It is proposed to take Questions Nos. 5, 15, 62, 86, 93 and 137 together.
My Department's policy in the area of drug misuse is based on the national strategy to prevent drug misuse. This strategy, which has been accepted by the Government, is based on the recommendations of the national co-ordinating committee on drug abuse which included representatives of the voluntary and statutory agencies involved in the drug prevention and treatment fields. The strategy recognises the validity of a multi-faceted approach to drug treatment and prevention including drug-free harm reduction, maintenance and rehabilitation programmes. The strategy, while recognising the multiplicity of treatment and prevention programmes, advocated a drug-free lifestyle as the ideal.
It is acknowledged however that a drug-free lifestyle is not an option for many drug abusers, at least in the initial stages of treatment. Consequently, my Department has sponsored the introduction of methadone maintenance programmes as a means of stabilising the behaviour of drug abusers and a means of preventing the spread of the HIV virus through contaminated needles.
As Deputies will be aware, intravenous drug misuse is the principal mode of transmission of the HIV virus in this country. At present 57 per cent of all HIV positive cases are drug-use related. Accordingly, the strategies for dealing with drug abuse and HIV-AIDS are closely interlinked. Since 1992 substantial funding has been allocated to these areas, particularly in the greater Dublin area where the majority of drug abusers reside. This funding has allowed for the development of extensive prevention and treatment services by the Eastern Health Board, which, together with the drug treatment centre and voluntary organisations, provides a comprehensive treatment network for drug abusers. It is intended to further develop these services during 1994 and the Minister has allocated specific funding for this purposes.
The national co-ordinating committee on drug abuse, which is chaired by me meets on a regular basis to review developments in this area.
In accordance with the Government's strategies on HIV-AIDS and drug abuse, methadone maintenance, i.e. an artificial drug provided as a heroin substitute, is made available by the Eastern Health Board and also by the Drug Treatment Centre. The rationale is that by availing themselves of this free "safe" drug, addicts are less likely to indulge in high risk needle-sharing and other anti-social behaviour. This helps prevent the spread of HIV and other infectious diseases as well as bringing addicts into contact with the range of services, treatment and otherwise, available for them. It is important to point out that once the addict's behaviour is stabilised a range of treatment options is offered including assistance towards a drug-free lifestyle.
Approximately 600 persons are now availing of methadone programmes in the Dublin area and there is also a substantial waiting list in the region of 400 persons: because of the particular circumstances of this group, however, it is very difficult to be definitive about this figure.
With regard to Deputy Gregory's question about the City Clinic, Amiens Street there is currently a waiting list of 200 persons who reside in the catchment area of the clinic.
Further measures are planned by the Eastern Health Board to involve more persons in the treatment services and thus reduce the waiting list at the existing clinics. Towards this end funding has been made available this year to allow the board to open two additional satellite clinics as well as establishing another community drug team to identify and liaise with drug abusers in particular areas.
In this regard, another development currently under active discussion is an increase in the numbers of persons on methadone maintenance programmes by the involvement of general practitioners in the community. The report of the expert group on the Protocol for the prescribing of methadone will form the basis for the involvement of these general practitioners. It is intended to circulate the report to general practitioners shortly with other relevant information about support services available in satellite clinics.
I am satisfied that there is a comprehensive framework of prevention and treatment services for drug abusers. I will continue to work to ensure that these services are expanded and developed as necessary and in line with our requirements in relation to the prevention of drug abuse and the treatment and rehabilitation of drug abusers.