Dáil debates

Wednesday, 25 September 2013

Ceisteanna - Questions - Priority Questions

Prison Drug Treatment Services

1:40 pm

Photo of Maureen O'SullivanMaureen O'Sullivan (Dublin Central, Independent)
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3. To ask the Minister for Justice and Equality the institutions that have drug-free units currently operating; the number of spaces in each drug-free unit; the number of prisoners currently in each drug-free unit; the number of vacancies in each drug-free unit; the type of treatment and programmes available to those in addiction in prison; the number entering prison drug-free that leave addicted; and if he will make a statement on the matter. [39935/13]

Photo of Alan ShatterAlan Shatter (Minister, Department of Justice, Equality and Defence; Dublin South, Fine Gael)
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I must warn the Deputy that as substantial work has been done in this area, I have a very long reply that I was anxious to receive. There is no chance the Leas-Cheann Comhairle will let me get to the end of it, so the Deputy will receive in written form what I have not been able to read out.

There are currently drug-free units operational in six closed prisons: Mountjoy, the Dóchas Centre, Wheatfield, Cloverhill, Limerick and Cork. There is an aggregate total of 472 spaces in these units, which currently house 421 prisoners, with 43 spaces currently available. The majority of units operate at or close to their capacity and prisoners are only accommodated in such units when they meet the strict criteria which apply, including evidence of drug-free status.

The breakdown of these aggregate figures is as follows. Mountjoy male prison has 34 spaces, with 34 prisoners currently in the unit and no spaces.

The Dóchas Centre has 60 spaces, with 44 prisoners currently in the unit and 16 spaces available. Wheatfield Prison has 267 spaces, with 242 prisoners currently occupying the unit and 16 spaces available. Cloverhill Prison has 52 spaces, with 53 prisoners currently in the unit and no spaces. Limerick Prison has 45 spaces, with 45 prisoners currently in the unit and no spaces. Cork Prison has 14 spaces, with three prisoners currently in the unit and 11 spaces available. This unit was only recently established and opened. I expect that there will be more prisoners using the unit in the coming weeks and days.

The Deputy may be aware that as part of the Irish Prison Service Strategic Plan 2012-2015, drug-free units are to be established in all closed prisons with the exception of Arbour Hill Prison. The Irish Prison Service anticipates that the establishment of these units will be completed by the end of 2013. The Deputy may wish to note that in addition to the spaces available in the drug-free unit in Mountjoy male prison, there are up to 54 places available in the drug treatment programmes provided in the prison.

Additional information not given on the floor of the House

The Prison Service has no information to suggest that there are prisoners who enter prison drug free who leave addicted. However, the Prison Service continues to provide a comprehensive range of drug treatment services tiered to meet the needs of the prison population. At present, any person entering prison giving a history of opioid use and testing positive is offered a medically assisted symptomatic detoxification if clinically indicated. Patients can, as part of the assessment process, discuss with health care staff other treatment options. Drug rehabilitation programmes for prisoners involve a significant multidimensional input by a diverse range of general and specialist services provided by the Prison Service and visiting statutory and non-statutory organisations. Prisoners who on committal are engaged in an opioid substitution programme in the community will have their substitution treatment continued while in custody. Methadone substitution treatment is available in ten of the 14 prisons, accommodating more than 80% of the prison population.

Drug treatment pharmacist services are available in Mountjoy, Dóchas, Midlands and Portlaoise prisons. Pharmacists are responsible for all aspects of drug treatment, mainly methadone - dispensing, administration, recording, ordering, storage, etc. - in those prisons, thus ensuring that drug treatment is provided on an equivalent basis to that available in the community while meeting all legal and professional requirements in those particular prisons. The HSE provides consultant-led inreach addiction services to Cloverhill and Wheatfield prisons. Merchants Quay Ireland provides a national addiction counselling service for prisoners with drug and alcohol problems in prisons and places of detention where prisoners require such a service, with the exception of Arbour Hill Prison.

Mountjoy Prison currently has two addiction nurses assigned. A clinical addiction team comprising the primary care addiction specialist general practitioner, addiction nurses, chief nurse officers, Merchants Quay Ireland personnel and addiction pharmacists provides a comprehensive overview of addiction services, which has resulted in a more streamlined service, better assessment and through-care outcomes. These programmes seek to reduce the demand for drugs within the prison system through education, treatment and rehabilitation services for drug-addicted prisoners.

In line with action No. 43 of the national drug strategy, the Prison Service ensures the seamless transition of prisoners established on drug treatment into community drug treatment settings as agreed in the protocol developed with the HSE. If the prisoner is on a community programme prior to committal to prison, the maintenance programme is continued during the prison term. Prior to a patient being commenced on methadone maintenance in prison, a drug treatment place in the community must be secured to ensure continuation of treatment upon release.

The Prison Service has conducted a review of its existing drug treatment programmes and proposals have been developed to reorient and extend the treatment options. Recent trends across prisons indicate a significant number of prisoners self-detoxing from methadone and a marked reduction in the average dose of methadone.

The proposals that have been introduced by the Prison Service on foot of this review include the establishment of a therapeutic detoxification and rehabilitation treatment programme, DRTP, with the allocation of seven additional places from March 2013. The DRTP will also operate in the medical unit of Mountjoy Prison and will be in addition to the existing drug treatment programme, DTP, which has nine places. Circa 50 beds in the medical unit, Mountjoy Prison, have been dedicated exclusively for drug treatment programmes, DTP, including the introduction of an eight-week duration in a DTP, a six-week duration DRTP, a maximum six-month duration slow detoxification programme and a maximum six-month duration stabilisation programme.

The training unit has been designated as suitable for prisoners on methadone maintenance treatment. Loughan House and Shelton Abbey will be designated as facilities for the treatment of prisoners seeking to return to a drug-free lifestyle.

The proposals set out have provided an increased number of options for prisoners who demonstrate a commitment to addressing their substance misuse. Progression from these programmes will include access to drug-free units, open prisons and ultimately the community return scheme, subject to normal operational considerations. The Deputy will note that the Prison Service is adding to the range of programmes, support services and through-care options for prisoners demonstrating a commitment to addressing their substance misuse.

1:50 pm

Photo of Maureen O'SullivanMaureen O'Sullivan (Dublin Central, Independent)
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I will wait to get the additional information. When considering this matter, I arrived at three categories, the first being those who are in prison, are drug free and want to stay so. The drug-free unit is a way forward in this regard. I received that answer from the Minister previously. How far advanced is the plan? The Minister mentioned that there would be drug-free units in all prisons by the end of the year, but is he confident about that? There is overcapacity in some prisons.

Photo of Alan ShatterAlan Shatter (Minister, Department of Justice, Equality and Defence; Dublin South, Fine Gael)
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The quick answer is "Yes".

Photo of Maureen O'SullivanMaureen O'Sullivan (Dublin Central, Independent)
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The second group are those in addiction who want to go into recovery. From people who work with such prisoners, addiction services, etc., my understanding is that they are advising prisoners to keep taking low dosages of methadone, as the services for those who want to come off drugs are minimal. If we wish to work with people who want to come off drugs, more services must be provided. Anyone who works with those in addiction must work with them where they are. If a prisoner who is in addiction wants to start the recovery process, it must start at that point.

Photo of Alan ShatterAlan Shatter (Minister, Department of Justice, Equality and Defence; Dublin South, Fine Gael)
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The Irish Prison Service is providing a comprehensive range of drug treatment services, not just the units that I described. These are designed to meet the needs of the prison population as a whole. At present, any person entering prison giving a history of opioid use and testing positive is offered a medically assisted symptomatic detoxification if clinically indicated. Patients can, as part of the assessment process, discuss with health care staff other treatment options. Drug rehabilitation programmes for prisoners involve a significant multidimensional input by a diverse range of general and specialist services provided both by the Prison Service and visiting statutory and non-statutory organisations. Prisoners who on committal are engaged in an opioid substitution programme in the community will have their substitution treatment continued while in custody. Methadone substitution treatment is available in ten of the 14 prisons, accommodating over 80% of the prison population.

Drug treatment pharmacist services are available in Mountjoy, Dóchas, Midlands and Portlaoise prisons. Pharmacists are responsible for all aspects of drug treatment, mainly methadone - dispensing, administration, recording, ordering, storage, etc. - in those prisons, thus ensuring that drug treatment is provided on an equivalent basis to that available in the community. The HSE provides consultant-led inreach addiction services to both Cloverhill and Wheatfield prisons. Merchants Quay Ireland provides a national addiction counselling service for prisoners with drug and alcohol problems in prisons and places of detention where prisoners require such a service. There is a whole range of services available to prisoners who have drug addiction issues.

Photo of Maureen O'SullivanMaureen O'Sullivan (Dublin Central, Independent)
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If all of those measures were in place, those who visited and who worked with them in prison would not supply me with the statistic that there is one counsellor for 550 prisoners in addiction in a single prison. The Minister's reply does not correlate with reality.

The third category are those who are in addiction but who are not at a place yet to start their recovery programmes. What is the status of harm reduction interventions and the needle exchange programme in prisons?

Photo of Alan ShatterAlan Shatter (Minister, Department of Justice, Equality and Defence; Dublin South, Fine Gael)
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To be brief, when the Deputy sees the written reply that she will get, she will see that I have covered all of the issues that she is raising. If there is an issue that I have not adequately addressed, I am very happy to engage with the Deputy. She may write to me about the matter or table another question. If she would like a briefing from the head of the Prison Service, I would have no difficulty in arranging that for her. This is an issue that I take very seriously. There is very substantial reform and change being implemented within our prison system to do everything possible to tackle the issue of addiction - both drug and alcohol addiction - and to try to ensure, in so far as we can, that we have a comprehensive range of available services.