Professor Catherine Comiskey:

I will say something on that. In our research with people on methadone, I have had somebody say to me that they were using heroin for two years and have been on methadone for 11. There is no movement of people through the system. If people want to stay on methadone and that is their recovery, that is well and good but some people want more contact with healthcare professionals and they see the nurse as the person they have the relationship with. When you go into the clinic, you do not see the doctor. When you go to collect your methadone, you do not see a doctor but you might see the nurse because the nurse is there all the time. The doctors come and go. They are not necessarily resident in the clinic all the time.

That is what we are seeing in our research. People have been on methadone for an average of approximately seven or eight years. There are people ageing on methadone. The wait times have certainly lessened in Dublin but that may not necessarily be the case in rural areas. My worry is, and I see it in Europe and the early warning systems, we need to be future ready. We need to have the systems, people and prescribers in place now if these fentanyls or synthetic drugs come here. That is what I am saying. When I told that story about Patricia, we were not ready then but we have had progressive policy and we have moved on as a country. The evidence is there. That is why I am saying to have progressive policy so that we can be ready. These things will come.

I am hearing the most horrific stories and they are really worried in Europe about the South American cartels coming here with Kalashnikovs and articulated lorries full of drugs. That is what I am hearing on mainland Europe. If we do not protect our people now we are going to have more Patricias and I do not want us to have more Patricias because we do not need to. We are mature and we can make mature policy. I really admire the work the committee is doing but I think we need to be brave. When we are brave, we are lauded internationally for it. We were the first to bring in the smoking ban. We were brave and we were lauded. I think we could be lauded again.