people with lived experience at the centre of our services.
The other Deputy spoke about the notion of a whole-of-government approach. Yes, we need that but at the moment we have co-ordination from our cross-sectoral partners. We need absolute buy-in and for those other agencies and sectors to strategise around recovery and prevention in a way they would if we were talking about economic recovery. That is the whole-of-government approach we really need. Until we do that, we will still have communities like the Deputy's and mine - I am from the north inner city - on their knees, struggling, pushing back, fighting and scrapping for resources. Ultimately it is about building up those supports and addressing the underlying issues like drug intimidation.
Mr. Cathal O'Regan:
Recommendation 26 is a good example of how these issues cannot be tackled in a piecemeal fashion. On one hand, members of the assembly voted for a zero-tolerance approach to drug-related intimidation and violence and every effort that can be made by community groups, the Drive Project and so forth to tackle that issue, but recommendation 14, which states that in parallel the State should develop alternative pathways for vulnerable young people in communities who are lured into a life of criminality at an early age, should not be ignored.
It is recognising that we heard a huge amount of concern about the role of criminal gangs in bringing young people in at an early age for low-level distribution. We are recognising the complexity of the problem and saying there are different parts of the solution. One is zero tolerance of the criminal activities of drug-related intimidation and violence. However, at the same time, it means taking a more sensible approach to helping young people. We heard a lot of input from community development workers, youth workers and so on talking about the challenges at community level to try to counteract the influence of criminal gangs in this area. There is a range of different recommendations that speak about the social determinants of drug use, the need for a focus on community development and trying to resolve the underlying problems of poverty and deprivation while at the same time not giving leeway to the criminal gangs that manipulate and damage the lives of so many young people.
Paul McAuliffe (Dublin North West, Fianna Fail)
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This is the third committee where I have dealt with the report of a citizens' assembly. The previous ones were for gender equality and the directly elected mayor. I have a little more insight into how the citizens' assembly works. I want to give witnesses an opportunity to talk a little about the criticisms that arose at the voting on the last day. They arose online from people who were not in the room. I think this a good opportunity for the witnesses to talk about that process and why those criticisms arose.
Mr. Paul Reid:
We highlight in the opening statement that the vast majority of support for the vast majority of our recommendations came from the assembly members. The one with a narrow vote margin was the issue relating to cannabis. We took direct polls and all votes reflected that all drugs should move to a decriminalised approach from the current criminal justice system. It was obvious throughout the debate that the issue of cannabis possession for personal use would be a contentious one. It was contentious throughout the debates, and we are glad we had that debate and had a wide spectrum of views. The voting process throughout all of the votes was led by an international expert on polling and voting, and they worked through every vote. Before every vote it was explained to every person exactly what was on the ballot paper, what was being voted on and how it would be counted. It is a fact that there was a difference of one vote in the vote relating to decriminalisation or legalisation of cannabis use. There was understandable angst among some members who wanted to see their approach adopted and others who felt we took the right approach.
Paul McAuliffe (Dublin North West, Fianna Fail)
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I have come from a weekend of narrow margins and disappointment so I can understand that. Does Mr. Reid feel it was clear enough that subsidiary preferences would kick in once the first preference was eliminated? Does he think that was understood in the room or was there confusion on it?
Mr. Paul Reid:
I believe it was overall. There were certainly voices that expressed it maybe was not for some people, and that is fair enough. It is not a simple process when you are balloting on a multi-choice voting system. It was not simple. It was explained thoroughly. If the Deputy has a chance to look back through the live video recordings, it is very clear-----
Paul McAuliffe (Dublin North West, Fianna Fail)
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I did watch them.
Paul McAuliffe (Dublin North West, Fianna Fail)
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That would be useful.
Ms Céire Moynihan:
I thank the Deputy for the question. If the outcome had been different, we potentially would not have heard those criticisms. It is the one issue that is quite divisive and emotive. People are on either side of the spectrum. There is no middle ground on it. In the round-table discussions certainly, people were either one way or the other. I think you can quickly go down a rabbit hole with that whole discussion. I urge the committee to consider it seriously because there are other issues on the table that are extremely important. I am not saying this issue is not important, but whether cannabis is legalised will not resolve the matters in our society. That was the view around the table.
Paul McAuliffe (Dublin North West, Fianna Fail)
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I believe the Oireachtas has the right to act however it wishes, and the citizens' assembly is advisory. However, as members of the citizens' assembly, do the witnesses think it would be in keeping with citizens' assembly report and recommendations for the Oireachtas to take a view on that, given that it was such a tight margin?
Paul McAuliffe (Dublin North West, Fianna Fail)
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Is that the case even given the very tight margin? I am not talking about that issue or debate specifically. I suppose it is the point that this is a nuanced debate and the recommendations of the citizens' assembly on that issue were very narrow. In my view, that leaves the Oireachtas the freedom to take it and respond to it, given that it was such a narrow margin.
Mr. Graham O'Neill:
While that is true in a sense, again, if we are to take away from the fact and take a different viewpoint to what was recommended, it would undermine the whole process. At the end of the day, the vote was cast, and the die was cast, and the result came out the way it did. To divert from the result would call into question why we would do that for one recommendation and not for the total process.
Paul McAuliffe (Dublin North West, Fianna Fail)
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I have a lot more questions and I hope to come back.
Mr. Paul Reid:
It is absolutely within the remit of the Oireachtas, and we respect that, to decide whatever. The point we are trying to make is that a difference of one vote does not get to the essence of the seven months' debate we had. What we believe is a solution to the whole issue of drugs, including cannabis, is in the report.
Paul McAuliffe (Dublin North West, Fianna Fail)
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I fully agree and wanted to give the witnesses an opportunity to address those issues because they are being addressed publicly. I have a lot more questions, but I want to particularly thank the members of the citizens' assembly. They gave up a big chunk of their time. I am sure they were not experts on the area in any way and they feel they have gained huge experience. I thank them so much.
Ms Céire Moynihan:
It was an absolute privilege for all 99 members selected. A lot of us did not know much about drugs before we attended. We can tell the Deputy that we came with an open mind. We considered the lived experience in particular, the community effect, the effect on families and the behavioural effect. Recreational drug use is fuelling the issue in this country. People are not understanding that message. If they are going out on a Saturday night and reaching for a pill or a bag of cocaine, we need to get the message out that they need to think of that seven-year-old in a marginalised society with no parental support. As Deputy Ward indicated, they are in a cycle in the area, and it is extremely difficult for them to pull themselves out of it. I would like this assembly to focus on prevention and what we can do in that regard. We can then inform people that, when they go out, the choices they make mean they are part of the problem. We are all part of the problem, but we are all part of the solution. That is the message I would like to get out there.
Mr. Cathal O'Regan:
With the tightness of that vote the Deputy refers to, we did a full recount on the day and got the same result. I did a post hoc audit of the ballot papers, so I can confidently say there was every evidence that people understood the single transferable voting process. There was no question that there was any confusion on the ballot papers. As far as we are concerned, everything was above board and in order with the result of that vote.
Matt Shanahan (Waterford, Independent)
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I thank the witnesses and congratulate all of them for their participation and all they have done. They have done a great body of work and practised great diligence in coming to their recommendations. I will synopsise what I have taken from it. Decriminalisation for personal use is high on the agenda. There is also a health-led approach, with greater political and policy supports required and increased resourcing right across the spectrum, including for recovery services and addiction.
These problems are all multifaceted and societal in nature. The question is how much can all this do to change what is happening in society.
On cannabis and the divergence of opinion in respect of it, there is something I would like to understand. Cannabis is not the drug it was 20 or 30 years ago. The addiction rates relating to cannabis are far different from what they were. The impacts of cannabis, particularly for younger users, are starting to become known in psychiatric services. Where was that taken into account? Cannabis is probably regarded as a soft drug compared with some of the others.
When it comes to community supports, what is working and what is not working? I am close to Aiséirí in Waterford. I have been there a number of times. It does great work, particularly in terms of the penal system, addiction recovery, trauma and marginalisation in society, but that is not all of it. There is the push-and-pull factor of drugs being forced on communities and people, for whatever reason, being open to drugs. When we talk talks about marginalised societies and trauma, it does not explain the rise in fentanyl use in Ivy League universities in America and that is coming here too. People are predisposed to try things and get into them for various reasons. It is not always about the levels of affluence or otherwise. Another big factor, which we see with drugs entering the country here, is that there are the push and pull factors of people using it but there is criminal enterprise here with international criminal syndicates. The ability of our State to tackle this is limited. The conversation here and education are both very important, but it is hard to know how we build from where we are now in the context of what is in the citizens' assembly report. What do we do first that we give us the best outcomes with the limited resources we have?
Mr. Paul Reid:
On what we can do, our strong view, which I mentioned earlier, is that we have wasted the seven years since 2017, when it was agreed in the strategy to make a small move forward by way of a health-led approach and not routing people through the criminal justice system. That was in the programme for Government in 2019. It is now 2024 and that has gone nowhere. On the small things can we do, we can act at pace on that. We set out that we need to legislate. We are not recommending that approach. We considered the approach that has been on the shelf since 2017 and we rejected it. We said that we need to go further in terms of a comprehensive health-led approach. We need diversion and dissuasion encompassed in that.
Second, as some of the Deputies stated, this has been a whole-of-government approach. It needs a whole-of-government structure around it. We urge that a dedicated Cabinet committee on drugs that will report annually and assess the impacts and consider all the data. That committee should be chaired by the Taoiseach. I have worked on two Cabinet committees during my career in the public service, and they work. It does get the key principals around the table and holds people to account. They are practical things that can be done, with the legislation and with the Cabinet committee.
After that, we agree, and I think Deputy Ward said this earlier, that addressing the drugs issue is not addressing the whole-of-society issue or those of social deprivation but it has to be addressed. The way we feel it should be addressed is by the wider 36 recommendations that are in the report. We saw great examples all across the country of community and voluntary services that are working. Some are a combination of the statutory services, such as the HSE working with community and voluntary sectors. They are excellent and they work. For example, a dedicated drugs court in Dublin and Cork takes a fundamentally different approach and it is working. Routing people through an education system. The Dublin drugs court has been a pilot project for 20 years. Judge Ann Ryan was on our advisory committee. The court has been pilot project for 20 years. It works; roll the thing out. Those are practical things that we believe can work.
On services, there are a couple of practical issues. If you are relying on the community and voluntary sector, which does a fantastic job, it is sporadic. It is different in different parts of the country with the funding and the accessibility so we said to take a wider look at that. For example, while it has been addressed by some of the recent pay agreements, some section 39 organisations really struggle to get people and keep them because there are better pay rates elsewhere. They also struggle because they only know their annual funding. They do not get multi-annual funding, so they cannot plan for resourcing or for service. They know what they will get next year, probably a couple of months into the year. There are some very real practical things which we believe can be implemented in our recommendations.
Matt Shanahan (Waterford, Independent)
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Has the group looked at any kind of programme for schools - primary schools - to drive a programme of education for young children who are not going to be offered drugs - I am talking age five, six, seven or eight here – to try and give them the awareness and understanding of what they may face in the future if they dabble or get addicted? That is what we are all afraid of.
Mr. Paul Reid:
We have recommendations for greater awareness at all levels of education - primary, secondary, etc. We had a good debate on whether such programmes are better delivered by people who have lived experience or by teachers, but we believe in bringing in people with lived experience. We should say, though, that it is not a silver bullet. If someone comes from an area that has high levels of social deprivation, has had early-life trauma, has parents at home who are self injecting, then it is a different solution. It is not just how you teach people about it. There is a recommendation there; I would not say it is a silver bullet to solve this but it is important.
Ms Céire Moynihan:
If I might add, I think the Deputy is in agreement with what we are trying to do with the assembly when he mentioned Ivy League. It is a pan-societal issue. Some would say that is why we are talking about it now and that it is because it is affecting every strata of society. It is not just the marginalised areas any more and now, all of a sudden, everyone stands up and wants to tackle this issue.
The Deputy mentioned that the potency of cannabis increasing and stated that some people think it is a soft drug. It is exactly this kind of behavioural norm that we are trying to get away from. There is no such thing as a soft drug. Every drug is harmful because it is harming people further down the ladder. They need suppliers. There are children being groomed from the age of seven to deal with supplying for these criminal gangs who have absolutely no regard for life. They are all interconnected. There is no such thing as a soft drug. There is no such thing as a drug user who does not have a harmful effect somewhere else in society. As soon as we start to realise that we are all interconnected and part of this issue we will not resolve it.
Lynn Ruane (Independent)
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Sorry, I will have to move on. I am sure there will be a point to come back in.
Marie Sherlock (Labour)
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We owe those here today and the wider citizens’ assembly a huge debt of gratitude for their work and the concise recommendations we have before us. To have 250 hours of round-table discussion is an enormous commitment so I thank everyone very sincerely and also Dr. Ivers and Mr. Galvin whose professional work is hugely valued in this area. We have a profound set of recommendations in terms of moving to a health-led approach. It is very clear that we need a whole-of-government approach on this. I heard what Mr. Reid said about the frustration expressed by many citizens’ assembly members with regard to the national drug strategy and the failure to implement some very modest proposals there. We all know the reality is that people do not wake up and have a drug problem. It does not happen overnight. It happens because of all the other issues in their lives. We owe it to the two- and three-year-olds in the SAOL project in Amiens Street, to children right across many communities and to the people that Ms Moynihan talks about to ensure that we as a committee make progress on these recommendations.
I have two specific questions. My first is to Mr. Reid on recommendation 7. His professional background brings something unique to the assembly, having been chief executive of the HSE and going on to chair the citizens’ assembly. There is an explicit call to publish a draft national drugs strategy by June 2024. It was a very bold call in some ways and very welcome.
We hear what was said about the need for urgent action. Will the witnesses give us some insight into the thinking behind that? That deadline is important for us. We heard what the Department of Health had to say on the matter, but I would like to hear their thinking.
Mr. Paul Reid:
I recall the debate we had on the day we came to that recommendation. There was a call from the floor. We originally said we would give it a year. It might even have been my advice that we give time to do it. However, from the floor, the assembly was very clear that we had to send a strong indication of the pace and urgency of it. That is where the June 2024 date came from.
Like the Senator, I was extremely disappointed to read statements this week from the Department of Health that it will get to this in 2025. It will continue evaluation and oversight but 2025 is when the national drugs strategy expires. We need a new strategy now. Again, I very publicly say that this is not getting the pace, urgency and attention it needs. It is not getting the focus. We are losing time, focus and pace. We are also losing lives. I am making a real call. June 2024 has not been achieved but if is going to be June 2025, we will lose many more lives.
Marie Sherlock (Labour)
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That is a very important statement. I thank Mr. Reid.
I will ask about recommendation 17. The assembly has very helpfully set out the questions that our committee needs to deal with regarding the issue of decriminalisation. I want to understand whether the citizens' assembly thought it was possible to go further. The recommendation is that ultimately there should be "a comprehensive health-led response to possession of drugs for personal use." I want to understand a little more about the conversation and deliberations on the specifics of the sanction of prison sentences for those found in possession and the number of times they are found in possession. Was there an attempt by the citizens' assembly to go further than what is in recommendation 17 to give greater guidance to us in the Oireachtas?
Mr. Paul Reid:
That is a great question. There are two issues. First, we gave assembly members five options. These ranged on a continuum from the status quo and the health-led approach that has been on the Department's shelves since 2017 to what we had, namely, a comprehensive health-led approach, which was recommended, to more liberalisation and legalisation. They had five options. We worked through each of them. Second, there was a very interesting moment for all of us in the assembly during a presentation by a senior individual from the European Monitoring Centre for Drugs and Drug Addiction who gave examples of what is happening with regard to legislation and decriminalisation in other countries. That presenter said we should try to articulate what we wanted to achieve. We may not have had the knowledge or legal expertise to describe how to legalise drugs, for example. Even lawyers who were before the assembly differed about what legalisation or decriminalisation meant. However, the presenter from the European monitoring centre gave very strong advice in the context of setting out what we wanted to achieve. We then refocused. We said we did not want people to get a criminal conviction for personal use. We wanted people to get supports for diversion and dissuasion and we wanted drugs decriminalised. We articulated it as that.
What we left open, as the Deputy quite rightly said, were some complex issues, which the Oireachtas and the Government can get the right legal advice on. These include what the limitations for personal use are and how many times people would be caught before no longer being routed through a health-led system. There is also the issue of whether our current legislation needs to be changed if we want to decriminalise some drugs. In addition, who would apply the sanctions? Currently, it is the courts and the justice system. Who would apply sanctions in future to help people through a health-led approach? If they are not going through that approach, who applies the sanctions? Those are the questions on which we believe we need to get the right complex legal advice from the Attorney General and others. We stuck to what we wanted to achieve as an outcome.
Marie Sherlock (Labour)
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On the participation of An Garda Síochána in the citizens' assembly, we have seen between 2019 and 2023 a 54% increase in the number of people charged with possession for personal use. That figure is 74% in Dublin or the eastern region. Deputy Gino Kenny is here; I think it was his parliamentary questions which uncovered that. Will Mr. Reid give us some insight into where he thinks An Garda Síochána's perspective is with regard to decriminalisation or going after those in possession of drugs for personal use? This is a huge concern for us in trying to change the approach from a criminal justice-led system to a health-led system. I would like to hear his thoughts on that.
Mr. Paul Reid:
First, we recognise that Garda members put their lives at risk every day in fighting crime. Second, they contributed very well to the debate. Third, they were consistent in their view that they did not want legalisation. We probed further where they lay on the spectrum of decriminalisation. I shared a platform yesterday with Assistant Commissioner Justin Kelly. I am not certain where Garda members stand on decriminalisation; they were certainly against legalisation. The assembly got frustrated at times. I said publicly that we perceived it as the status quo being seen as fine and we should keep it. Our strong view was that the status quo is not fine. I will not answer for where the Garda Síochána stands now, but its members were certainly against legalisation. I am not fully clear on where they are on decriminalisation.
Thomas Gould (Cork North Central, Sinn Fein)
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I thank the representatives for a great piece of work. It is a very complicated piece of work on the part of everyone who was involved in the citizens' assembly. Sometimes, citizens' assemblies can be used to tackle very complex questions and maybe give the Government cover when it needs to deal with those questions. There are 36 recommendations. The committee now has a job of work to do to bring out a report in the next seven months.
I will make a few points. I believe the Government and those which preceded it have had no interest in tackling the development of a drugs strategy that would work. That was referenced with regard to the health-led approach that was never acted upon. When we look at what happened with austerity after the financial crash in 2007 and 2008, and the absolute destruction caused by the slashing cuts to task forces, community services and education, most of that funding has not returned. Now, 17 years after the financial crash, many of these services are operating with a similar level of money, no multi-annual funding, and are not able to plan how they will deliver services. If we are to get a drugs strategy right, the first thing that must happen is resources, staffing and money must be put into community services, the HSE, detox beds and residential beds.
We have a situation where the Keltoi centre, which was seen as a brilliant facility that engaged with people going into recovery, including their mental health, was closed. What should have been rolled out nationally has been closed for years at this stage. The frustrating thing for me as Sinn Féin spokesperson on addiction, recovery and well-being is that the Government is not serious about developing a drugs strategy that would work. If it were, the first place it would start would be to fund these services in communities.
The fact that some communities are disadvantaged was referenced. Sometimes, I hate using that word because it is a stigma. Saying it is disadvantaged puts a whole community into a box. I come from Knocknaheeny in Cork city, which is one of the areas under regeneration. I never considered myself disadvantaged. Do not get me wrong; we have many challenges. We have seen many of the consequences of the harmful, devastating effects of drugs. While we know people all over Cork and throughout the country who came from affluent families who see that same devastation, it is certainly right to say that areas that have suffered deprivation, disadvantage, and a lack of services and funding, are way more affected by drugs and their consequences.
In the community I represent, I am involved with St. Vincent’s Hurling and Football Club. I have been involved in coaching teams all my life, and I am a former schools coach. As soon as a child joins our club or any club, you look at the family and their personal circumstances, In some instances, you know the child will be gone by the age of 12, 13 or 14. That applies to the vast majority of children. I could never figure out why the Government did not act on this. We have very good schools, a good HSE and a good Department of Education. I do not know why there was no link to identifying children at risk. When we are dealing with Tusla, we are only dealing with the children who are at extreme risk, whereas we can identify other children who are at risk and get them onto the pathways of sport and education.
I have looked at some of the assembly’s recommendations. Recommendation 25 focuses on community responses to drugs, recommendation 27 focuses on prevention and recommendation 29 focuses on communications with a view to reducing stigma. These are all things that should be in place now. There is so much I want to say about this. There is so much in the report that is good. In some ways, I do not see why the assembly had to do its work; this Government and those that preceded it should have done it. Surely the expertise was there in the HSE and the Departments of Education and Justice to look at all of these things.
I may have been rambling but I really care about this subject. I greatly appreciate the work the assembly has done. I ask the witnesses to comment.
Mr. Paul Reid:
I suppose the answer is that it is all of the above. We would not disagree with much of what the Deputy said. On his point about what needs to change in terms of strategy, we have a number of recommendations. We talk about having clearer responsibilities and accountability and knowing who is responsible for delivering what across the spectrum of services. We should be producing an annual action plan on how we are performing against the strategy and measuring our good KPIs. We should be involving the people with lived experience and the community and voluntary groups that are involved in developing the strategy. We should be looking at the issue of dual diagnosis, which is an issue in many cases, particularly as there may be mental health issues involved. They are not simple problems but we are very specific in respect of them.
We outline some issues that have not been debated so far. With regard to the criminal justice system and the prisons, I was at a presentation yesterday at which I learnt that there are now 4,900 people in prison . Almost 70% of these people have some form of addiction, but there are no specific services in the prisons for them. With the help of the Chair, I spent some time in Mountjoy dealing with long-term prisoners and learning about some of the issues the Prison Service has to deal with. We outlined in the report that there is a complete lack of comprehensive or, in many cases, any services to support the Prison Service and the prison system.
We are very clear and specific on the strategy. We do not just say we should develop a new one but we have some very clear recommendations as to what should be in it.
Ms Céire Moynihan:
I would make one suggestion. Deputy Gould mentioned the idea that it seems to predominantly affect marginalised communities. We talked a great deal about social capital and the idea that people would have support around them, such as community, family, kinship, care and all of what we have in certain sectors of society that just does not exist in others. We need to look at that. The details are in the report.
Deputy Fitzpatrick mentioned how it is depressing in one way because of the enormous amount of human capital, time, effort and money that the Government is putting into this but it is still not enough. Mr. Galvin deals with data. It is about evidence-based solutions, what is working and whether we can roll it out. It should not be patchwork across the country. Everyone should be entitled to this type of care and the sooner we pull together to get that done, the better.
Lynn Ruane (Independent)
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I acknowledge that Senators O’Hara and Seery Kearney are online and listening in but, given their location, they will not be able to contribute. I call Deputy Kenny, who is visiting the committee.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I thank the witnesses for coming in and for their excellent work on the citizens’ assembly. This has been a forthright and healthy debate and one that has needed to happen for some time. We would all agree that we have had six decades of legislation that has not worked. It has criminalised whole swaths of communities and left in its wake a trail of failure. If anybody in this room can say we have had six decades of misuse of drugs legislation that has worked, I would like to hear about it. What it has done is criminalise people, put people into the prisons and embolden and enrich a tiny few individuals in society who have done extremely well out of the drugs industry. Drugs are going to be used, whether we like it or not. There is drug use, drug abuse and everything in between.
My question concerns the interpretation of the health-led approach and decriminalisation. My instinct is that there are different interpretations of what decriminalisation looks like in an Irish context. From my reading of the situation, I am of the view certain sections of the Government, certain sections of civil society and certain sections of the police actually want the status quo to remain. In fact, they want to even go further; they want society to go backwards. That applies to certain sections of those three entities. In order to make decriminalisation work and to start changing things, we have to look at the Misuse of Drugs Act. If we do not change that, it is very arbitrary how decriminalisation will work and how it can benefit society.
Decriminalisation is a good model, but we need to go further. The elephant in the room when it comes to decriminalisation is that the black market still exists. The ultimate irony is that the drugs are not controlled by the Government or the State but by criminal gangs. Once we have that situation in place, we will have what we have had in the past six decades. Do the witnesses think the establishment and those three bodies have the stomach to go further than just paying lip service to a health-led approach and implement decriminalisation, even along the lines of the Portuguese model, which itself has limitations?
Mr. Paul Reid:
We have yet to test what is the appetite among all statutory bodies to adopt the change we are recommending and whatever change is recommended by this committee. This is the moment. It cannot wait for another few years to make decisions on it. We are very clear on this. The status quo was looked at as an option and it was ruled out by the assembly. We looked at the current health-led approach that was in the 2017 strategy and it was ruled out as an option. We went further and we believe that it needs legislation to decriminalise. That is the different approach that we recommended based on the current strategy. We believe legislation is needed to decriminalise it.
As I said to Senator Sherlock earlier, we left some things open. This committee will consider what that legislation will do, what legislation has to be tackled, issues around prison sentences, whether legislation on prison sentences needs to be introduced, how prison sentences for drugs can be eliminated and a few other issues. As I said to Senator Sherlock, our view is clear that we need to decriminalise in order to get us out of this vicious cycle.
As to where the appetite is for the other statutory bodies, my own sense is that that is under test now. If we are really serious about it, we should not be talking about 2025.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I do not think they have the appetite for it, to be honest. The work the assembly has done is excellent. I think there is a mood change in the public and even in the Oireachtas, but I do not sense there is an appetite in certain sections of the Government. They just want the status quo to continue. I hope I am wrong.
Mr. Paul Reid:
It is certainly under test now. The presentations we had at the assembly are all that I can go on. There was a range of views from “Let us hold where we are now because things are okay”, to “We have to do something completely different because we are not addressing the fundamental issues”. There was a range of views from the statutory bodies, including An Garda Síochána, the HSE, the Department of Justice and the Department of Health. It went from one end of the continuum at “Let us tweak what we have” to our view, which was “No, let us leapfrog two steps further.”
Mr. Graham O'Neill:
From the citizens' assembly members' point of view, Mr. Reid mentioned there was a wide range of presentations that dealt with issues of the status quo right through to legalisation. The big takeaway was that at the end of the day we wanted to step away from the status quo, so the members do not want things to remain the same. We had the presentations and decided they had not dealt with the issue, very much as the Deputy mentioned in his statement. It has been this way for however long and clearly is not working. It was something the members definitely agreed on, that the status quo cannot remain the same.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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Does Mr. O'Neill agree the status quo has been a policy by successive governments and they are happy enough with it?
Mr. Graham O'Neill:
I do not know if they are happy enough but certainly the fact the citizens' assembly has been set up is a recognition by the Government that this issue is not being dealt with appropriately or else we would not be sitting here. Throughout the number of discussions, from my personal interpretation, there is definitely no silver bullet that will deal with the issue. I do not think we can say that decriminalisation will solve the issue. There are 36 recommendations that deal with both education and funding. As recommended, the health-led approach is just one arrow in our quiver to deal with the issue. That was how I felt, from a citizens' assembly member's point of view.
Lynn Ruane (Independent)
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I will move on. I think we will go into a second round but I want to ask a few questions before we do. There are lots of conversations there and from my contribution I would rather focus on recommendation No. 17. When we look at the caveats relating to the citizens' assembly and what it laid out, it is really about understanding the assembly's idea of what decriminalisation actually is and whether justice has a role in decriminalisation. If drug use is decriminalised, justice does not have a role at all. Even if we are looking at that administrative piece, because the block seems to be that we cannot do administrative sentences, why are we saying we are looking for administrative offences in terms of completely removing possession with regard to any sort of diversion, because not everyone needs a diversion? There are plenty of people who are within the walls of power here who use drugs and who will never need a diversion. It would take a huge amount of resources and money if we were to assume every single person who is stopped and has a substance in their pocket needs to be sent for supports and help. Obviously, addiction affects a minority of people who use drugs. This minority of people is where the rest of the recommendations come in, for me, with regard to social determinants such as poverty, trauma and all of those so that people do not use drugs in a way that is chaotic and is accumulative across whole communities.
I would like to understand from Mr. Reid what he and the witnesses understand decriminalisation to be and what they feel the assembly members understood decriminalisation to be? Forgetting for a moment the idea there may be some questions around constitutionality or Garda powers around stop and search, what does true decriminalisation look like because prohibition has not worked? That is the evidence. Also, decriminalisation of the user and of addiction does not also reduce drug use. I think some people maybe think we will reduce drugs or drug use in this country because of decriminalisation, but really what we will do is not compound the harm and give people a way out. From the witnesses' and the assembly members' perspective, and it is up to the Oireachtas to legislation on this, what is decriminalisation?
Mr. Paul Reid:
We were clear, and it is described in our report and statements, that decriminalisation is a paradigm shift to take it out of a criminal system and put it into a health system and to be health-led. It is not a hybrid system. We are not saying it is a bit of both. We are saying it is a fundamental shift out of a criminal system and into a health-led approach. To substantiate that or make that work, supports will be needed in terms of dissuasion and diversion. Quite rightly, not everybody needs diversion. Somebody might not have a problem and they do not have to be diverted off somewhere else. We were very clear it is a paradigm shift out of a route to market that is currently a criminal system to a health system and to take the stigmatisation out of it. People will be dealt with in a fundamentally different way.
Lynn Ruane (Independent)
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Does that still involve a garda stopping and searching you, finding you are in possession, and him deciding whether you need diversion? The whole threat of stop and search is criminalisation back a step because it still involves policing. Should you only be stopped and searched if there is suspicion around whether you are selling drugs or involved in the sale and supply? A person who is on the street who may have heroin in his or her pocket and quite clearly coming in and out of Merchants Quay is not, so there are all of those differentiations. Where does the police force come in at all and should it only be involved if there is suspicion around criminal activity? If possession of a drug is not a criminal activity, why should stop and search exist for something that is not a criminal activity?
Mr. Cathal O'Regan:
It is a very complicated set of questions. The report has quite a lot of detail on what the citizens' assembly meant by a comprehensive health-led approach, and we sent a supplementary paper last evening which I hope will give the committee members a much better understanding of the confusing different ways decriminalisation can be explained and is meant because very different meanings can be attributed to the same term. It is a highly problematic word.
What the assembly did, instead of trying to define decriminalisation, was to define the policy objectives it wants. The objectives are a combination of a version of decriminalisation that supports health diversion and dissuasion. The two points of reference its model can be equated to are Austria and Portugal. Both of those have comprehensive health-led approaches and in both cases there is a role for authorities other than the health services as the first point of contact. That includes the police, both in Portugal and in Austria, because in the version of decriminalisation in use in those countries, and this is the version recommended by the citizens' assembly, the possession of drugs continues to be an offence and to be illegal and prohibited under law. At the first point of engagement, whether that be with the police or other authorities that find a person in possession of drugs, they have a legal mandate to refer that person to a health-led intervention. That, in theory, should be the end of the police or authorities involvement other than in the case where somebody then does not co-operate with the dissuasion sanctions imposed, for example, by the dissuasion committees in Portugal or the health authorities in Austria. A person will then potentially run the risk of committing an offence. In Portugal there is an offence called "disobedience of".
Lynn Ruane (Independent)
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There is the issue. Even in the old understanding from Portugal, which is 20 years old, and they would see their decriminalisation model now as completely outdated, when we look at the fact there would be even later sanctions, and even though addiction does not work that way, it is still criminalising addiction but actually decriminalising personal drug use. If you are a recreational drug user, there is not the same likelihood of you not fulfilling the sanction or being stopped and searched again and again because you are not from an overpoliced community, but we still have a system where if you are in addiction, it could take ten years to find any sort of abstinence or recovery and you could be stopped and searched repeatedly and not be able to take up your appointments.
Lynn Ruane (Independent)
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Also, in the current system, the 2017 proposal the Department is saying it is running out, which is an adult caution system, would the witnesses also see that as not being decriminalisation, that it is a case that we are going to temporarily say it is a health issue and then we are going say it is not a health issue but a criminal issue?
Mr. Cathal O'Regan:
The starting point here is that there are two very distinct versions of decriminalisation. One is the 100% decriminalisation, which we heard legal experts explain at the citizens' assembly is tantamount or equivalent to legalising possession. In that situation there would be no role for any authorities-----
Lynn Ruane (Independent)
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Within limits. There would still be limits set on the amount.
Lynn Ruane (Independent)
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Beyond the limit.
Mr. Cathal O'Regan:
-----personal possession that would be an offence under the supply and distribution legislation.
There is a version of decriminalisation that is equivalent to legalisation. That version is something the citizens' assembly voted against. What it voted for instead was a comprehensive health-led approach, which is not legalisation. There is still an offence. The nature of that offence has to be defined but there is still an offence under law. Possession of drugs would remain illegal and prohibited. It is just that the way it is dealt with by the State changes, as Mr. Reid said, from a criminal justice-led approach to a health intervention-led approach.
Lynn Ruane (Independent)
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Is it though? It is still criminal justice-led because it still allows people to be stopped and searched.
Lynn Ruane (Independent)
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So it is actually still criminal justice-led with a potential health outcome.
Mr. Cathal O'Regan:
If you unpack the concept of decriminalisation, what are you looking for? Arguably, you are looking to reduce or eliminate the prospects of somebody being prosecuted, convicted and receiving a custodial sentence. That is unbundling the concept of decriminalisation. Diversion here is supporting diversion and dissuasion as well as decriminalisation. The detail of recommendation No. 17 is what the assembly recommended rather than a version that achieves legalisation of possession.
Mr. Paul Reid:
We had two lawyers with two contrary views about what was decriminalisation and what was legalisation. One gave a view and the other said that if it is decriminalised, it is fully legal. We were clear that we just want to take it out of the criminal justice system. We were unambiguous about it.
Lynn Ruane (Independent)
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That is saying two different things, because if we want to take it out of the criminal justice system, then we also want to take it out of policing. We cannot uncouple policing of people on the street and possession of drugs in the criminal justice system.
David Stanton (Cork East, Fine Gael)
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Apologies for having to leave. I had a parliamentary question to take in the Dáil Chamber. I was listening online as best I could to the debate. I thank the witnesses for being here and for the work they have done. To continue the conversation on the Portuguese model, I went there a number of years ago with a committee. We visited and spent time engaging with all the actors involved in that. Has any analysis been done with respect to how effective the current system is? Could the witnesses speak to that at all? I have heard reports that it is not effective at all and that there are people on the streets who are really and truly in trouble with addiction. The other issue is that people are being offered drugs on the street. I asked the police that when I was in Portugal and they asked if I bought some. I said no and they said that if I had, it would not have been an illegal substance because it was a scam and they were aware of it.
Mr. Brian Galvin:
The question of whether decriminalisation works is difficult. I have spoken to colleagues in the general directorate for intervention on addictive behaviours and dependencies, SICAD, in Lisbon who have looked at this over recent years. The basic principle is that decriminalisation on its own has very little impact. There is no point in changing the law unless you put the services in place. Portugal was keen to do that. The other thing about Portugal is that it has a different police system from our police system. We have a community policing model. Portugal was coming from a post-authoritarian system, so people did not trust the police. While it depends on what indicator you look at, in the early days, there was a decrease in deaths. There is no question about that. In the past five or six years, it has become a bit more problematic.
As the chair alluded to, Portugal is having a closer look at its model to see how it can be improved. Oregon had a decriminalisation approach but did not have the kind of public health services we have in Europe so it did not achieve what it set out to achieve. I do not know if there is a direct link between the changed criminal status of drugs and the availability of drugs on the street. Nobody has really examined in that. Anybody who visits Lisbon can see an open drug-dealing scene. If that is connected to the change in the law in 2001, that has not been established yet. It could be part of the culture. It could just be the street life and culture of Lisbon.
David Stanton (Cork East, Fine Gael)
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The witnesses talked about different metrics and the need for services. That was evident when we visited a number of years ago. Without the backup and follow-on services and treatment, and help and support in that area, once people got into the dissuasion area and the services were not there, they were in trouble and going nowhere. Have the witnesses carried out analysis or discussion of the number, cost and structure of services we need here? If we used the dissuasion model, where people were encouraged to go for counselling, treatment or education, depending on the level of involvement, what would that look like?
Mr. Cathal O'Regan:
The HSE and Department of Health were asked that several times during the proceedings. They explained that they have an initial plan which only covers, as Mr. Reid said, the limited health diversion model that is being proposed. That limited plan would have one SAOR intervention worker in each community health area. They were asked how they would cope with a more comprehensive health-led approach where more people were being diverted into the services and their answer was that they would just have to scale up according to the level of demand. There is very limited capacity in the existing framework but the HSE would understand that it would have to significantly scale up if there were a significant increase in demand, because the one thing you cannot afford to have is endless waiting lists just to access this SAOR brief intervention model.
David Stanton (Cork East, Fine Gael)
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Will Mr. O'Regan speak about the different levels of intervention he mentioned? I take it there is education, treatment, counselling and so on. What levels of intervention are we talking about?
Mr. Cathal O'Regan:
The current plan, which only relates to something less than what the citizens' assembly referred to, provides for a SAOR brief intervention model. It is a motivational interview that is in some ways equivalent to what you would see in the dissuasion committees in Portugal but it is not as extensive, so it is focused on health interventions only. Portugal also provides a wider range of services, such as a gateway to employment, education and training opportunities, or social services. There is an element of that, but if the citizens' assembly recommendation for a comprehensive health-led approach were to be implemented, the existing model would have to be expanded to be a bit more robust.
Mark Ward (Dublin Mid West, Sinn Fein)
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I also want to talk about recommendation 17, which is about the decriminalisation of the possession of drugs for personal use. Speaking to people in the community, family members, and even people in Leinster House, there seems to be fear and confusion about what exactly this is. For example, decriminalisation of personal drug use does not mean that a criminal act carried out to obtain drugs is decriminalised. There seems to be fear about that. Work needs to be done on that. Any act that is criminal, irrespective of what it is carried out for, is still criminal. That needs to get out to the public. Fear about that is coming back from ordinary members of the community and even from talking to people in here who are not on the citizens' assembly and asked me questions about it.
There is also an issue regarding personal use in public spaces. This was another issue that was brought up with me regarding a fear of increased antisocial behaviour or maybe people hanging around. It is happening already but it was about an increase in that and that it could lead to more fear and intimidation as well. Was any of this discussed as part of the citizens' assembly's discussions? As I only have four minutes, I will ask my other questions on recommendation 17. I know the question was asked on what personal use is and we have to come up with legislation on this. The question is if it is a monetary amount, a weight and what is personal use. I mention that piece about public spaces as well. Was this discussed?
Mr. Paul Reid:
Once again, these issues were discussed and debated. Views were expressed though not in the level of detail as to what quantity might constitute personal use and how often you might be caught for personal use. I will bring it back to a contribution we heard which shifted our approach. We were trying to define to the nth degree, as much as we could, and the advice we were getting from lawyers was differing all the time. It was confusing on the whole, to be frank. The best advice we got at that moment - and it was not a cop-out - was to describe what we were trying to achieve. What we want is to get people out of this criminal system. We want it to be done differently. We do not want them criminalised. On how to execute that, to be frank, we did not have the expertise or the time to answer some of the specific questions the Deputy has, on what legislation might need to be changed to encompass that. However, we were very clear that legislation is needed to have a decriminalised approach. We do not want the current approach. We need a shift. To be frank------
Mark Ward (Dublin Mid West, Sinn Fein)
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Basically pushing it back on ourselves is what that is. It is asking us to come up with a definition on that-----
Mark Ward (Dublin Mid West, Sinn Fein)
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Absolutely. 100%.
Mark Ward (Dublin Mid West, Sinn Fein)
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I was just looking for guidance.
Mr. Paul Reid:
The best guidance is that we are very clear that it is not the current system. We need to shift two legs ahead of it, decriminalise people, stop the stigma that is going on and paradigm shift out from a criminal-led system to a health-led system. We need to get it out and not have a hybrid.
Mr. Graham O'Neill:
I will come in quickly on that to maybe give a bit of insight into the feeling around the room at the time. I will try to keep it really brief. My basic understanding of it, and I think I may speak for some of the members of the assembly as well, is that we do not want someone who is using drugs for personal use to be put in front of a judge or dealt with in that way. The whole point is that we want to them to be taken out of that method. From the presentations we received, it was clear access to drugs does not stop because you go into a prison system or anything like that. In some instances and in some presentations we were led to believe that it is actually sometimes easier to obtain drugs and it does not help the addiction to be dealt with in that criminal manner. It was that whole point of taking people out of that system of being put in front of a judge and divert them to that health-led approach.
Lynn Ruane (Independent)
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I will invite Dr. Ivers next as she has not come in much.
Dr. Jo-Hanna Ivers:
It is really worth clarifying that at the heart of the assembly was this notion not to have this lasting punishment for people who use drugs but also to recognise that they need support, and again to bring it back to the evidence base, so they get diverted into this brief intervention. What we know about brief intervention is that it is an incredibly staunch hard science that has been tested in terms of its efficacy so you can absolutely take it to the bank. Yes, I am on the record as saying 90% of people will use drugs without consequence, which means 10% or up to 15% in other jurisdictions might be addicted. What we know is that there is another population that is kind of hidden and that is anywhere up to 30% back who are using in a harmful or a hazardous way. When we screen that population, two things happen. The high majority of people, up to 20% of them, will get the information, adapt their behaviour and have the intervention they need to change it and the recovery capital to move on and all the rest. However, there is 10% of those people who are at risk. They are holding it together and when they get a health intervention, they then need specialist care. Therefore, we are also talking about a hidden population. It is worth going on the record for that, particularly when we are emphasising why this health-led approach is necessary, or more specifically why are we making everybody go for a screening they may not need. The point is that a lot of times people need stuff they are either not willing to talk about, they have not joined the dots or they do not want to put themselves in a stigmatising position. Again, we are talking about hidden populations. It is important to note that. I thank the Leas-Cathathaoirleach for giving me the time.
Lynn Ruane (Independent)
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I appreciate that. We will now go to Deputy Shanahan.
Matt Shanahan (Waterford, Independent)
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I thank the guests. I will go to Dr. Ivers for a moment please. Will she just speak about the kind of success rates she sees in terms of treating people with addiction, trying to get them through the system, the recovery rates, and any concerns she has about the rise of harder drugs particularly the likes of fentanyl and crystal meth, which is already here but the question is where it is going. Will Dr. Ivers speak about the work she is doing and where she is positive or maybe not so positive about it?
Dr. Jo-Hanna Ivers:
I thank Deputy Shanahan for the opportunity. I will go back particularly to the point he spoke about earlier of where we are doing well. The current system in terms of treatment, and where the gains are, is we favour people at the moment who have less complex needs. They are the people who will be pushed through the system. These are people who do not have a co-occuring mental health issue, have a house to go to, have positive relationships, most likely have a job or have had employment that they can pull on from the past and have education either in small doses or the ability to go on to do that. They have what we refer to as capital in their arsenal. These are things that will help them sustain recovery. What is happening is that we look at our treatment data - and it is not what the people on the ground are doing because they are doing tremendous work - but we have a system that is stacked against people who have complex needs and we really need to bookend the supports in terms of recovery capital and build that systemic capital the Deputy alluded to earlier, particularly in this cross-Government approach. We know in this country that when we have political will we get things done. When we have political will we invest in people, communities and put a plan in place. We put a timeline in place and we make people responsible for that timeline. Ultimately, they are the ingredients for where we need to go. I know the Deputy has not asked me what I would do. However, regarding what we are doing well, we are doing well for people with less complex needs and if we are going to look at this in respect of a societal shift, we need to do better by people who are more vulnerable.
Matt Shanahan (Waterford, Independent)
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Due to the addictive nature of the harder drugs, it will obviously be harder for people to get off these. That has been seen worldwide. Where does Dr. Ivers think we in Ireland are on that graph at the moment? Are we in the early stages? Have we even started looking at this?
Mr. Brian Galvin:
We have come a long way from the early 1990s and the Rabbitte report. At that time, there was no opportunity for anybody who was using heroin. Now, we have introduced the methadone programme, we have needle exchange if they decide to cease treatment, and we are going opening up a supervised injection facility. We still have a high number of deaths - there is no question about that - but a lot is being done to keep people well and alive. We have a way of measuring the hidden population of opioid users, mainly those on heroin. The last time we looked at it was 2019 and we are updating the research now. It shows that the numbers are very small in the younger cohort of 15 to 24-year-olds. In the older cohorts, because they are living longer, to be as brutal as that, there is the same number of opiod users in the country, that is close to 20,000, as we had back in 2006. That overall number is not changing.
They have access to a lot more sophisticated services and they have more opportunities to use drugs in a safe way. If you use needle exchanges, it saves lives. If you use naloxone, it saves lives. Supervised injection facilities are going to save lives as well. I do not want to use phrases like "everything has failed" because it has not but we have achieved a lot. Opioid users always were the main problem drug user coming in for treatment. That changed in the mid 2010s and cannabis became the most common drug for those coming in to treatment for two to three years. That has been overtaken by cocaine. I was talking with a colleague yesterday who is looking at all the indicators of cocaine and she said something mad happened in 2015 and everything has been going up since then. As for those coming for treatment, from the population study we can see it is the highest in Europe and cocaine deaths are a significant portion of the overall number of deaths. It is an entirely new problem and I think in some ways, people can be fixed on the old model and that model is shifting.
Thankfully, we have hardly seen any fentanyl here. We have to be careful not to adopt the model of North America, which is astonishing because the numbers are unbelievable. Last year in Europe, about 8,000 people died from opioid overdoses. In America, it was close to 20 times that. There is no complacency here because many things came last year and created a lot of damage but I think the response was quite astonishing and lives were again saved. We are in a much better position to save lives. Recovery is a whole other issue that we have to examine but on that hard crisis of deaths, there is a lot to do but we have achieved a lot.
David Stanton (Cork East, Fine Gael)
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I am interested in two areas. The first is respect of recommendation 21 and when the witnesses speak about family members and resourcing family members, extended support networks and supporting people affected by drugs use. I am also interested in the role of education in schools, particularly youth services in this space and the role they would have. Could Mr. Reid comment on those please?
Mr. Paul Reid:
We had presentations from many family members who have been impacted and they shared their experiences. They were quite powerful, and they were from all parts of society in terms of the impacts, their capacity to get into the addiction services and the impact it has on the family, which can cause awful carnage within the family itself. We had presentations from kinship care, putting families into care and supporting families in terms of caring for children, and they were quite powerful presentations. We felt this is kind of a hidden issue that is probably not resourced or spoken about to the levels need. Again, there were good little islands of excellence of community groups but they were not really on the radar from a wider statutory perspective.
Mr. Cathal O'Regan:
There was one very specific issue which was the level of financial support that kinship carers are entitled to compared with what foster carers are entitled to. There was a call from those involved in kinship caring to equalise that difference because it would make a significant difference, not just financially but in terms of the access to psychological supports and other things that family members need.
As Mr. Reid said, there is a reality that in communities in both urban and rural Ireland, there are family members who are getting together through family resource centres or through family support networks to provide one another with support as their loved ones are going through addiction challenges. That is something that we, as the citizens' assembly, felt could be significantly increased and strengthened.
On the question of education, a big focus of the citizens' assembly was on prevention. A dedicated meeting focused on prevention and the role of the education system. One thins that everybody, including the Garda, said was that policing your way out of the drugs problem cannot be done; you cannot simply focus on policing. You have to focus on the upstream question, which is how do you prevent people from starting to use drugs in the first instance or, if they are using drugs, how do you stop them from becoming problematic drug users. That is the whole area of prevention. It seems to me the assembly members felt that Ireland is very weak at prevention.
We heard information that only a small fraction of secondary schools provide proper prevention education and that normally only kicks in when in transition year. That is far too late for the young people in our society. At this stage, we have generations of adults who have never been exposed to any proper drug prevention information and that is one of the root causes of why we are seeing such a rate of prevalence in society. There was a call for a really significant increase in the preventative strategies, both for primary prevention, which is stopping people using drugs, but also secondary and tertiary prevention.
David Stanton (Cork East, Fine Gael)
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The other question I had concerned the youth services and the link to the Garda diversion programmes, but the youth services in particular. In my view, they have a huge role to play. It is informal education outside of school.
Mr. Cathal O'Regan:
There are things that can be done within the school system. We had a fantastic presentation from a young teenage girl from Clondalkin who had gone through a drug prevention programme, which was partly done in school but was also partly done in the youth work setting. That was driven or co-ordinated by a community drug and alcohol task force. That was a really good example.
Thomas Gould (Cork North Central, Sinn Fein)
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I thank the Leas-Chathaoirleach. I apologise, as I had to step out for a few minutes. To go back to comments made about the new drugs strategy not coming out until 2025, is this not a kick in the teeth to everyone who is involved with drug treatment or with helping people in addiction and recovery and even to the citizens' assembly itself? This is the type of attitude the Department, led by the Government, has on the drug issue.
Mr. Paul Reid:
It is disappointing from our perspective. The assembly members were clear from the floor that they felt waiting until 2025 was not good enough. They put it down as June 2024. We knew that was a challenge, that being said. It is, however, extremely disappointing. You do wonder whether, were some of these problems happening in more affluent communities, there would be a different sense of urgency. Would there be a different sense of focus? The harm is very much concentrated and while I appreciate there is harm in every community, the significant harm is concentrated in those areas that struggle from a wider societal perspective. You do wonder whether there would be greater pace and speed if it was happening in more affluent areas. Would there be greater urgency on this issue? I think there would be. We do not believe waiting until 2025 is the right approach.
Thomas Gould (Cork North Central, Sinn Fein)
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First, I want to say any death on the road is a tragedy. We have seen an increase in road deaths and loads of work needs to be done to try to bring those figures down. For any families involved this is not meant to hurt them personally but, when you look at the type of action the Government is taking in response to road deaths and the money it is putting in, and then you see the number of deaths of people through overdose and drug use, there is no comparison, is there?
Mr. Paul Reid:
The evidence and the data are produced by the Health Research Board. We have the data and Mr. Galvin can talk about it in detail but in 2020, there were 409 drug induced deaths overall. We are the worst performer across the EU. In some cases, we have three times the level of deaths of other EU countries. You cannot get an indicator that is any larger, more impactful or more urgent than that. That is an awful indicator to have.
Thomas Gould (Cork North Central, Sinn Fein)
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I raised this issue in the Dáil yesterday. I am dealing with a lady who is 12 months in recovery and Cork County Council will not house her. She was in the throes of addiction because she was being abused by her partner at the time, both physically and mentally. She got away from her partner, got a barring order and got into recovery. She is a year into recovery and is trying to get her two children back but cannot get emergency accommodation because the attitude of some local authorities towards people in recovery is a disgrace.
I wrote to the new chief executive of Cork County Council and the person who was there before her. There is an attitude to people who are in addiction and to people who are in recovery. This lady wants to get her two children back. She is a year into recovery and when I spoke to her last week, she said she had gone through a very black phase a few weeks ago. She is on the edge and if we cannot get that woman accommodation, even temporary accommodation, she could relapse and her children will stay in foster care. We need more supports even around emergency accommodation. What we do know is that when people get into recovery, the contributions they make to society because of their lived experience and what they have gone through is brilliant.
I brought out a charter of rights for people in recovery as part of my portfolio two years ago. We met with over 20 groups and we did focus groups. I did not put housing as the number one issue because people will say Sinn Féin is always on about housing. When we met with the focus groups, however, they said to that the number one issue for people in recovery is housing. If people cannot get housing, they are put into centres where others are openly drinking, openly taking drugs and openly trying to sell drugs to them while they are trying to fight against it. The whole issue of recovery - and I think it was touched on - is that more needs to be done to support people who are going through this battle. It is a battle every day being in recovery.
Dr. Jo-Hanna Ivers:
I will be very brief. This is an excellent of example of where we have a system that is supposed to co-operate or co-ordinate. We have Cork City Council that is supposed to be a partner in a care plan, but it decides whether it plays or not. Ultimately, if we shift towards that systemic model of building capital, we hold it responsible and suddenly the policies it makes that directly affect people in recovery need to be monitored, evaluated and pushed back at it.
Currently, the system we have is led by health. With the goodwill of our partners in housing and education, they may come to the table and do something for us. If we are serious about shifting and changing, we need those partners to row in with resources and policy that is going to directly affect the people that are in drug use, addiction and recovery and ultimately build that prevention.
I am going a little off script but I will be very quick. We often talk about prevention being this off the shelf package where we go into schools and tell kids not to use drugs. Prevention is no different from recovery. It is about investing in communities so that people are dissuaded and have other opportunities instead of buying into drug use or learning to cope with drugs and becoming addicted.
Thomas Gould (Cork North Central, Sinn Fein)
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I want to clarify to that it was Cork County Council and not Cork City Council.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I thank the Leas-Chathaoirleach. I want to go back to the decriminalisation model in an Irish context. We have to look to the past in order to look to the future. Senator Marie Sherlock referred the response I received to a parliamentary question a few months ago. It was very revealing and startling in terms of the adult caution scheme in regard to cannabis. It stated that from 14 December 2020 to 16 February 2024, 5,139 people were issued with an adult caution for simple possession of cannabis or cannabis resin. When I asked the same question in terms of prosecutions, and get ready for this, in the same period, 17,125 people were prosecuted for the same thing. The arbitrary nature of leaving it to the discretion of the police does not work. That is my fear in respect of decriminalisation in the Irish context because the establishment, from what I am taking from its sound bites, is that it does not want to go as far as changing legislation. It is very fearful and will leave it to the arbitrary nature of the adult caution scheme or something a bit broader than that.
Mr. Paul Reid:
I cannot comment on An Garda Síochána or the details in the parliamentary question, PQ. Was it its response to the PQ? I am not quoting verbatim but Assistant Commissioner Justin Kelly was presenting yesterday and he made the point that many of the figures quoted, relating to the approximately 17,000, were not just for possession but also other criminal activity for which they were put forward for conviction. All I can go on is the presentations we had from the Garda Síochána to the assembly. It was consistent in its view and clear on both presentations. It did not want to move to a legalised model. As chair, I pushed it on what its view was on a decriminalisation model. I would not be very clear on what that is or whether it would prefer the status quo. I know the assistant commissioner said yesterday at the presentations that the Garda Síochána would be in favour of a health-led approach. At our citizens' assembly meetings, it certainly came across to us that the status quo was the preferred model.
Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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It is happy enough with the status quo. There are elements within the Garda who would be more progressive regarding the status quo, but those at the top echelons of society are more than happy with it. Mr. Reid said before that there is a class element to this issue. If the devastation of what is happening was happening in more affluent areas, it would be a completely different response and we all know that.
Ms Céire Moynihan:
I want to refer back to Deputy Kenny's point and the Leas-Chathaoirleach's point on stop and search and the stigmatisation around that. At the round-table discussions, members felt very strongly and uncomfortable with the level and degree of stop and search that was going on in our city and across the nation. The Garda Síochána presented to us that it was focusing on the chain of supply, but there was another statistic provided to us. In Dublin the search and supply are higher than in London, which has 9 million people. There is truth somewhere in between all of that. There is stigmatisation around the stop and search. It is criminalising a behaviour that we are trying to say is a health issue and we need to look at that.
An Leas-Chathaoirleach:
I have never been shy speaking about my own experience growing up. As a child I was stopped and searched many times on the walk to the shop. Just because there were more than two or three of us together, we were assumed to be a gang. It is only in working class communities that you are called a "gang of youths". In any other community, you are called a "group of youths". The stigmatisation is well and truly built into how policing happens. The stop and search is a really important issue for us to grapple with over the next few weeks as we get into the crux of the committee.
I want to ask two questions. The first is a simple "yes" or "no" question. Everyone or the most appropriate people can answer this if they feel they would like to answer. Some quarters of the Department, Government, the DPU, etc., are waving this idea that what they are currently doing is what the citizens' assembly has recommended in regard to recommendation 17. I refer to what is de facto the criminalisation in terms of the adult caution scheme. When the Government and particular State bodies say that what the citizens' assembly said is already set in motion, would the witnesses agree with that sentiment?
Mr. Paul Reid:
No. Let us be very clear. We asked assembly members whether they were in support of the current model, or the model that was proposed, and this was rejected. I would be very concerned if the model that we proposed was projected as what is in plan. It is not. It is a leapfrog ahead of that.
Lynn Ruane (Independent)
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I appreciate that.
Mr. Cathal O'Regan:
To get nerdy about it, the planned health diversion model applies for first, second or maybe third time offences but after that, the process reverts to the status quo, the criminal justice system. The comprehensive health-led approach calls for either complete or extensive opportunities for people to engage with a health-led system. It is a different order of magnitude.
An Leas-Chathaoirleach:
I thank Mr. O'Regan. I refer to the recommendations 12, 15 and possibly others that speak about the importance and the effectiveness of stakeholder engagement in relation to people who use drugs, communities, community projects and families. Community development has also been mentioned. Sometimes what some people in Departments understand to be community development is not what community development is in practice. A lot of the recommendations in the report would really benefit from a community development approach, especially in relation to service provision, social and cultural capital and recovery capital. Does anyone want to speak as to how they see that community engagement being carried out? On that group Dr. Ivers spoke about - that almost unrecognised or unreachable group that is a little bit invisible - sometimes when we look at that community engagement piece, we are looking at community engagement that has already been brought closest to the State in terms of its funding and its arms. It is a gatekeeper in a sense in terms of what actual real community engagement and family engagement are. I would love to know what our witnesses think about what real effective community engagement may look like in some of those recommendations.
Mr. Paul Reid:
If we could bring in the extent of community groups, family groups, lived experience groups and individuals over six weekends over six months, this can be done. It can be done very quickly if we are talking about a five- or six-year strategy. The kind of community groups we mean are people who are on the ground rolling up their sleeves and delivering the supports to the services. In a previous role, I was CEO of Fingal County Council. I want to mention that there are some Housing First programmes that have been a successful for people with addiction. There are ways to reach into the community and to groups that may not be the traditional headline groups that we might reach out to. If we look at some of those community voluntary groups that we brought in, this was their first outing.
Matt Shanahan (Waterford, Independent)
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This is slightly nuanced around that. I think this is what Mr. Reid is reflecting but is it a case that the policing position regarding decriminalistation is that this is going to essentially normalise drug use in society and open the floodgates to informal drug use right across society? Despite everything the assembly has done, we have not been provided with the empirical evidence that tells us that will not happen. If we take away the safeguards, they cannot be re-implemented. Would Mr. Reid say that that is the position of the police?
Mr. Paul Reid:
To do justice to the policing position, they did say that. They said that their fear is that further liberalisation could result in Ireland becoming a tourist destination for drugs. They would have concerns over some of the controls that they need such as stop and search being reduced. I am paraphrasing them but they did present that position at the first assembly meeting.
Matt Shanahan (Waterford, Independent)
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We talk about what Portugal is doing and we know there are changes, trends, etc. Whether you say there is merit or not to it, the policing position is that you cannot tell them otherwise and you cannot prove otherwise. They are also aware of the ability of the State to fund all the different sectors which will have to be funded to provide this purely health-led approach and they have have no confidence that money will be provided.
Mr. Paul Reid:
Looking at our recommendations, we did hear the position of An Garda Síochána and all of the other positions. We took a view, which I believe was extensive and comprehensive and took on board all of those views. Our report is not all about extra funding. There will be an extra funding demand on the services from the diversion and dissausion approach but also in terms of some of the cross-government co-ordination of it, the pace of introducing the legislation, involving some of the community groups in the design of supports, the statutory and voluntary organisations having different remits and the court system. In the current model, which is not what we recommend, there are some successes through that. There are many things we can do now.
Mr. Cathal O'Regan:
I thank the Leas-Chathaoirleach, and I will be brief. I am not speaking specifically about the viewpoint of the gardaí, but a number of stakeholders in the room who had, as you might expect, concerns about legalisation. I am including medical representative associations and others who are on the record as being against legalisation. What a lot of them said was that they were concerned about was a version of decriminalisation that would be tantamount to legalisation. That means one thing and it sends out a very clear public signal about the State's approach to drugs whereas there is another form of decriminalisation which does not liberalise drug use but it changes the way the State responds. There was a broad degree of consensus across most of the stakeholders who spoke, including those who are against legalisation, that simply criminalising a person for having a drug issue is not the solution and there is scope within the way the State responds to change from the status quo to a more health-led response.
As we saw across the political system when we published our findings, there is a large degree of consensus in support of a health-led approach. The design of that is one that is up for grabs but as long as it is not interpreted that the citizens' assembly is recommending something that liberalises or legalises drug use and that it is recommending a different version of decriminalisation, which is a health-led response, I believe we will find that there is a considerable level of support across society.
Mark Ward (Dublin Mid West, Sinn Fein)
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I thank the Leas-Chathaoirleach. I would like to pick up on one point. If anybody thinks that Ireland is not already a tourist destination when it comes to drugs, they have not been in Temple Bar over the last couple of years. This is part of the issue that we have. Alcohol is the most abused drug that we have in Ireland but the stigma is not the same. That is something that we have to break down as well, but that is for another day.
I refer to what Mr. Reid mentioned regarding multi-annual funding. For front-line drug services, that could be an absolute game changer. What is happening at the moment is that our drug services which are on the ground are getting into a situation where they are being reactive, rather than proactive. They see things happening and they see changes in drug use emerging before we do. They are on the ground and are on the front line but they cannot change their approach, change to another drug or whatever or to a recovery model, they would have to drop something else that is already there and that may be working well. They do not have the ability to change because of the the handcuffs on them in relation to multi-annual funding. I remember working in a service where the manager was so focused on funding that we had to close the service for a week just to get forms filled out, which meant we were not seeing any of the service users. They were left on their own. We need to move away from that.
On multi-annual funding, and Mr. Reid may need to put his previous HSE hat on, are the barriers within the HSE or are the barriers within Government or it funds the HSE? I am always asking about multi-annual funding and I would like to know if that barrier relates to the Government or the HSE.
Mr. Paul Reid:
Not necessarily. If you go back all the up down the value chain, ultimately, it is at the Department of public expenditure level and what is approved by Government in terms of budgets. It is revised on an annual basis. There is a mood in some services to give a greater predictability on a multi-annual basis, whether it is capital or operational funding. It would go back to an approach in terms of budgeting. The HSE or most bodies would not have the remit to commit to multi-annual funding. It goes all the way back up the value chain to how budgets are set and how the estimates are taken onboard.
A practical issue arising in the community and voluntary organisations is retaining staff. Staff might have an annual contract and do not know beyond that. In the current environment, that is really unstable. These are great people in many cases, in most cases.
David Stanton (Cork East, Fine Gael)
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It took us a full year of hard work and consultation to produce the current national youth justice strategy. It is out now and is being worked on. Mr. Reid mentioned the national drugs strategy a few times and has been critical of the fact that it has been frequently delayed. He said the report, or at least its first iteration, should be published this month. What is his sense of where it is at? Is work being done on it? Is it more advanced? Has he any idea at all from his work in this area and the feedback?
Mr. Paul Reid:
The current one was to expire in 2025. I gleaned from the Department of Health statement this week that it is taking on board the feedback from the national drugs strategy committee and oversight committee. It will evaluate it over the next six months, assess our report and encompass all the information in the report to be published next year. That is what I understand and I hope I am doing justice to the matter. That was the statement this week.
David Stanton (Cork East, Fine Gael)
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I think we should write to the Minister and get an up-to-date report on the matter straightaway.
Lynn Ruane (Independent)
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We will proceed to Senator Fitzpatrick, who was not here for our four-minute rounds. We might just restart the clock.
Mary Fitzpatrick (Fianna Fail)
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Apologies as I had to attend a vote. I apologise if I ask questions that were asked while I was out, but I ask the delegates to bear with me.
I want to return to recommendation 17. I heard very clearly what Mr. Reid said about the citizens' assembly and the advice given by the legal experts. Could he articulate what the assembly wants to achieve? I am not asking him to worry about the mechanics of legislating for it or its operational implementation. Do Mr. Reid and the members of the citizens' assembly believe the intention, in its simplest form, was to decriminalise the individual user, addict or victim of drugs as opposed to decriminalising the substance?
Mary Fitzpatrick (Fianna Fail)
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I am sorry to be pedantic about this. It was not about decriminalising the substance.
Ms Céire Moynihan:
I think the Senator is absolutely accurate. It is a very good way of stating it. Mr. O'Neill will probably agree that the majority of members of the citizens' assembly believe drugs are harmful and do not want them to be legalised, but they equally believe that the users of the drugs are, for want of a better word, victims. They do not like the word "victim". I have met some of them and have noted that they are some of the most resilient people. As Deputy Gould said, they really add a lot to society when they come through the other end. We went to visit Coolmine drug rehabilitation centre. I would recommend that every member do so to see the preschool children with their mums who are going through rehabilitation. We do not want to stigmatise people using drugs; we want them to be treated like those treated for alcohol abuse. It is a health issue, not a criminal issue.
Mr. Graham O'Neill:
I share those sentiments. A personal sentiment is that the individuals are people, not criminals. An individual who consumes drugs for personal use should not be dealt with as a criminal. We went through a plethora of reasons individuals might consume drugs and we also went through the various levels, but ultimately the view is that the individuals should not be dealt with in a criminal justice context because they are people who use drugs; they are not criminals.
Mary Fitzpatrick (Fianna Fail)
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That is what I thought but I appreciate Mr. O'Neill's confirmation. A challenge occurs for the Garda when dealing with this issue. I appreciate that we are dealing with only one of the recommendations and that there are very many more, all of which are equally important, if not more. However, this is an issue that we will have to grapple with, so I want to tease it out. The problem for the Garda, as I see it, is that it is not effectively policing all illegal drugs. I would be interested in knowing what the witnesses took from the Garda's contribution. We all accept the Garda cannot police even the most socially acceptable drug, alcohol. Society polices it a little because it is not socially acceptable to abuse it in some spaces. Even that is borderline, however, and we need to accept how out of control things have got. The issue becomes one of how in God's name, if a substance were in any way legalised, the Garda would operate. Did it give any insight? Do the witnesses have any insight from other jurisdictions on how it would operate?
Mr. Cathal O'Regan:
Earlier a question was asked about the degree to which the police should have discretion. The answer is that, in the two case studies we examined, Austria and Portugal, each country had a different legal mechanism but was achieving the same objective. The first point of contact in most cases in Austria and Portugal is the police. They do not have discretion and are required by law to refer the person to a health-led intervention. It is not a case of the police deciding who gets referred to the health system and who gets referred to the court system; everyone is referred to the health system, so the police do not have discretion. However, the police do have a role. That role is as the first port of call. In Austria, for example, school principals and others, if they find somebody in possession of drugs, have a legal responsibility to refer him or her to the health-led intervention.
Mary Fitzpatrick (Fianna Fail)
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Is the legal responsibility similar to the child protection obligation of a school principal?
Mary Fitzpatrick (Fianna Fail)
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It is a legal obligation on the individual. How does that work in practice? When the member of the police force comes into contact with the individual, is the latter referred there and then electronically? Is the individual referred to a court similar to the drugs court that has been in pilot for 20 years, in which case the court would issue a direction?
Mr. Cathal O'Regan:
The best comparator might be a garda stopping somebody for a road traffic offence. The garda issues a fixed charge notice and the information is conveyed to the Road Safety Authority, which then issues the penalty points. There is a point of communication. The person is given a notice stating he or she is required to attend a SAOR brief intervention or HSE service, and the service itself is also notified. That is where the role begins and ends, rather than having the Garda issue adult cautions, for example, or make referrals for prosecution in the courts. The Garda's role is simply as the first point of referral into the services.
Lynn Ruane (Independent)
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It is a referral. Since it does not involve a court system, have the police power to compel somebody to go to a diversion service?
Mary Fitzpatrick (Fianna Fail)
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It would be a referral from the Garda that would compel the individual to attend the service-----
Mr. Paul Reid:
Sorry, but one point of differentiation relates to the good example of alcohol, which is often used. Alcohol, having been legalised, is regulated, so there are rules on who can buy it, where it can be bought and the times at which it can be bought. We have not gone down that route at all in this case.
Thomas Gould (Cork North Central, Sinn Fein)
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I will touch on the attitude of senior management within An Garda Síochána, the lack of community gardaí and the lack of resources the Garda have. Is the reason the Garda does not want to go and change the status quo because it knows it does not have the resources to work a new system? At the moment there is a system that most people would acknowledge is broken. Why would the senior management in An Garda Síochána advocate a system that the majority of people believe does not work?
I am from Cork. If one walks around Cork, Dublin or Limerick, or any of the big cities, one can see that gardaí do not have the resources. That all goes back to the austerity years of 2007 when the college in Templemore was closed and Garda numbers were slashed. Now we are trying to get Garda numbers up but cannot because of retirements and people opting for different careers. I believe that Garda management does not have the resources in terms of staff or financially to support a new model of policing if there was a new drug strategy. This is why, I believe, they are slow to change.
We were talking about similar incidents. I said that we need a whole-of-government approach but it might be a whole-of-society approach. I know a lady with four children who was refused social housing because she had a conviction for having cannabis for personal use. The question then is: how can having a tiny amount of cannabis prevent her and her four children from being housed? Whether it is the HSE, the Department of Justice, the courts system or the Garda, the strategy would have to go right across all the systems.
Reference has already been made to the Garda and how it wants the status quo to stay. Why is that?
Mr. Paul Reid:
There are three points to be made there. I am sure the committee may or may not decide to call in An Garda Síochána, so I do not want to speak for the Garda but at every citizens' assembly meeting it was recognised the job the members have in putting their lives on the line in battling crime. I just wanted to put this on record.
Second, with regard to the demands that may or may not be on them given what we are recommending, we would be of the view that there may be less demands, fewer days in court, less working through the criminal system, and more people to do community policing. There may be different ways of working and in approach but we would not necessarily see extra demands for An Garda Síochána. We would see extra demands for health services and community services.
On the strategy - and Dr. Ivers answered this earlier - under the current model people can opt in to help but it is not their responsibility to see the wider solutions through, whether it is Housing First or whatever the solution is. This is why our strategy would propose to bring this up to a very senior political level with a Cabinet committee to oversee the responses, chaired by a Taoiseach. We see this rising up.
Dr. Jo-Hanna Ivers:
I will just qualify that. One of the recommendations very clearly states to place health in all policies and that is exactly what this refers to: making cross-sectoral Government Departments responsible. To qualify that, when I talk about cross-sectoral Government Departments I am talking about a whole-of-society approach because they are the Departments that represent society. It will absolutely mean that.
Thomas Gould (Cork North Central, Sinn Fein)
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On that last point, each of the 31 local authorities have different definitions. When people apply for social housing and if they have had a criminal record within the previous five years, it can prevent them from being housed. To me this definition is for people who are involved in serious criminality not for the person who may have been driving with no insurance, who maybe was caught for shoplifting or who might have had cannabis for personal use. Each local authority has the ability to set its own rules and I believe that is a problem. We need to have universality among the local authorities. For those people who are in recovery every way they turn there is a block. We should have support for those people everywhere they turn.
Lynn Ruane (Independent)
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I believe that everyone is in agreement that the housing issue will come up and especially in the work of Dr. Ivers around that recovery capital piece. If the person cannot access housing then he or she is already at a deficit. Drugs possession is in the most serious category. No matter how simple the possession is, it is currently in the category with serious sexual crimes, murder, and firearms. It is already captured in something that will not ever leave the person's record even under the spent convictions regime that currently exists. Hopefully, as we go through the modules, we can look at all those other blocks around people being able to safely seek help, whether it is with abstinence or harm reduction models, going forward.
I will finish with one or two comments and one question. Sometimes I am a little bit uncomfortable when it slips into the conversation about the drug trade. In my work with people who have been involved in the drug trade, they are people who have come from the exact same vulnerable backgrounds. They have experienced the exact same poverty, abuse and violence. Obviously, there are different levels of that but we need to remember that often they are not two mutually exclusive groups. Sometimes they are the same group but unfortunately they are in a situation where they may appear to now have some sort of power or extra resources or whatever, when actually the underlying issues of the social determinants of dealing at a community level and upwards are often similar social determinants to those who end up in drug addiction. We need to be careful about the language we use when we talk about those people. They are within the community and they are loved ones often of people who are on the other end and caught up in addiction. The idea of being a victim of drugs gets me thinking about sometimes seeing people who use drugs to survive, because they have been victims of abuse, inequality, poverty and all of those things. It can be really hard for some people to understand that heroin kept somebody alive. It dulled and numbed a part of them they did not have the capacity to process in the real world in real time everything that was happening to them. It is counter intuitive to think that. I am happy that we spoke about the social deterrent determinants, trauma and poverty because the addiction piece is the outcome of all of those. It is good to try to keep that in our minds as we continue.
I have one final question before we go and it follows on from points raised by Deputies Kenny and McAuliffe about the legalisation of cannabis. The vote went a particular way, and I understand that. I know we cannot go back to put a different question to the assembly, but consider if an alternative question was put to the assembly, namely, to look at the model in countries such as Malta and Spain where cannabis is not for profit, is not about the tourism piece and is not in the shops but it is about social clubs and a licence to grow a small amount. Do the witnesses believe that if an alternative question on the legalisation of cannabis was put to the assembly, where cannabis was not a for-profit industry, there may have been a different outcome given the conversations in the room?
Mr. Paul Reid:
We did have a presentation on that. Crainn presented a similar model. There was also a presentation on other countries' models by the European Monitoring Centre for Drugs and Drug Addiction, EMCDDA. Assembly members are here with me, and as the chair of the assembly I believe the outcome was extremely tight but it is reflective of the debate happening in society at the minute. Thankfully, as chair I did not have to cast my vote on the day because it was extremely tight.
Lynn Ruane (Independent)
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How would Mr. Reid have cast it? I am only messing.
Mr. Paul Reid:
I will not say here. I believe the result was reflective of the debate that is happening here, in the Oireachtas, in the debates and in public society. There was a parallel debate happening, which we were quite happy with. I thank the political system that gave us the space to have that assembly process.
There was a parallel debate happening politically, on social media and in the media in general, which we were happy to see. Committee members can see that it was not a simple debate at all.
Lynn Ruane (Independent)
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That did not answer the query about an alternative question that only looked at the models used in the likes of Malta and Germany rather than legalisation in a universal sense. They are different questions.
Mr. Cathal O'Regan:
I do not believe that the decision was rejecting just the idea of a commercialised cannabis market. That was going to be a follow-on question. If the vote had been in favour of legalisation in principle, there would have been a series of follow-on questions, for example, what form of supply was preferred between a State monopoly, home cultivation clubs, social clubs and a commercialised market. We did not get there, though, because the principle of legalisation was rejected, albeit narrowly. From what I understand, the presentations that were made in favour of legalisation contained some cogent arguments around eliminating the criminal market, improving the safety of supply and so on, but the compelling argument that I believe assembly members picked up on was that legalisation and the messaging that gave would lead to an uptick in prevalence, which would, in turn, lead to an increase in the harms caused in society in general. From a public health perspective, I believe that was the critical distinguishing factor between the vote supporting legalisation and the vote supporting an alternative approach.
What we can say clearly is that, regardless of whether people voted in favour of legalising cannabis or taking a comprehensive health-led approach, both options represented a paradigm shift away from the status quo.
Lynn Ruane (Independent)
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It is not within the legalisation model, but all drugs are to be decriminalised equally according to the model of the citizens’ assembly.
Mr. Graham O'Neill:
I wish to put on record something from the round-table discussions at my table. It was a very close vote and, as Mr. Reid and Mr. O’Regan have stated, that was representative of where this issue lies in society at the moment. One of the key questions asked by a member at my table was about whether we would be sending a message that it was acceptable to consume drugs if we legalised it. In this instance, it related to cannabis. A counter question was asked about the difference between how acceptable it would be to consume a drug like cannabis and how acceptable it would be to consume another drug and where the distinction lay. There was a big round-table discussion about that and about not wanting to send the message it was acceptable. That is where the conversation pivoted at my table when it came to the vote.
Lynn Ruane (Independent)
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I thank Mr. O’Neill.
As the chair of the citizens’ assembly, is there any question that was not asked today that Mr. Reid wish had been in terms of what he would like to see happen?
Lynn Ruane (Independent)
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I was just checking.
I thank the witnesses. This meeting has been informative. It makes sense that they be the first people in the room over the coming seven months. I thank them for their work and the clarity they have provided so far. We are grateful.
I ask committee members to remain in the room so that we might go into private session. We will then adjourn until Thursday, 20 June 2024.