Dáil debates

Thursday, 28 June 2018

Implementing the National Drugs Strategy: Statements

 

1:10 pm

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I welcome this debate on the implementation of the national drugs strategy, Reducing Harm, Supporting Recovery: A Health-led Response to Drug and Alcohol Use in Ireland 2017-2025. It is timely to have this debate, as next month marks the first anniversary of the launch of the strategy by the Taoiseach, the Minister, Deputy Harris, and me. On taking up my role as Minister of State with responsibility for the national drugs strategy, I was tasked with developing and implementing our new strategy.

I know first-hand of the devastation that the misuse of drugs and alcohol can cause to individuals, their families and local communities. I have worked as a local Deputy and councillor in my community for nearly 20 years and long before that I worked in my community in a voluntary capacity. I have met many people along the way whose lives have been destroyed by drugs and, sadly, I know of far too many who have lost their lives to drug addiction. Their deaths have devastated their families; partners, parents and most of all their children. In some cases, some of those who died were practically children themselves, young teenagers who got involved in drugs at a young age. It is for all these reasons that I strongly support the adoption of a health-led response to substance misuse, one that focuses on minimising harm and promoting recovery and rehabilitation, which reduces drug-related deaths and gives people the support they need to live a healthier life.

The strategy is guided by a strong set of values, including compassion, respect, equity, inclusion and partnership. It is evidence-informed. During the public consultation carried out in advance of the new strategy, these values came to the fore and I am committed to progressing the implementation of our strategy with these values firmly at its core.

As a first step in implementing the strategy, I secured an additional €6.5 million in the budget in 2018 for drug-related actions. That is on top of the €250 million spent every year on drug and alcohol services and programmes across all Departments and State agencies. The €6.5 million additional funding is being used to expand the availability of drug and alcohol treatment services.

The main priority in 2018 is for the Health Service Executive to tackle pressure points in drug and alcohol treatment services and reduce waiting times. New initiatives include the establishment of a treatment service in Kildare; the enhancement of treatment services in other areas, including Wexford, the midlands, Tipperary and Limerick; enhancement of the capacity of Cuan Dara unit to provide treatment on a national level for people with the most complex drug and alcohol dependency programmes; and the expansion of naloxone training for 300 people as well as the purchase of 1,300 naloxone kits. In addition, an extra 200 people will be receiving Suboxone treatment, which can be an alternative to methadone, in 2018.

A total of €3.2 million has been allocated to the HSE in 2018 to facilitate the expansion of drug and alcohol services with a particular focus on strengthening governance structures and increasing access to opioid substitution treatment by reducing waiting times across community health organisation areas. Further measures include the recruitment of four new clinical leads and three nursing managers, the recruitment of two new drug and alcohol liaison midwives in Cork and Limerick and the establishment of a step up, step down intermediate care facility for homeless people with drug and alcohol addictions. A total of €750,000 has been allocated to the HSE in 2018 to provide for the establishment of a supervised injecting facility in Dublin at Merchants Quay.

I welcome each of these developments but I am fully aware that the demand for drug and alcohol treatment services remains high. Through my regional visits and discussions with public representatives I am aware of the many worthwhile community projects seeking funding. I have discussed these at my parliamentary party meeting last night and with many Deputies in the Chamber. Members of the Seanad have raised the issue of funding of the taskforce as well. I am pleased to announce funding of €1 million to support and enhance services nationwide. This funding will be allocated as follows: once-off funding of €290,000 for taskforces in the fourth quarter of 2018, an allocation of €10,000 for each local drugs and alcohol taskforce and €15,000 for each regional drugs and alcohol taskforce. I believe these latter groups need a little extra because they have a wider remit and a greater spread over the country. Moreover, €710,000 will be allocated by the HSE in consultation with the taskforces. The taskforces will make recommendations for the funding of priority projects and services as well as new initiatives in the nine HSE community healthcare organisation areas.

The Department of Health is developing two new programmes for at-risk young people in disadvantaged areas and community awareness of alcohol-related harm. These programmes will each have funding of up to €1 million in a full year. These arise from specific commitments in the Department's Reducing Harm, Supporting Recovery publication. There will be a consultation process with the stakeholders to inform the development of the two programmes.

Having more resources is only one part of the challenge. We must also ensure that the money allocated for drug-related actions is spent wisely. I am strongly of the view that the resources should be directed towards projects most likely to lead to a reduction in drug and alcohol use. Measuring the effectiveness of responses to the drug problem is, therefore, a key objective of public policy. I am keen to progress the performance management framework to which we have committed in the strategy.

The health service is leading a two-pronged approach to address the hepatitis C issue. The approach involves a combination of specialised treatments to treat the disease and a range of harm-reduction initiatives to reduce the incidence of the disease. It is encouraging to see that the national hepatitis C treatment programme, which is run by the HSE from a budget of €30 million, has facilitated some positive developments in recent years. I understand that over 2,000 people have been successfully provided with treatment for hepatitis C since 2015. Moreover, all persons infected with hepatitis C through contaminated blood and blood products have been offered treatment as at the end of 2017.

In February of this year, it was announced that Merchants Quay Ireland would deliver Ireland's first medically supervised injecting facility in Dublin city centre on a pilot basis. This facility will help to prevent injury and death and will connect people with health services. It will also help to make our streets safer.

There is a strong overlap between addiction and homelessness. We have taken action to address the health needs of people who are homeless in line with Rebuilding Ireland. This includes the provision of funding for an intermediate care step up, step down facility in Dublin run by the Dublin Simon Community for people who are homeless and who require nursing and related care prior to hospital admission and post discharge from hospital.

The drug and alcohol taskforces play a key role in assessing the extent and nature of the drug problem and in initiating appropriate responses. They strive for a co-ordinated approach involving all sectors relevant to the problem of substance misuse in local communities. The taskforces are instrumental in harnessing the efforts of community groups, families and residents in identifying problem drug use and in building partnerships with the community and voluntary sector, statutory services and local representatives to address them. Taskforces actively support and promote the participation of service users and their families, including those in recovery, in local decision-making structures and networks as well as in feeding into regional and national decision-making structures. I secured additional funding of €250,000 in budget 2018 to improve the organisational effectiveness of the taskforces in implementing the national drugs strategy. The Department is currently processing the applications for this funding with a view to issuing approvals over the coming weeks.

The impact of drugs goes far beyond individuals. They impact on wider society. Drugs are strongly linked to criminal activity. We are all aware of the consequences of gangland feuds and how they can impact on local communities. The Government commissioned the Mulvey report on the north-east inner city to address this issue. There is now a project implementation board reporting to the Department of the Taoiseach. It is seeking to improve the reduction in criminality and improve living conditions in the area.

I acknowledge that many people in local communities live in fear due to drug-related intimidation. It is one of my priorities to help communities and protect them from intimidation because of drug use. An Garda Síochána and the family support network are looking at whether the current reporting system is working.

I am concerned, however, that criminal convictions for the possession of drugs can impact on a young person's life. For this reason, I set up a working group to look at alternative responses for personal possession of drugs. The group is due to report to me by the end of 2018. The working group is now asking the public for views. To date, there have been 16,000 responses to the online consultation from a broad spectrum of the population. It is encouraging to see people from all walks of life having their say on this important issue for society. Everyone will have had a chance to give views and outline experiences to the working group. This input will shape the recommendations we receive. I look forward to receiving the report from the working group and bringing it to Government at the end of the year.

On average, three people die each day as a result of drinking alcohol. Nearly four out of ten Irish people binge drink regularly. The Government is committed to reducing the widespread harm and pain that alcohol causes to those who engage in harmful drinking and to others who are affected. The Public Health (Alcohol) Bill sets out a number of measures to reduce the substantial harm alcohol causes in society. It is clear that the Department of Health and the Government are taking a pro-active and multifaceted approach to our drug and alcohol problems.

I thank Deputies for their engagement and I look forward to hearing their views. I thank the community groups and NGOs I have met through my journeys throughout the country. I thank them for the support they have given me in implementing the national drugs strategy. I thank the oversight forum and the standing committee, both of which are doing tremendous work on the national drugs strategy.

1:15 pm

Photo of Jack ChambersJack Chambers (Dublin West, Fianna Fail)
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I am sharing time with Deputy John Curran. We intend to take five minutes each.

I am pleased to be able to speak on this issue. I am pleased that the new national drugs strategy was published last year. I was previously the spokesperson on drugs for the party. That role has been taken over by Deputy Stephen Donnelly, but I am glad to speak on the issue.

I am glad the Minister of State has tried to initiate a health-led approach in this area and that she is engaging in a public consultation process. That is something I and my party support. It is important that we remove the criminal code from those who have an addiction. They should not be triaged and processed through the criminal justice system. They should be given care, support and compassion through our health system.

That is where it stops because our health system is not currently calibrated to help those people. Even if we tried to initiate a health-led approach, despite positive changes in some areas and increases in funding, we could not take on the number of those suffering addition, whether drugs or alcohol. Over the coming months, the system must be calibrated to try to initiate a health-led approach. Putting more people behind bars for personal possession will not help them. I was disappointed that the Minister of State did not mention prison as an issue because one of the biggest problems is addiction and mental health issues in prisons. Much of that relates to the cycle of addition to drugs and alcohol and the deprivation those people have experienced in their lives. We need a specific focus in the national drugs strategy on the prison population, the majority of whom have had serious problems with addiction which is only reinforced in our prison system, where they are not helped. She needs to address that in the coming months.

As Fianna Fáil's spokesperson on drugs, I have visited the Tiglin residential treatment centre, Aiséirí Aislinn centre in Kilkenny, and the Rutland Centre as well as many local and regional drugs and alcohol task forces. Many of these groups do admirable work in the most testing of environments with tight budgets. These people do significant work and it is important we recognise that in the debate.

When the national drugs strategy was unveiled in July 2017, I welcomed it but said that there needed to be more than a glossy launch. I said it was imperative that it delivered real and tangible results for communities. My fear was that it would be another strategy that made all the right noises but we would not see the right approach in our public health system. Public health strategy around drugs and alcohol is a microcosm of our health service generally. We have the right strategies and approach, the Government is doing the right thing in consulting the public, but when it comes to services there has not been a real and tangible improvement. The people I speak to on the ground are facing significant budgetary tightening along with increased demand for their services.

What has happened in the past 12 months? How many people have died from drug overdoses? How many lives have been destroyed by substance abuse? What is the net impact of 12 months of inaction? The health system has not been rebalanced to help people with addictions to the extent that is needed. The Government will be glad that there are no statistics for this year as I fear they would show no improvement. Ireland has one of the highest rates of death by overdose. My party and I welcome the Government's action to pilot an injecting centre, which allows intervention for people should they overdose. Ireland has the highest rate of intravenous heroin use in Europe and, as a consequence, the rate of drug-related death is three times the European average. Two people die from drug-related deaths every day in Ireland. This is unacceptable and the figures, unfortunately, show no signs of improving.

We need to look at a public health-led approach to tackling addiction and I welcome the changes being introduced in this regard. Fianna Fáil will engage proactively with the Government's public consultation.

The expansion of local community-led drug projects and needs-based services is a crucial element of the challenge to curb Ireland's drug crisis. However, many social workers and community drug support teams tell me that this expansion has not happened over the past 12 months. The Minister of State referred to the homelessness crisis. Those figures have not improved at all. People who have exited addiction say their complex needs are not currently being met in respect of accommodation or accessing health services. I recognise that is the strategy's focus but we have not seen outcomes.

I welcome that Suboxone and Naloxone are being progressed, which I called for, but it needs to be expanded beyond the current numbers. They will do a great deal to help people. The issue of methadone being the end point or cul-de-sac for many with addiction must also be addressed. It is an important weaning mechanism but treatment must progress beyond it.

1:25 pm

Photo of John CurranJohn Curran (Dublin Mid West, Fianna Fail)
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I welcome the opportunity to contribute to this debate and the Minister of State's opening statement. Implementing a national drugs strategy requires the leadership of a Minister but also requires a whole-of-Government response. I am disappointed that it has taken a year from the launch of the strategy until now for us to have this debate. This debate should have happened much sooner and there should have been an emphasis on the implementation of that programme.

Nevertheless, the Minister of State's opening statement gave rise to hope. It is well acknowledged that those seeking treatment experience better outcomes when the treatments are delivered in their communities. The work, projects and programmes developed over many years by both local and regional drug and alcohol task forces need to be acknowledged. One concern I have is that in a direct reply to me earlier this year, the Minister of State said:

In excess of €27.6 million in funding has been allocated to task forces by the Department of Health and the HSE for community-based drug initiatives this year. This level of funding is consistent with the amounts provided in 2014, 2015, 2016 and 2017.

We have come through a difficult time but I am concerned that while the budgets of both the HSE and the Department of Health during that period have increased, the task forces have been left behind. That has caused problems because they are forced to provided diminished services with reduced funding. They are in competition for staff. People who work on these projects as counsellors and so on are finding alternative work elsewhere through other publicly-funded projects, some of which may be funded by the HSE. I welcome that the Minister of State announced an additional €1 million funding, with €10,000 for local task forces and €15,000 for regional task forces. However my concern is that it is once-off funding. If they are going to provide any continuity of services, task forces need an annual funding base. They need certainty on funding because these programmes cannot be turned on and off.

Later this year, the Minister of State is developing a new programme to promote community awareness of alcohol-related harm. In that regard, €250,000 will be made available in 2018 for phase 1 and €1 million next year, which will be divided among the various task forces. This funding is grossly inadequate. I am sure there will be funding for other alcohol-related issues but she should consider the amount spent on road safety awareness. When one compares the number of accident fatalities with drug-related deaths, we are not putting the same level of effort into prevention and awareness. Allocating €250,000 to all local and regional task forces and €1 million in a full year will not be sufficient to do what we expect it to do. I ask the Minister of State to review this realistically.

I agree with the comment of my colleague Deputy Chambers regarding methadone. For too long, people have been prescribed methadone. It has played an important role and has brought a degree of stability to people's lives. However, many people have been left on methadone programmes indefinitely. There must be better progression and long-term outcomes, and other alternatives need to be sought. I am not critical that people have entered programmes, but I am critical that enough people are not progressing through them and exiting.

Finally, the Minister of State mentioned the gardaí and the issues of serious crime. I acknowledge that the Garda has been successful in some high profile intelligence-led operations. However, I am concerned that divisional drug units which have all been reduced in size. While well-known figures are arrested and big seizures are taking place, my concern relates to those who are dealing in our communities and on street corners. I am regularly contacted by constituents about this and I am sure the Minister of State has the same experienced but divisional drugs squads are not as large as they used to be. While it is not directly the responsibility of the Minister of State's Department, she has responsibility for national drugs strategy, which requires a whole-of-Government response. This issue needs to be addressed because I am seeing more and more drug dealing in public and that needs to be dealt with.

1:35 pm

Photo of Dessie EllisDessie Ellis (Dublin North West, Sinn Fein)
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The national drugs strategy document, Reducing Harm, Supporting Recovery, is another fine document among many dealing with a substance misuse problem that has, unfortunately, been part of the fabric of our society for a number of generations. Drug addiction has resulted in the deaths of thousands of people across the country and has affected society at every level. No one, no social group and no demographic is immune from the issues of substance misuse. However, addiction is a problem that has particularly affected marginalised communities which have experienced widespread social and economic deprivation.

Drug and alcohol addictions will continue to adversely affect all aspects of community life because of the unfortunate reality that, while this current strategy has many commendable aspirations and goals, its lacks the teeth to implement them fully. Simply put, we need more investment. The once-off funding of €290,000 across all task forces for the fourth quarter of 2018 to which the Minster of State referred is simply not enough. The Minister of State also mentioned €710,000 to be allocated by the HSE. While this is welcome, it is essential that each task force avails of it and decides on its use. I have visited many groups and organisations across the city that have been at the coalface in terms of dealing with the substance misuse problem over the past year and they have told me that this lack of funding is a serious problem for them. My own involvement with the Finglas Cabra Drug and Alcohol Task Force, which incidentally, receives proportionately even less funding than other such groups in the country, tells me that all the fine words, reports and aspirations are meaningless if the groups are not given adequate funding to implement these strategies. Increases in funding in more recent years have not even brought funding levels back to the levels prior to 2007 and 2008, years in which significant cuts were made to funding for drugs and alcohol task forces. The resulting cuts in funding had a hugely negative impact on service provision and continue to do so.

As regards the general concepts of the strategy, we can all agree that drug and alcohol misuse are primarily public health issues. Sinn Féin would equally support and advocate an holistic approach to prevention, rehabilitation and recovery. Strategies for those in treatment must include proper access to accommodation, education, vocational training, employment and, most importantly, childcare. There is also a need to increase employment opportunities. That requires working in partnership with trade unions, employer organisations and Government agencies helping those in recovery to rebuild their lives and integrate back into their communities. However, none of this can be done, or done adequately, without significant investment, even just to restore services cut at the time of the economic crash without even taking into account inflation since then.

While there is much to comment on in the strategy, I welcome the fact that it gives consideration to issues concerning mental health, mental illness and co-morbid substance misuse. I recently visited the HSE's Keltoi centre. This is an award-winning substance misuse and trauma residential treatment centre at St. Mary's Hospital in the Phoenix Park. Keltoi has developed programmes that work with people presenting with mental illness and co-morbid substance misuse. I would strongly suggest that organisations such as Keltoi, which have the experience and the programmes, be given a role in the development of the mental health dual diagnosis programme envisaged in the Minister of State's drugs and alcohol strategy.

Substance misuse is an ever-evolving scourge on society. Our children are being groomed to be couriers. The introduction of drugs such as crack cocaine, meth and other highly-toxic substances into communities has led to a near breakdown in society in other jurisdictions. These drugs are now coming into Ireland. We need the investment and resources to combat them. Society needs to be vigilant and we, as legislators, also need to be vigilant. While this document goes some way to recognising these concerns, it lacks bite when it comes to delivery.

Photo of Maurice QuinlivanMaurice Quinlivan (Limerick City, Sinn Fein)
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I am a member and director of the Mid-West Regional Drugs and Alcohol Forum. In Limerick we call it a forum rather than a task force. The drug and alcohol forum in Limerick funds a number of groups, some of which I would like to mention. The Minister of State met with a number of them when she was in Limerick. The Community Substance Misuse Team deals with young people with addiction problems. The Northstar Family Support Project deals with families who are affected by a family member’s substance misuse. One of the groups of which I am really proud is the Limerick city community network. It is a voluntary group comprising people from across the communities, particularly in Limerick city, who come together. They receive no funding but are supported by the task force. Other groups that do great work in Limerick which I would like to mention include Palls, Ana Liffey, the Saoirse Addiction Treatment Centre and Novas Initiatives. I commend the Minister of State for the public consultation she carried out in Limerick. It was very positive.

I am not 100% in favour of the strategy but I wish the Minister of State well with it. Unfortunately, I do not believe the strategy will work because the additional necessary funding is not there to tackle what is a huge problem across the State, particularly in parts of my own constituency of Limerick City. The misuse of drugs in Limerick is increasing almost daily. The continued failure to properly resource those working on the front line to tackle the scourge of drug addiction is simply not acceptable and is not sustainable. The problem worsens.

Local groups and people in Limerick I have worked with and spoken to recently - some of them today - describe the extent of cocaine use in the city as unprecedented. I am hearing stories of very young people being deliberately targeted and used as guinea pigs for mixtures of heroin and cocaine. Crack cocaine is sometimes mixed with cocaine to get these young people immediately hooked on that drug. As the Minister of State is well aware, this is a recipe for disaster. The groups in Limerick I mentioned earlier are having a real positive effect on people’s lives every day but they are starved of funding as the forum is not properly resourced. Limerick does not, for instance, have a detox centre. Most services will say that they have a huge waiting list and that their staff are under huge pressure to deliver basic services.

Official statistics show a rise of almost 25% in the total number of people treated for illegal drug use between 2009 and 2013 across the State. It is estimated that upwards of 1,000 people in Limerick are addicted to heroin alone. The Mid-West Regional Drugs and Alcohol Forum has taken cuts of more than 50% since 2008. Funding in 2018 sees no real increase from what was allocated in 2017. Over the years these cuts have impacted massively on, and prevented, the delivery of drug and alcohol services that are urgently needed in Limerick and across the entire mid-west region. Failure to allocate additional funding means the problem will continue.

The drug task force was established to address the growing alcohol and drugs issues facing the region, especially the city, and yet it has lost more than half of its funding since 2008. It funds a large number of local projects but is now under sustained pressure due to cuts over the years. The Government’s failure to restore some of the massive cuts it has imposed on those working in the fight against drugs in Limerick and nationally over the years is shameful and shows how out of touch it is on the issue. Even in the boom times, successive Governments did not devote anywhere near enough resources to ensure that we could tackle the blight of drug abuse. Now is the time to invest in doing so.

The city of Limerick clearly has a worsening drugs problem. Heroin, the excessive use of alcohol, gambling and the misuse of prescription drugs are causing huge problems across the city and wider region. In the mid-west, the drugs and alcohol forum has provided a drugs project worker who works with students across the third-level institutions in Limerick - the University of Limerick, Limerick Institute of Technology and Mary Immaculate College. This has been hugely successful and the Minister of State should look at trying rolling this out at across the country. It is working really well.

I want to raise with the Minister of State an issue that is brought to my attention constantly. It is the issue of the Criminal Assets Bureau, CAB. People are furious that drugs dealers can flaunt their wealth without fear or favour. They ask how these known drug dealers, who have no visible means of income, can drive quality vehicles. They also ask how their children and relatives can drive similarly expensive vehicles and how can these individuals - again, with no visible signs of support - enjoy the villa-type homes in which they live, often in council estates. How can they afford multiple holidays a year, as can be seen in the photos and itineraries they display on their Facebook pages, while their tax-paying neighbours struggle to pay bills? How can these individuals have the type of social life that has them drinking in well-known hostelries in Limerick most nights of every single week? It is time for the activities of CAB to be expanded in Limerick and for the Government to amend the Proceeds of Crime Acts to ensure money seized by CAB goes back into local communities affected by drugs.

The Minister of State announced a few additional grants. I plead with her to allocate that money directly to the task forces. They should not be put through the hoops of filling out application forms, which I understand are already causing problems that the task forces do not have time to deal with.

The money, if divided among all the task forces, including local task forces, is a small amount. The Minister of State should just allocate it to each one and do so as soon as she can.

1:45 pm

Photo of Alan KellyAlan Kelly (Tipperary, Labour)
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I welcome the Minister of State's comments. We should not be debating the new drugs strategy a year after it was launched. It is kind of crazy. There is so much talk about the need to address this issue and we are debating the strategy a year late. We talk a lot about new politics but this is as an example of where it is not working.

The new national drugs strategy is rightly called Reducing Harm, Supporting Recovery, and I welcome the shift in tone towards caring for people who suffer from addiction, which is an illness. Therefore, it makes sense to take a health-led approach to the drugs issue but we must not underestimate the scale of the challenge.

The number of cases of people in treatment for drug addiction has increased steadily since 2007. Back then, there were 5,259 people in treatment for addiction, not including alcohol. In 2015, that figure was 9,710. That is an increase of 84%. The number of new cases each year has also gone up, from 2,431 cases in 2007 to 3,650 cases in 2015, representing an increase of 50%. These are just the people in treatment. We know that many more people are affected by addiction but are not included in these numbers. Some are not because they do not want to admit to or make public their use of illegal drugs. They do not want to show the impact drugs have had on them. Others are not included because the State simply does not offer them any services. Therefore the number is far higher than recorded.

The issue concerning the figures is that the services are not at the same level outside Dublin or one or two other main urban areas. I say this as a Tipperary Deputy. I welcome in particular that the Department of Health engaged in a much more comprehensive consultation process on the strategy this time round . It is important that the Department continue to engage in serious listening exercises because drug use has changed and it is affecting people across Ireland in new ways. The Department needs to continue to listen to how addiction is affecting communities and families across Ireland. This is not an problem specific to one period but is iterative and continuing.

We used to see the drugs issue as concentrated in urban areas where there was a concentration of social housing. Now the drugs issue is nationwide. Proportionately, villages and rural areas may be even more affected by addiction than some urban areas. I am not sure if anyone has said that before in this House. Some villages in rural counties probably have a higher percentage of drug abuse than inner city Dublin. There is a smaller sample but a bigger problem proportionately.

The level of service provision in the State is nowhere near that required to tackle the addiction issue. The new strategy will need to be backed up by serious investment in services if even half of the intended actions are going to be implemented. Otherwise it is just wishful thinking. Ireland's level of opioid addiction, to heroin among other substances, is much higher than in other western European countries. Opioid addiction affects seven in every 1,000 people here, compared with four in every 1,000 across Europe.

Most of the State's infrastructure for dealing with drug addiction is focused on opioids. This has been the case since the heroin epidemic of the 1980s. In addition to that serious problem, the situation on the ground has moved on. Cocaine and crack cocaine are prevalent and highly addictive. We have few detoxification and rehabilitation options for people. Amphetamines, cannabis and ecstasy are all widely used. There also continues to be abuse of solvents. People are becoming addicted to sedatives or tranquilisers, which they may or may not have acquired on prescription.

Drug dealing has changed too, with people ordering drugs online through so-called dark web websites, and even getting drugs delivered by post. This kind of thing has spread addiction to every corner of Ireland, including every village. There is a risk of drug addiction becoming totally out of control unless the Government puts in the necessary resources to get a grip on the issue. There is obviously a divide between legal and illegal drugs in this mix. We could mention tobacco and alcohol, which are legal, are also associated with addiction.

One of the actions under the national strategy is for the consultation on the potential decriminalisation of the personal possession of illegal drugs. This consultation is currently ongoing. I understand that more than 14,000 submissions from the public have been received to date. I welcome this because it is clear evidence, if any were needed, of the level of public interest in and concern over the issue of drug misuse.

The most important point I want to make to the Minister of State is that there is a real opportunity for Ireland to take a new approach to the whole issue of addiction. One does not often get to spend much time in government but if there is one issue regarding which the Minister of State has an opportunity, it is this. Countries such as Portugal have achieved a major reduction in the use of opioids and much fewer drug-related deaths because they changed strategy. There is something wrong, however, with the focus on the question of what substances should be legal or illegal. That is not the real issue; the real issue is how we treat people who have an addiction. The Labour Party's proposal is that we should decriminalise the person who is addicted to drugs. It should not be a criminal offence to be in possession of a small amount of soft drugs when one is addicted to them. Fear of a criminal record should never stop a person from seeking the medical help he or she needs. The vicious drugs gangs involved in drug dealing of course need to remain outside the law. Garda resources should be freed up to deal with them. At present, by contrast, Garda time is taken up with minor cases where people who are addicted to drugs are found in possession of small quantities. If we make it clear that possession of drugs by addicts will not be a criminal offence, we can focus on getting people into treatment for addiction. In Portugal, people are offered the choice of medical and social supports instead of getting a criminal record and facing a judicial sentence, which hangs over them for the rest of their lives. This is the option we should be discussing for Ireland but it will not work if there are not the services put in place to help people deal with addiction.

A wide range of services is needed to deal with different types of drug addiction and different groups of people. For example, different services are needed for long-term heroin users compared with services for young people. The real test of the national drugs strategy will be whether the Government is ready to put the serious resources into the front-line services that actually help people to escape from addiction and to move forward with their lives.

Massive cuts were implemented in services since 2008 and none of the funding has been restored proportionately. Staff working in drugs services have had their pay cut and frozen. Since they are in the community and voluntary sector, funded through section 39, about which we all know, they are not getting the pay restoration that public servants are getting in the HSE.

Rent costs and insurance costs have increased and many of the services are on their knees. At the same time, as I said at the outset, the number of people presenting to services with drug addiction problems has grown enormously.

Simply decriminalising substances in the absence of funding for addiction services would be a dereliction of duty by the Government and the Minister of State and would lead to anarchy. There is a need for the creation of proper working conditions for those who provide addiction services. They need proper working conditions like me, the Minister of State and everyone else. There should be some standardisation among addiction workers to ensure minimum quality standards. That would involve a lot of training and the development of addiction practitioners. It would also have to include pay grades and career opportunities equivalent to those enjoyed by HSE workers. That is simply not the case now. It is part of the problem when it comes to the provision of services because we cannot get the people.

The new national drugs strategy is going to be health-led but the HSE is not in a position to lead on this topic. We need to think outside the box because if we just throw it in as part of the mix of what the HSE is meant to be doing, we will still be here. We will have a nice, shiny document but no implementation. Therefore, we need to think outside the box and create a different format and pathway for dealing with this issue.

There are political challenges to do with drug addiction that require clear political leadership. This returns me to my point that we do not always get to be in government for long. This is the opportunity of the Minister of State, who I acknowledge has a passion for this issue. She should please try to deal with it. She needs to deal with it and put up the money to develop addiction services. She should put in place the right format and the right organisation and should ensure it provides services nationwide and not just in Dublin.

Services in many of the prisons are simply not working.

The number of prisoners addicted to drugs who are not being provided with the services they need will become a significant issue. I also believe many of the people working in the Prison Service are being treated appallingly where they have to deal with prisoners in this situation but the backup services are not available. When they do find people in possession of drugs, sometimes they feel they are the ones who are getting into more trouble than those who are bringing them in or carrying them within the prisons. The whole issue of drugs in prisons, how those who work in the Prison Service are being treated and the lack of services has been left behind. It will blow up in our faces.

1:55 pm

Photo of Gino KennyGino Kenny (Dublin Mid West, People Before Profit Alliance)
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This debate has been going on for years but, frustratingly, it seems to have stalled. There is much talk but no action. I am glad 14,000 submissions have been received so far in the public consultation on the law on possession of drugs for personal use. I look forward to the report being completed by October. Hopefully, the recommendations can consider some of the issues around personal drug use.

I also want to commend the critical roles played by community drug projects and local drug task forces, which continue to deliver a fantastic service in their communities, even though their budgets have been cut by 37% over the past eight years. These cuts have led to dramatic changes in what they can give to their communities. I have seen this for myself in Clondalkin.

The strategy of criminalising people for drug use has been an abject failure. There is a catchword that the war on drugs has been a failure. In fact, it has been an abject failure. It just does not work. It has failed communities and judicial systems. One must look at a radical approach to dealing with drug use and what that entails. Whether we like it, people will continue to use drugs. They used drugs generations ago and generations to come will continue to do so. Do we criminalise them? No, we should not. People found with drugs for personal use should not go through the criminal justice system because it has failed. In my community, I have seen the abuse of drugs ravage not only friends of mine but family members. I have seen whole communities destroyed. What it does to people’s mindsets acts like a cancer in communities. Words cannot articulate what drugs do and what they leave behind.

Nobody is born a heroin addict but, sometimes, addiction chooses people. When heroin gets a hold of a person, it is a difficult drug from which to get away. Some people do and others do not. Friends of mine have passed away due to heroin addiction. I know others who got away from addiction and have done very well. They have children and good jobs. Sometimes, regardless of whether we like it, drugs take hold of people. In the debate on drugs, I have always heard that cannabis is a gateway to harder drugs. That is absolute rubbish. The gateway to heroin, crack and all the drugs which bring misery, is alienation and poverty. I accept people who have chronic heroin problems probably smoked hash. However, it just does not lead on to harder drugs. I know many people who smoke cannabis but will never touch heroin, crack, cocaine and so forth. We need a radical approach in this regard.

Decriminalisation, as the previous Deputy said, decriminalises the person rather than the drugs. In 2001, Portugal decriminalised drugs for personal use. A person found with a particular drug on them for personal use will not go through the criminal justice system but will be given counselling, health-led products and assistance with harm reduction. Last year, 80% of drug-related offences in this State were for personal use, meaning 10,000 people have gone through the criminal justice system because of personal use of drugs. That is a complete waste of time for the criminal justice system and the police. The police at the front line in the war on drugs will admit that it is failing them and civil society and that we need a new approach. Decriminalisation is one approach to that.

If people who are found in possession of drugs for personal use get a criminal record, this will have a profound effect on their future job prospects. I know people who were caught 15 years ago with a small amount of cannabis but still have a drug offence record. I remember going to a festival 15 years ago at which undercover police were looking for people with a small possession of cannabis and arresting them. It was ridiculous. Obviously, civic society has moved on and we cannot criminalise people for cannabis use in particular because it is a complete waste of time. Decriminalisation of drugs is inevitable.

The Minister of State will have to look at the whole range of drugs contained in the Misuse of Drugs Act 1977. Classifying cannabis as a Schedule 1 drug having no medical or recreational use is ridiculous. For example, this year the Minister for Health granted a licence for medical cannabis that involved the raw form of cannabis. It meant the person was basically granted a licence for a bag of grass. That is a fact. While I am glad the Minister granted a licence to a person in the State for the medical use of cannabis, it is classified as a Schedule 1 drug.

More controversially, all illicit drugs are controlled by criminal individuals or gangs who do extremely well out of selling drugs. They have big cars, holidays and so forth. The war on drugs has been a failure. Society must look at ways of taking drugs out of the hands of criminal gangs and individuals and to take them back. These gangs are unregulated and do not care what they sale. They sell to children, individuals die from using their drugs and communities are destroyed by them. We must look at the legalisation of some drugs. This is a nuanced argument which some people will find difficult. I also believe we will need to look at a more radical approach than decriminalisation. My starting point is whether this will save somebody's life. If it can, then it is worth approaching and looking at. At present, hundreds of people die of overdoses, use opiates or are affected by drugs.

If we can cut that by half, by any means, and if we can save one life by decriminalisation, regulation and legalisation of some drugs, we can have a different approach to this issue. We are losing the war on drugs. It should not be a war. It is a war on people.

I ask the Minister of State to comment on the points I have raised, particularly repeal of the Misuse of Drugs Act 1977.

2:05 pm

Photo of Joan CollinsJoan Collins (Dublin South Central, Independent)
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I am glad this debate is taking place. A few people have contacted me to say there should have been a debate on the issue earlier because the national drugs strategy has been in place for over a year, so I am pleased it is taking place. I am pleased - I know the task force is also happy - to see the progress of the working group on alternative approaches to the possession of drugs for personal use and the high level of response to the public consultation process. Over 14,000 submissions - over 16,000 now according to the Minister of State's report - have been made to date. I know from my contact with Addiction Response Crumlin, my role on the Canal Communities Local Drugs Task Force and contact with other community network groups that they look forward to the report of the working group being completed by October, as indicated by the Minister of State, and its recommendations being considered promptly by the Government in order that issues of addiction and drug use are no longer treated as criminal issues but health issues, in line with the commitments in the national drugs strategy.

The community drug projects continue to develop and deliver a wide range of services across treatment and harm reduction; rehabilitation and recovery; young people and children's services; family support services; and awareness and support programmes in schools, clubs and communities as they respond to every kind of drug use that people present with, including heroin, cocaine, crack cocaine, hash, weed, benzos and tablets, new psychoactive substances, NPS, steroids, amphetamines and alcohol.

I attended the Canal Communities Local Drugs Task Force's monthly meeting on Monday. A crucial part of the two-hour meeting involved breaking into groups, dividing the national drugs strategy into five areas or groups. Each group had to devise strategies on how to implement the national drugs strategy into the projects and the task force. It was a really good exercise except for the fact that we were advised there would be no definitive figures on extra gardaí - community gardaí, drugs gardaí - coming into the jurisdiction in the coming period. This is a key area that is not just for the Department of Justice and Equality but for Deputy Byrne, as Minister of State with responsibility for the national drugs strategy, in ensuring that the community gardaí and the drugs gardaí get the resources they need to assist the communities and work with them, not above them.

The projects have struggled through the devastation of seven years of funding cuts, with an overall cut of 37% to the drugs initiative budget between 2008 and 2014, and have seen no increases to their budgets from 2014 to 2017 or to their wages, which has been mentioned already. The workers in the task forces come under section 39 of the Health Act 2004 and are not getting the increases that other public services are receiving, yet their funding was cut as promptly and as quickly as that of those workers back in 2011-12. This is despite a significant additional allocation of €4 million to €5 million to the drugs initiative budget for 2018. However, none of this additional funding is currently set to be allocated to the community drugs projects that are on the front line of delivering services to our communities. This is completely unjustifiable and needs to be remedied immediately. I see from the Minister of State's report that she has now sourced other moneys for the fourth quarter of 2018, €10,000 each for the local drugs and alcohol task forces and €15,000 for each regional drugs and alcohol task force. Is this on top of the announcement she has already made about the €10,000 going to the task forces?

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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Yes.

Photo of Joan CollinsJoan Collins (Dublin South Central, Independent)
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That is good and will be welcomed, but it is still not enough and does not bring funding back to the level in 2007 and 2008, before the 37% cut in funding to the services.

The Taoiseach stated in the foreword to the national drugs strategy that the Government "recognises the importance of supporting the participation of communities in key decision making structures [of the national drugs strategy] so that their experience and knowledge informs the development of solutions to solve problems related to substance misuse in their areas". Despite this commitment of An Taoiseach, all the key decisions, such as the prioritisation of actions and allocation of resources, continue to be made at a centralised agency and at departmental level and not by the interagency structures set up as part of the national drugs strategy, resulting in the effective exclusion of communities from any meaningful decision-making process.

The Taoiseach's Department should appoint a senior official to the national drugs strategy's national structures to support the role of the Department of Health in ensuring direct accountability of all agencies at national, regional and local level for their active participation in implementing the new national drugs strategy through the agreed mechanism of the partnership interagency structures. Furthermore, the new national drugs strategy recognises the central role of drug and alcohol task forces in co-ordinating the delivery of the strategy at local and regional level. However, in 2018, the additional allocation to each task force is limited to the sum of €10,000 - that is what we had got in the previous announcement - for the entire task force area. This extra funding will go some way in helping but is still not enough for the work they are do on the front line. The task forces must be supported and resourced to carry out this role and to respond effectively to their local needs, whether it be the community drug problems in disadvantaged areas, the growing drug problems in towns outside Dublin or the often hidden drug use in rural areas. Each task force must be given an immediate mandate to develop a three-year action plan that sets out how the national drugs strategy actions will be implemented in its local or regional area through a collective interagency partnership response, and that €10,000 and the extra money must be increased.

I will make three final points. Drug-related intimidation continues to be reported from all parts of the country and is having a particularly damaging and insidious impact on a number of marginalised communities with a concentration of serious problem drug use. The national drugs strategy document states that the NDS structures will develop and monitor responses to drug-related intimidation as a matter of priority. Families are being devastated by this. This commitment must be acted on immediately by bringing together all the relevant stakeholders at the highest level to develop an action plan specific to the challenges of addressing drug-related intimidation.

There is no clear indication as to how an integrated strategy on drugs and alcohol is to be implemented, and this discussion needs to take place on the national committees as a matter of urgency with all the partners engaged.

Finally, the Public Health (Alcohol) Bill, which has been called for desperately by all the task forces and all the community networks, should be passed without further delay.

These are some of the key areas the task forces have raised with me in recent days and they wanted me to raise them here. I hope the Minister of State can respond to some of them.

Photo of Róisín ShortallRóisín Shortall (Dublin North West, Social Democrats)
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I am glad to have an opportunity to speak in this debate. It is just a pity there are so few Deputies present. Perhaps that has something to do with the timing of the debate. It would have been nice to see it more centre stage. I wish to contribute to the debate as a long-standing member of the Ballymun Local Drugs Task Force. I have also had an involvement in the Finglas Cabra Local Drug & Alcohol Task Force.

The drugs strategy was established in 1998. I think it is true to say that at this stage in the development of the response to drugs, there are still a huge number of gaps in it and in some ways we have gone backwards. I read the statement the Taoiseach made this time last year when the new strategy was launched. He spoke about the republic of opportunity and said that, if it is to be meaningful, it must apply to all. However, I suspect that in the meantime very few people who have been excluded through addiction feel any sense of this being a Republic for them because not much progress has been made in implementing the strategy. There are 50 actions set out in the strategy. Most of the task forces, I think, are serious about taking on these actions and have no choice but to do so really because of the fact that they deal with all aspects of addiction on a day-to-day basis. However, the same cannot be said of the national agencies and Departments and their commitment to implement the strategy.

It has been like this for some time. When the drugs strategy was established initially at a time before the crash in the economy and when the Taoiseach of the day took a more centre-stage role on the strategy, a clear instruction was given to all Departments and relevant agencies to participate fully. That co-ordination of the strategy was taking place in the Taoiseach's office, which gave it muscle and a status it has lost in recent years.

In 2011 I had a short period of having responsibility for the drugs strategy. I was appointed first of all as Minister of State with responsibility for primary care. It was some time later that I got a telephone call from a Minister saying they had forgotten about the drugs portfolio and asking if I would take it on as well. It has become a bit of a pass-the-parcel. Since the days when the national strategy team was based in the Department of the Taoiseach, it has lost much of its priority in political eyes. We see that in how the different oversight bodies function. This is in respect of the national steering committee and that co-ordinating body. While it is not a new thing and not specifically the fault of the Minister of State, it is a fault of Government that insufficient priority has been given to this important area.

With the steering committee, people come along to fill a seat without participating and without taking responsibility for the implementation of the strategy. I have seen this at first hand and I know it has continued for a number of years. Representatives from different Departments come along and give the impression it is a real drag for them to have to attend these meetings. They sit there and generally do not contribute very much. In the main the meetings are organised such that there are constant presentations on different things, which in turn lets everybody off the hook, rather than those meetings being challenging meetings where, for example, the Garda representatives are asked what they have done to respond to the issues raised at the previous meeting or officials from the Department of Employment Affairs and Social Protection are asked what they are doing to provide adequate training for people struggling with addiction problems.

The Department of Education and Skills refused to provide a representative for a long period. Officials from the Department of Education and Skills need to be asked what that Department is doing to solve that aspect of the problem because we know that a large number of drug users have a problem with education disadvantage. The profile is there; we know what contributes to a high likelihood that somebody will get involved in substance misuse and addiction that can blight their lives.

There is a huge issue there. It is not just about the Department of Health. It is all very well to say that it has to be a health-led response. However, all these other agencies also have a responsibility and it seems they are not fulfilling that responsibility. From reports I hear, I know how those two national bodies operate and they are not being challenged.

Moreover, they are not participating in local drugs task forces either. The Garda will send along a community garda instead of the inspector or superintendent attending and bringing along somebody from the drugs unit. People from the Department of Education and Skills occasionally attend. It took years for them to agree to participate. I have long maintained that it is not just about them coming along to contribute to the drugs task force meeting; it is about the drugs task force discussions informing senior people from the Department of Education and Skills who need to be educated about the areas that have the biggest drug problems.

The Minister of State has a responsibility to challenge these people and I do not think that is happening. For example, there is a question about how these meetings are organised. Is it about putting in the time, coming along, doing the two hours and sitting there silently? That is what it seems to be and that is how it is viewed. The Minister of State and the support people she has with her who have a responsibility for chairing those meetings need to ensure that those meetings are meaningful.

Those attending should start off by hearing what is happening outside the walls of Departments, which in the main are rarefied areas. The Minister of State needs to be hearing back from the drugs task forces as to what it is actually like in the real world. That information coming back to her should inform the work of the national agencies and Departments.

Those meetings need to be challenging for all of the attendees. One way to do that is to put up the 50 actions that have been promised and to seek regular progress reports from the different agencies on what they are doing to implement them. We all know how it is possible to put in two or three hours at a meeting that ends up being pretty meaningless unless people are challenged and expected to actually do things between those meetings.

We heard much from the previous Minister of State about injecting rooms, which is a very small aspect of the drugs issue and it should not have been allowed to dominate. It is no big deal but it seems to have been treated as a big deal.

We are now talking about decriminalisation and have appointed an expert group, which is fine. I believe that should happen but let us not fool ourselves into thinking that will somehow solve the drugs problem. Some people have serious addiction problems that are destroying their lives. They need to be responded to and that is the hard end of the thing.

In addition, let us not fool ourselves that it is all about heroin. Heroin treatment seems to be fixation of the Department of Health and the HSE. That is why there has been such a poor response to the growing problem with cocaine and crack cocaine. I have raised this several times and it is very hard to know if there are any services to address the growing cocaine problem.

It is shocking that it is six and a half years since a memo was first brought to Cabinet about the alcohol Bill and we still have not seen it passed. We have been promised it time and time again. It was definitely supposed to have been through before this summer but that has not happened.

All of these issues need urgent attention. However, unless we start to tackle the causes of addiction in a meaningful way, we will not change the situation; we will continue to have a major problem that blights particular areas. That is why the Government must be challenged to tackle the problem of economic, social and educational disadvantage, as well as the lack of housing which all feed into our shameful level of addiction.

The Minister of State has one part to play and I have outlined that she should be challenging everybody and driving this strategy to make it a reality. All of her ministerial colleagues have a responsibility in eradicating the causes of addiction.