Aubrey McCarthy (Independent)

I congratulate the Minister of State on her new role. I look forward to working with her. I thank her on behalf of the people of Kildare for opening a new sensory garden, Hope Cottage, last week, which was a fascinating event for family members of people caught in addiction.

To bring the Minister of State’s attention to the national drugs strategy, which is about to expire, there is one key issue that comes constantly to my desk. I am the chair of the south western regional drug and alcohol task force. I was also involved in the east coast task force for ten years. We renamed all the task forces as the alcohol and drug task forces, yet it seems alcohol is not being focused on in this strategy. I wish to ensure the emphasis is kept on alcohol because a lot is at stake regarding not only prevention and treatment, but also detoxification services, which I have spoken to the Minister of State about. In order to fully understand the strategy, we need to look at alcohol statistics and the present strategy, Reducing Harm, Supporting Recovery, to look at how that needs to be progressed in the next strategy.

I took part in the Citizens’ Assembly on Drugs Use in 2023. It focused more or less entirely on illicit drugs and left alcohol in a sort of blind spot. If one looks at the figures, however, alcohol remains the single most harmful drug in terms of deaths, hospital use and economic cost. There is large-scale harm. There were 8,163 cases in specialist treatment services in 2023, which was nearly as many as all of the other drugs combined, according to a Health Research Board report. An estimated 1,500 acute hospital beds are occupied daily due to alcohol-related illnesses. Up to 30% of emergency department presentations are linked to alcohol use, especially at weekends and during holiday periods. Approximately four people in Ireland die every day due to alcohol-related diseases. We also heard on “Morning Ireland” today about alcohol’s link with cancer. I am involved in a women’s centre for women with addiction. Foetal alcohol spectrum disorder often comes up, which is a lifelong, serious complication. What I am saying is that alcohol causes huge harm. It takes approximately 11% of the entire health budget to deal with alcohol each year, and alcohol-related issues cost our country €12 billion annually. It is not a substance to be left on the side. It certainly needs to be a dominant aspect of the strategy because that is where the demand in our health services is going.

The annual reports of 2023 and 2024 from my organisation, Tiglin, show that alcohol remains the primary reason for entry into most of the residential programmes, with more than 60% of the admissions being for alcohol. It rose 15% in 2024 among males aged 30 to 55, which even surprised me. Women who come into the centres often cite alcohol as being a leading factor when it comes to presenting with domestic violence and trauma issues. It seems there is a whole issue regarding alcohol and detoxification. One quarter of treatment cases require inpatient detox, which is more than 2,000 people per year. Figures from a reply to a parliamentary question asked in October show there are only 120 publicly funded detox beds in Munster and Leinster, for example. There are long waiting lists. We see that every day through the organisation I am involved in and through working with many others.

The HSE would argue that 79 general hospital beds are routinely occupied by people awaiting a dedicated detox. This is costing an estimated €12 million per year. That is for out-of-place services being focused on alcohol. Unless we expand detoxification, clear the gaps and address all the other aspects, such as aftercare, rehab and recovery capital, it will all backlog. The options are either to keep alcohol very much focused as part of the new strategy, which will avoid duplication, or to come up with a parallel national strategy for alcohol with a dedicated budget and a single accountable lead. Alcohol Action Ireland has a focus on trying to get a 40% reduction in per capita consumption. If we double our detoxification capacities from 120 to 250 beds and ring-fence funding streams, it will have an amazing impact in Ireland in reducing alcohol harm. I have mentioned that alcohol takes up 11% of the entire health budget. Financing detox beds would lead to huge savings and enhance enforcement regarding alcohol harm prevention.

Alcohol presents the greatest burden on our hospitals, treatment services and economy. It is a greater burden than heroin, cocaine and methamphetamines combined. Although heroin is a bogeyman and we hear about cocaine and these other awful illicit drugs, alcohol is doing more damage. If we roll alcohol into a wider strategy without dedicated leadership, we will repeat the cycle of what we have done so far, that is, a strategy without delivery.

I ask the Minister of State to consider what I have said and to try to give alcohol the equivalent priority that other drugs have taken with regard to funding and the expansion of detoxification services. Anything else will leave the most harmful drug, alcohol, once again in a policy blind spot in Ireland. In her new role, the Minister of State has decisive action to take. This could be a generational change in Ireland’s relationship with alcohol. We need to seize it.

I am 53 years of age now. I was brought up in a home where alcohol had a very negative effect. It impacted me for life. There are many people out there in the same situation. Back then, the Eastern Health Board was in operation. Steps could have been taken that would have impacted the likes of myself.