Dáil debates

Tuesday, 2 October 2012

Addiction Services: Motion [Private Members]

 

7:55 pm

Photo of Maureen O'SullivanMaureen O'Sullivan (Dublin Central, Independent) | Oireachtas source

I move:

That Dáil Éireann:recognises:
— the scale of the problem of addiction throughout Ireland and the increasing demands on services;

— that poly-drug use has increased significantly due to the increase in the accessibility and range of dangerous substances, both illegal and unregulated;

— the increased risk to individuals using substances and lethal combinations of substances with respect to overdose, fatality and long-term ill health;

— the numbers of drug and alcohol related deaths each year are more than twice that of the numbers of deaths on our roads;

— the strong association between drug-alcohol abuse and suicide, and also accidental death;

— the increased use of technology in accessing harmful substances;

— the continuous on-street dealing in disadvantaged communities, the levels of intimidation and fear because of violence by drug gangs and the increased availability of firearms;

— that alcohol has been identified as a contributory factor in 90% of public order offences as recorded under the police using leading systems effectively, PULSE, system and alcohol related crime costs the Irish State almost €1.2 billion a year;

— that alcohol and drug related illness costs the health system a further €1.2 billion yearly;

— the link between economic and social disadvantage, including early school leaving, unemployment, housing conditions and problem drug-alcohol addiction and crime;

— the increase in the number of children with need for child protection because of families’ problems with drug and alcohol addiction;

— the links between mental health, homelessness and addiction; and

— the unacceptable levels of drug abuse in our prisons and the increasing emergence of ‘process’ addictions in gambling, food, sex, Internet usage and other compulsive behaviours;
acknowledges:
— the work of the drugs task forces, the partnership model, the pillars of treatment and rehabilitation, supply control, prevention and research and family support;

— the work and commitment of the young people’s facilities and services fund in targeting those most at risk of drug abuse in funding services and facilities in many areas, particularly to those most vulnerable;

— the work of the Dublin north inner city community policing forum as an example of best practice in collaborative work between the communities, local authority and Garda to resolve local drug related and anti-social behaviour issues;

— the work of the various groups, Departments and agencies, the community and voluntary sectors and others in producing the national substance misuse strategy report;

— the work of the community and voluntary sectors and the projects in engaging those in addiction and in recovery from addiction in services;

— the work of fellowships and 12 step programmes for those in addiction and those affected by the addiction of a loved one; and

— the improvement in best practice and the range of treatment, rehabilitation and recovery for those in addiction; and
calls on the Government to:
— prioritise addiction as a health issue and not primarily as a criminal issue and ensure the necessary allocation of resources;

— continue to support and enhance the local, regional and national structures of the drugs strategy and drugs task forces involving community, voluntary and statutory services in the co-ordinated delivery of responses at individual, family and community level to the benefit of those most affected by problems of addiction;

— improve supports for those high risk lower socioeconomic populations experiencing underlying social disadvantage leading to addiction problems, and in particular to improve supports in areas of health care, education, housing and employment opportunities;

— improve care planning and case management for individuals in addiction treatment, rehabilitation and recovery, as envisaged by successive national drugs strategies;

— increase the availability and affordability of residential rehabilitation, including non-abstinence based options and respite for highly vulnerable individuals in addiction, particularly young people under 18 years of age, mothers of young children, individuals affected by mental health issues and homeless individuals;

— introduce legislation to deal with Internet sourcing and accessing of drugs, to apply the harmonised EU definitions of a medicinal product to a new psychoactive substance so that national medicines agencies can prohibit its unauthorised importation, marketing or distribution;

— provide clear oversight and leadership so as to ensure the implementation of the national substance misuse report, including minimum alcohol pricing, reduction in alcohol advertising and sponsorship, greater health promotion programmes to the entire population on the dangers of alcohol misuse and abuse and to indicate a timeframe for implementing the recommendations of the report;

— ensure that, while acknowledging the stabilising effect of methadone, it is seen as part of the treatment process and not a stand-alone treatment;

— implement the review of the methadone treatment protocol, ensuring timely availability of access to treatment through primary health care;

— fully implement the hepatitis C strategy in the areas of surveillance, prevention, screening and laboratory testing and treatment, particularly affecting injecting drug users;

— open the debate on decriminalisation of illegal drugs and safer consumption;

— make available the assets of drug related crime through the Criminal Assets Bureau to counter the negative impacts of drug related crime and to be used in support of communities in tackling drug-alcohol abuse and misuse;

— refrain from further cuts to the services provided by the community and voluntary sectors for those in addiction and continue to support the special community employment, CE, schemes for those in drug rehabilitation;

— ensure that the ring-fenced betting taxes, proposed to be re-invested in the racing industry, includes a contribution to resourcing programmes addressing gambling addiction;

— integrate mental health services with addiction services in responding to dual diagnosis of individuals, affected by substance misuse, experiencing mental health difficulties in recognition of previous recommendations of the national advisory committee on drugs;

— demand that prison programmes provide, at a minimum, parity of esteem with community programmes with respect to addiction services to minimise harm to individuals in prison and that integration of prisoner release dates with community-based programmes is improved to lessen the harm done to individuals with addiction histories resulting in unco-ordinated release; and

— promote innovative programmes that will support mental health and addiction issues such as mindfulness and applied suicide intervention support training, ASIST.
Ar dtús, ba mhaith liom comhghairdeachas a ghabháil leis an Aire Stáit as an phost nua atá aige.


There is a public face of addiction. It is the zombie-like drug addict we see on the streets or the alcoholic who is staggering home or falling off the bar stool, drunk. The private face presents differently. Not all addicts fit the stereotypes I have mentioned. Addiction affects many people in our society. For every person in addiction, at least six or ten other people are affected by it, often very seriously. We know the economic cost. It is more than €3 billion, considering the crime related and health related matters. I move this Private Members' motion to bring this matter onto the floor of the House and to look at the scale of the problem, what is being done to address the matter and what is lacking in tackling these issues, and to ensure the issue does not end up on the cutting-room floor of the budget.


It is also important to look at the changing nature of addiction. We are now in the area of polydrug use of lethal combinations, including alcohol. Services must be able to keep up with these changes in use. Many of the statutory services are focused solely on heroin use. We must also consider the use of the Internet in sourcing substances. In acknowledging the scale of the problem, the point must be made that it is not confined to Dublin. It is a national problem. Alcohol was always there, but now the towns and villages of Ireland are seeing heroin, cocaine, head shop products and so on. We must also consider other addictions, such as gambling, food, sex and the Internet.


We know there is gangland crime. It is one part of the problem. The horrific recent killings, particularly in front of young children, were especially gruesome. I hope the other aspects of addiction will get the same attention and resources as the gangs are getting.


I am hoping for an honest, thoughtful and thought provoking debate. The motion calls for addiction to be prioritised as a health issue and not primarily a criminal issue. It is good to see drugs are now the responsibility of the Department of Health. That is a positive step.


Heroin first appeared in the late 1970s and 1980s in Dublin's inner city, where cynical operators and dealers targeted poor communities. The drugs were dispensed like sweets until the teenagers were hooked. I saw so many lovely young people taken over by heroin. Their families were devastated and their communities held to ransom. The lone voice of the late Tony Gregory brought the issue into the Dáil Chamber, where it was not taken seriously because officialdom had no real interest in tackling the issue then. The flat complexes in the inner city were known as heroin supermarkets at the time. Tony Gregory continued to make drugs a major issue in the Dáil and in Dublin City Council. This debate is so that the issue will not be off the agenda.


Currently, we are seeing a rise in heroin use. It is interesting that it is coinciding with another economic depression. Again, there are no geographic bounds. At a meeting this morning we were told of increases in seizures of heroin for personal use and supply in Dublin city. The European monitoring centre for drugs and drug addiction places Ireland top of the table of EU countries for heroin use. This is compounded by polydrug use, including alcohol use.


We are also seeing an alarming emergence of grow houses in suburbia, in rural areas and in rented apartments. It is not confined to poor communities. The growers' expertise is considerable. They are producing higher strength cannabis. The main psychoactive chemical, THC, is several times higher in grow house skunk than in hash. Project workers working with young people are concerned about this. It is being confused with the more benign name of hash which, whether we agree or not, has a different effect on people. I will not be like various Presidents of the United States or Ministers and admit to smoking the odd joint when I was in college. I did not. This is irrelevant, but I thought I would put it out there.


I have seen the long-term effects of significant use of cannabis. It is not good to see. However, we should open the debate on cannabis use and look at the arguments for and against. Ireland is the only EU country not to regulate the medical use of cannabis. The Netherlands is looking at classifying this high potency cannabis with cocaine and ecstasy. More young people are using skunk in Dublin. At one of the projects young people talk about paranoia and panic attacks. Other substances are mixed with skunk and young users, in turn, mix it with Benzodiazepine and alcohol. There is great pressure on some drug projects because they are dealing with a broader array of drugs, rather than cannabis or heroin on their own. There is also crystal meth, crack cocaine and tablets.


It may be because the heroin epidemic began there that Dublin's inner city has become associated with drugs. The response in the inner city has been remarkable. We have excellent projects and services in the voluntary and community sector. There is SAOL, Soilse, Chrysalis, HOPE and Crinan, to name a few. They are taking on these challenges. The SAOL project produced the Reduce the Use booklet which is being used in Ireland and throughout Europe. There are other interesting initiatives on harm reduction. I was at the north inner city drugs task force today. I used to chair it when I was a teacher and I am now back as a public representative. I listened to project workers talking about their work, how they are coping with funding cuts and with their terror of the effect of further cuts to front-line services.


The late Tony Gregory once said, "Follow the money". That eventually led to the setting up of the Criminal Assets Bureau, CAB. The Minister for Education and Skills, Deputy Ruairí Quinn, was Minister for Finance at the time. It took the murder of Veronica Guerin to get people moving. That is not good enough for all the other people who are involved in the addiction area. In 2007, Tony Gregory also spoke about the middle rank of dealers, and called for a mini-CAB for those areas where young people see dealers with extravagant lifestyles and no visible means of income. The motion calls for some of the assets of drug related crime acquired by CAB to go back into communities most negatively affected and used for treatment, rehabilitation, prevention, education and family support services. The money could also be used to deal with the intimidation and fear that families must deal with because of drug debt.


We know about death from overdose, lethal mixing and suicide. We have innovative programmes that are seriously at risk of being cut. I am talking about ASIST training, particularly for those dealing directly with vulnerable people. Statutory agencies sometimes send people to do this training and then do not use it, while community projects whose workers would use the training might not have the funding for it. Mindfulness also has a programme. It is a proven strategy for those in recovery. The Oasis Deora counselling centre in North Wall, Dublin, is one of the few that will deal with people in addiction. So many programmes wait until people are in recovery.


Between 20,000 and 50,000 are affected by hepatitis C but effective treatment is available. We know that injecting drug use, especially the sharing of injecting equipment, is the leading risk behaviour for the transmission of hepatitis C. The national strategy has set out a clear plan. The Government amendment refers to the expansion of needle exchange services. Will this include the provision of injecting rooms which are in some other cities but not in Ireland? This is controversial, but we need that debate.


We also need the debate on decriminalisation. We need to have a reasoned debate looking at the research.

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