Dáil debates

Wednesday, 4 March 2009

Priority Questions

Drug-related Deaths.

1:00 pm

Photo of Jack WallJack Wall (Kildare South, Labour)
Link to this: Individually | In context

Question 36: To ask the Minister for Community, Rural and Gaeltacht Affairs his views on the figures published by the alcohol and drug research unit of the Health Research Board in regard to drug related deaths; his further views on whether these figures reflect a continuing unacceptable use of illicit drugs; the steps he will take to reduce the demand for such drugs; and if he will make a statement on the matter. [8978/09]

Photo of John CurranJohn Curran (Dublin Mid West, Fianna Fail)
Link to this: Individually | In context

The publication last November of the National Drugs-Related Death Index by the Health Research Board provided for the first time a comprehensive understanding of the death toll associated with problem drug use in Ireland. The Index, which has been compiled to the highest European standard, was commissioned under the national drugs strategy by the Departments of Health and Children and Justice, Equality and Law Reform.

The index covers the period 1998-2005 and I accept that it presents a stark picture of the consequences of problem drug use. It found there were 2,442 drug-related deaths over the eight year period examined. In 2005 there were 400 drug-related deaths, of which 232 were directly related to drugs, with 168 linked indirectly to drug usage. The index showed that the number of deaths increased over the period from 1998, with the greater rate of increase relating to indirect deaths, where drugs were a contributory factor.

The report's analysis implicated heroin and other opiates, poly-substance use of both illicit and licit drugs including alcohol, and prescription and over the counter medication as causes, to varying degrees, in the direct deaths. While the report does not include deaths relating to alcohol only, I understand that research in that regard is ongoing by the Health Research Board.

The report confirms the significant health dangers, including premature death, associated with problem drug use. The results of the all-island drug prevalence surveys, carried out in 2002-2003 and again in 2006-2007 by the National Advisory Committee on Drugs in conjunction with its colleagues in Northern Ireland, sets out the most robust evidence of the prevalence of problem drug use in the general population in Ireland. Comparisons between the two all-island surveys indicate that the drug problem facing the country is changing to a degree. Evidence from the first bulletin of the 2006-07 prevalence survey launched last year indicates that while rates of lifetime and recent, that is, last year, overall illegal drug misuse have increased, the level of current, that is, last month, illegal drug use has stabilised.

Additional information not given on the floor of the House.

The increase in lifetime use for all drugs was expected given that older people tend to have less exposure to — and usage of — drugs over their lifetimes and that illegal drug use is primarily a youth-younger adult — under 35s — phenomenon. The increase in last year use is of more concern and it emphasises the challenging task that we continue to face in tackling problem drug use in Ireland. Meanwhile, the overall stabilisation in last month use is to be welcomed and I am hopeful that, with the continuing valuable work being done through the national drugs strategy, this trend will continue.

The findings from the index further supports the approach adopted in the National Drugs Strategy 2001-2008 involving a combination of demand and supply reduction measures to tackle problem drug use. The current strategy has sought to reduce the impact of problem drug use in our society, including the level of drug deaths, through the development of treatment and rehabilitation services, including harm reduction approaches, for those engaged in problem drug use; promulgating prevention and awareness messages throughout society, but most particularly aimed at young people at risk and those already involved in problem drug use; and supply reduction initiatives through the Garda and Revenue's Customs Service.

As the Deputy is aware, a steering group comprising representatives of the statutory, community and voluntary sectors is currently developing proposals on a new national drugs strategy and I expect to receive its recommendations in the coming weeks.

In the context of developing its proposals, the steering group is considering what further actions can be developed to counter the level of drug deaths. In this context, the Deputy should note that the Health Service Executive has already initiated work on the development of a national overdose prevention strategy which is a very welcome development.

Photo of Jack WallJack Wall (Kildare South, Labour)
Link to this: Individually | In context

I am sure the Minister will agree with me that the numbers involved represent a sad loss and a waste of young life. When we consider that 2,442 people have died from drug abuse in that period, it puts a huge emphasis on what must be done to ensure that this issue is brought to public notice.

I would like to know from the Minister the geographical spread in terms of these deaths. Are they occurring, as some would assume, mostly on the east coast or is there an equal spread in terms of these deaths throughout the country? We have continuously said in the House that we want to highlight the stark reality of what drug misuse does to young people. I understand that most of the deaths are of young men. Can the Minister of State indicate if any research has been done on that? Why is it the case that it is mostly men who are affected?

Also, what is the mix in terms of alcohol and the use of drugs? I recall asking the Minister's predecessor a question on cocaethylene, where a mixture of cocaine and alcohol creates a different drug. What research has been done on this? It causes heart problems. What is the situation regarding its effect on young people? The main issue is the geographical spread of the problem. What are we doing to highlight the fact that 2,442 young people die as a result of drug misuse in a seven year period?

Photo of John CurranJohn Curran (Dublin Mid West, Fianna Fail)
Link to this: Individually | In context

I am pleased the figures have come to light because I spoke with a number of people over a period of time who clearly felt what was reported regarding drug-related deaths was significantly understated. This is the first comprehensive report and is very detailed and thorough. The numbers, as the Deputy said, are staggering. In 2005 alone 400 people died as a result of drugs. When we discuss those people here, we talk about them as a statistic but behind every one of those deaths was a family. The person was somebody's son, daughter, parent, brother or sister. The loss of life has been staggering, as has been its impact on families and communities.

The Deputy asked a number of questions. The incidence is higher in the Dublin area than in the rest of the country. Just over half of the deaths are as a result of poisoning or using more than one substance, including legal and illegal drugs. Opiates, including heroin, are still the main cause of deaths among people who die from poisoning. The information on the 400 deaths is from 2005. Cocaine was implicated in 100 of those deaths. A quarter of the poisonings were as a result of alcohol in conjunction with another drug. Again, this information is only for 2005. The majority of cases were males aged between 20 and 40 years of ages.

I want to make some general points. The Deputy asked what we would do about it. Before we can address the problem, it is important to identify there is not one single problem but multiple problems to be addressed. Illegal drugs are involved in many cases of drug-related deaths. However, prescribed drugs and over-the-counter medication, such as anti-anxiety drugs like valium, antidepressants and pain-killers are frequently involved in such deaths, either alone or in conjunction with illegal drugs. For example, benzodiazepines are often combined with an illegal substance and have resulted in almost one in every three deaths by poisoning. That is one aspect of the issue. It is very complicated and there is not just one solution to the problem.

Not all deaths were from poisoning. Other issues arose, such as infection with HIV through needle sharing and cardiac events due to cocaine use. Again, the profile in that age group was male.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
Link to this: Individually | In context

Deputy Wall can ask a brief supplementary question.

Photo of Jack WallJack Wall (Kildare South, Labour)
Link to this: Individually | In context

My question relates to the assistance given to people to get off drugs, and concerns the use of methadone. Some articles state that methadone is involved in many deaths. A question raised here asked if drug addicts were getting access to methadone from more than once source. If that is the case, instead of curing themselves, addicts are creating more problems for themselves and can become addicted to using methadone. The figures stated that in 2005 more than 60 deaths were as a result of one drug and 60 deaths involved the use of methadone.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
Link to this: Individually | In context

The Minister of State can make a final reply.

Photo of John CurranJohn Curran (Dublin Mid West, Fianna Fail)
Link to this: Individually | In context

The figure Deputy Wall stated on the numbers using methadone is correct. Not everybody who uses methadone uses it exclusively. A combination of other drugs can be used and that appears to be the case. The HSE, which is specifically charged with responsibility for the matter, is in the process of implementing a national overdose prevention strategy which would address the issue of benzodiazepines, prescription drugs and methadone.

Since I became a Minister of State, I specifically asked the HSE to review what we are doing about methadone use. I have a grave concern that people seem to be on methadone for an extended period of time. I may not be in my position long enough, but I would like to see the hard evidence to show progression. In other words, I would like to see an active methadone reduction programme. The overdose prevention strategy would specifically address the issue to which Deputy Wall referred.