Seanad debates

Thursday, 16 November 2006

Drug Misuse: Statements

 

1:00 pm

Photo of Noel AhernNoel Ahern (Dublin North West, Fianna Fail)

I am pleased have an opportunity this afternoon to update the Members of the Seanad on the efforts we are making to combat the misuse of drugs in society. Given that all jurisdictions have difficulties in coping with this problem, which is encountered throughout the world, it is hardly surprising that Ireland has problems in this regard. We are dealing with the misuse of drugs in a concerted, planned and integrated manner on several fronts. Considerable progress is being made under the national drugs strategy, for example. I will outline the Government's plans to disrupt drug misuse in Ireland and to alleviate the problems caused by drugs. We should state honestly that there are no quick and easy answers. There is no magic wand. No single action will solve this problem overnight. Ireland's drug problem is part of a worldwide problem. All we can do is try to manage it as best we can.

The national drugs strategy, which covers the years between 2001 and 2008, demonstrates the Government's commitment to addressing the problem of drug use in a proactive and decisive way. The strategy places a balanced and complimentary focus on reducing drug-related harm, continuing efforts to disrupt the operation of the drug market and increasing the focus on the rehabilitation of problem drug users, which are particularly important policy goals. There have been encouraging signs of progress in recent years in areas like drug seizures and the expansion of treatment services. Preventative services aimed at young people who are at risk have been rolled out through the work of the young people's facilities and services fund. The research outcome study in Ireland, which evaluated the effectiveness of heroin treatment, recently issued some positive findings. It is important to recognise that progress has been made in the past few years through a process of co-operation and partnership. While that process can be difficult at times, we must focus on the fact that it is more beneficial to work together in a united way than to utilise a fragmented approach, especially when we are dealing with a problem as pervasive as drug misuse. The co-operation, work and involvement of many agencies and communities throughout the country are important in dealing with this problem.

Our policies need to be flexible because the nature of this country's drugs problem is constantly evolving — the increased use of cocaine is a case in point. I am confident the problem of cocaine use is being addressed by the implementation of the actions in the national drugs strategy. When I recognised the need for an overview of this emerging threat, I sought a joint briefing paper from the National Advisory Committee on Drugs and the national drugs strategy team. I am awaiting responses from the relevant agencies and Departments, such as the Health Service Executive and the Garda Síochána, about how the recommendations of the joint briefing paper might be progressed. I envisage that the matter will be followed up further in December, at the next meeting of the interdepartmental group on drugs. I am determined we will continue to emphasise that cocaine is a dangerous drug which drastically affects physical and mental health and causes social and economic harm to individuals and society. Like the Tánaiste and Minister for Justice, Equality and Law Reform, I stress that the use of cocaine directly contributes to the illegal drugs industry and the crime and violence associated with it.

Six local drugs task force area projects which are specifically aimed at cocaine have been allocated funding of €420,000 in 2006 under the emerging needs fund. Five of the projects, which focus on the provision of direct community-based services for cocaine users, are located within existing services. The sixth project is supporting the development of an information booklet. The purpose of the emerging needs fund is to address the changing demands in local drugs task force areas, which is what the communities have requested. I approved 67 projects under the fund, but I am disappointed that just six of them deal specifically with cocaine. When I initiated the fund, I thought that communities and local drugs task forces would propose many projects relating to cocaine, but just six such projects have emerged.

I have launched four pilot cocaine treatment projects, which will examine various ways of treating cocaine use, and a training initiative, which will focus on frontline workers. I have provided funding of approximately €400,000 to support these initiatives. While the projects are at varying stages of progress, preliminary evaluation reports will be available on most of them shortly. It is hoped the results of the evaluations will lead to the formulation of effective actions aimed at tackling cocaine misuse. Next month's meeting in Belfast of the British-Irish Council sectoral group on the misuse of drugs, which I will chair, will consider the challenges presented by problem cocaine use.

There may be some validity in the accusation that a great deal of the treatment being provided under the national drug strategy relates to heroin. If one considers the problems which originally led to the establishment of the local drugs task forces, one will find that many of them related to the misuse of heroin in disadvantaged areas. Many of the services which are currently offered have evolved from that background. The charge that is sometimes made — that our services and treatment facilities are very opiate orientated and we are not taking other drugs into account — probably has some validity. If one is being counselled for a problem relating to a specific drug, one should be able to receive counselling in respect of other drugs if one needs it. If workers are upskilled, they should be able to deal with problems relating to ecstasy and cocaine as well as to heroin. I do not doubt that some of the people who are using cocaine at present are traditional heroin users. Some of them are polydrug users — they will use different drugs from week to week. They will use anything that is available to them, including alcohol. The third category is made up of the so-called recreational users. We must examine this group to see how we can treat the people involved because they represent a different cohort. They would not normally seek what they see as traditional drug treatment services.

The strategy addresses the problem of drug misuse across a number of pillars, namely, supply reduction, prevention, treatment and research, with a fifth pillar on rehabilitation now added to bring more focus on this important aspect of the work. The overall strategy is being implemented across a range of Departments and agencies in conjunction with the community and voluntary sectors, all co-ordinated by my Department. We have made considerable progress in implementing the 100 actions set out in the strategy. This was borne out by the mid-term review that took place last year.

As indicated, rehabilitation emerged as a central issue during the consultation process of that review. The conclusion was that, although there had been significant improvements in treatment provision and while a great deal of work was already being done with respect to rehabilitation, a more focused approach was needed on this element of the strategy. Arising from the review, rehabilitation was made the fifth pillar of the strategy and a working group on drug rehabilitation, chaired by my Department, was established to develop an integrated rehabilitation provision. The group has taken a holistic view of rehabilitation and while it recognises the importance of clients being activated and prepared to fulfil their role in the push towards rehabilitation, it sees the empowering of recovering problem drug users as a key aim of the process so that they can re-engage with society in a manner consistent with their needs and expectations.

The view was expressed that we were putting people on methadone and I will speak about the success of that later. Many felt that methadone treatment is only a short-term measure and that we needed to pull the rehabilitation services together and provide a continuum of care. In this way, people could progress from one level of rehabilitation to another. Their education, employment and housing needs should be brought together so that we could stabilise them, wean them off methadone and get them back to making a useful contribution to their families and to society.

Some of the key recommendations of the working group are likely to focus on ensuring that actions 47, 48 and 50 of the national drugs strategy are met. These actions largely relate to providing a continuum of care for clients through planned progression paths for each problem drug user while ensuring that quality standards are achieved in the services provided. The group is also likely to deal with wider supports needed by recovering problem drug users in areas such as community employment schemes, education, housing and child care while recognising the need to involve the families of problem drug users in the process. I expect the working group to complete its report shortly with a view to beginning the implementation of its recommendations in 2007. The Health Service Executive has also set up a working group specifically dealing with residential treatment and rehabilitation for substance users. This group, on which my Department is represented, is examining the residential rehabilitation requirements of substance misuse, including alcohol, and it will report as early as possible next year.

The national drugs strategy team and the drugs task forces, local and regional, have played a very important role in tackling the drug problem. Many services and facilities have been established in recent years through the local drugs task force system. Since 1997, almost €125 million has been allocated to support this work across the 14 local drugs task force areas. More than 450 community-based projects have been established, employing more than 300 staff. They deliver services such as advice and support for drug misusers and their families, treatment, outreach and crisis intervention services, as well as drug training programmes for community groups. The focus of the local drugs task force plans is on the development of community-based initiatives to link in with the programmes and services already being delivered or planned by the statutory agencies. Under the emerging needs fund I allocated €4 million to 67 projects over the past 15 months.

The creation of the regional drugs task forces, covering all parts of the country outside the 14 local drugs task force areas, is further proof that we are delivering on the commitments in the programme for Government. An initial total allocation of €5 million was approved in 2006 to the ten regional drugs task forces to begin implementation of the plans they drew up and submitted to us. It is envisaged that the funding will be increased on an incremental basis to achieve the full roll-out of the plans. This is estimated to cost around €14 million annually, but it may take them about three years to implement their plans fully. Meanwhile, nine of the ten regional drugs task forces now have full-time co-ordinators in place and the rate of progress is increasing. The national drugs strategy team has been working closely with the regional drugs task forces to get their programmes up and running. A total of 68 projects have been initiated in 2006. It is envisaged that around 80 projects will be in progress by the end of the year. The projects involved range from prevention initiatives and work with youth to treatment services and outreach work.

With respect to supply reduction, I acknowledge the work of the Garda Síochána and the Customs and Excise service of the Office of the Revenue Commissioners on their considerable successes. The strategy specifies a number of challenging supply reduction targets for the Garda Síochána through drug seizures, and these targets are being met. Garda strategies for dealing with drug offences are designed to undermine the activities of organised criminal networks involved in the trafficking and distribution of illicit drugs. These strategies include gathering intelligence on individuals and organisations involved in the distribution of drugs, conducting targeted operations on criminal networks based on intelligence gathered as well as working in collaboration with other law enforcement agencies, both within and outside the jurisdiction, to address the national and international aspects of drug trafficking and distribution.

I have also overseen the Government's investment in facilities and services aimed at diverting young people away from drug misuse through the young people's facilities and services fund. This fund was established by the Government in 1998 to assist in the development of youth facilities, including sport, recreational facilities and services in disadvantaged areas where a significant drug problem exists or has the potential to develop. We have spent more than €100 million on 460 facility and services projects, employing 325 people. Between the local drugs task force projects and young people's projects, about 650 jobs have been created that did not exist nine years ago. Those people are doing a great deal of work and I am sorry we did not ask these community people nine years ago how many youth and project workers were needed. I think they would have said that 20 or 30 people were needed and not 650. A massive investment has been made by the State in those areas. Most of the 650 people employed are in the Dublin area and they provide a range of services. We will have to examine carefully whether they are all delivering what they set out to do because it is a significant annual investment by the Government.

The Health Service Executive has also made great strides in the provision of treatment. More than 8,300 heroin users now receive methadone treatment. Recently the national advisory committee on drugs published the research outcome study in Ireland, ROSIE. That study, carried out under action 99 of the national drugs strategy, involved 404 people in drug treatment services, following them for a year. They were interviewed periodically, and changes were observed and documented. The overall message from the study was that treatment works. I was very pleased with the results, since one often wonders, and people ask, whether the substantial State investment every year is achieving its aims or whether we are simply providing 650 jobs without doing anything to wean people off drugs or minimise their drug problems.

The clear message from that study, which followed more than 400 people in drug services, was that treatment works. The key findings from the outcomes at the end of the first year were that there were significant reductions in heroin and other drug use; 27% were abstinent from all drugs, excluding alcohol, after one year; there were extensive reductions in drug injecting, both in the number of days and the number of times per day; there were improvements in the study group's physical and mental health; there were extensive reductions in criminal activity; and there was increased contact with health and social care services and a low mortality rate.

Some people were still involved in crime, but we all know that if one does not provide services, people with a drug problem will feed it in two ways. The first is through involvement in crime such as robbery and mugging to get the price of their next fix. The other is that they turn into mini-dealers themselves, recruiting friends and others to make money. Through our bringing them into services, putting them on methadone and supporting them, after a year they were much more aware of the damage their habit was causing them. They had not all walked away from drugs but many of them showed an improvement. While they were still on drugs, it was a lesser problem for them.

The national advisory committee is also involved in organising the all-Ireland drug prevalence survey, for which a contract has recently been placed. Fieldwork is in progress and will continue until April 2007, with the first report on national prevalence figures and trends expected in autumn 2007. We had an all-Ireland study a few years ago, and this new one will enable us to measure the effect of action taken in recent years.

Three basic questions are asked in such studies: whether one has ever used drugs, whether one has done so the last year, and whether one has done so in the last month. The last two are the important issues because the numbers who have used drugs at least once in a lifetime are increasing all the time because some younger people who have done so are now entering older categories. When we receive the outcome of the study next year, it will show us trends in drugs and how many are using each drug. While that question is asked overall, it is also asked regarding cocaine, heroin, ecstasy, magic mushrooms and so on in particular.

Education, prevention and awareness initiatives with regard to drugs are continuing. Our children are now being educated on the dangers of drugs through dedicated modules of the social, personal and health education, SPHE, programme in all primary and post-primary schools. That is complemented by the work of the national drugs awareness campaign.

Tackling the drug problem is a key priority for the Government and will continue to be so. That commitment is evidenced by the allocation of €43 million to my Department's Vote for the drugs initiative and young people's facilities and services fund in 2006, an increase of 37% on the original 2005 allocation. More or less everything that we do is a pilot project and when those are evaluated, they are made mainstream and devolved to other agencies and Departments. When mainstreamed projects are included, one sees that the Government is spending €70 million per year on projects that originated at community level. Projects worth €20 million or €25 million that started in phase 1 of the plans have been mainstreamed.

At community level, approximately €70 million a year is being spent by the Government on projects that started at local community level, serviced by approximately 650 full-time staff. That shows a substantial Government investment. The Health Service Executive spends approximately €80 million a year, and there are also the Garda and Customs and Excise. Overall, the Government now spends between €190 million and €200 million a year through various arms, agencies and Departments on dealing with the problems of drug supply and treatment.

I look forward to hearing Members' comments and will be happy to assist them by clarifying any issues. I thank the House for the opportunity of speaking on the issue today.

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