Dáil Éireann debate -
Wednesday, 26 Apr 1995

Vol. 452 No. 1

Adjournment Debate. - Dublin Drug Problem.

Ms Shorthall

Thank you for allowing me to raise the important matter of the need for a high level co-ordinated response to the drug problem in Dublin. I am glad to see the Minister for Health in the House to respond to this motion but I am surprised it is that Minister rather than the Minister for Justice who has primary responsibility for this area.

In calling for a drugs task force for the Dublin area I am not denying the existence of the problem in other areas, particularly in cities. However, as a Dublin representative my principal concern is about the major drugs problem in the capital city. There is overwhelming need for a task force which would operate on a Dublin wide basis. I understand there is an existing national coordinating committee which, in theory, should deal with the problem on a countrywide basis but, in practice, this body does not function and I understand it is some time since it met. A more local response is required.

A new task force should be made up of the highest level representatives from all the relevant agencies. The drug problem could be said to be out of control and the official response is unco-ordinated and ineffective. Flat complexes and housing estates are being taken over by a drugs culture. Many communities which made great progress in community development in recent years see their efforts undermined by the scourge of drug abuse. As we know, drug abuse is most likely to flourish in areas of social deprivation and high unemployment. Increasingly we consign young people in these areas to a life of addiction, crime, ill-health and sometimes death because of our failure to tackle the problem.

The law abiding public feel increasingly threatened by the high level of urban crime, the vast bulk of which is drug related. We are failing them also. When we consider there are at least 5,000 drug addicts in the Dublin area each of whom needs to raise between £40 and £100 a day to feed their habit that represents an enormous number of muggings, house break-ins and other crime, all leading to heartbreak.

The drugs problem can only be efficiently dealt with in a co-ordinated way with all the agencies involved. The Garda has a major role in reducing the supply of drugs. This must be the key approach in stemming the problem. Vast quantities of opium such as heroin and morphine as well as ecstasy and cannabis are now available in the city and pushers are dealing openly in many areas. If time permitted I would give details of how that is evident in my constituency and in many Dublin areas.

In addition, the Department of Justice must tackle head on the problem of drugs in our prisons, both in terms of supply and treatment. The Eastern Health Board is providing a number of treatment programmes for drug abusers but these are totally inadequate. There are long waiting lists for the treatment clinics and the number of detoxification beds can only meet a small fraction of the demand.

On prevention, there is a need for an input from the Department of Education. A number of education programmes of varying quality are in operation. Unfortunately, there is little evidence of their efficacy. Some may even exacerbate the problem. There is a glaring need for co-ordination and, ideally, the establishment of a life skills programme for all schools which would concentrate on children's self-development and encourage a sense of self-worth which would offer the best safeguards against being drawn into the drugs scene.

Other agencies who would be involved are the Revenue Commissioners and the Department of Social Welfare who should have access to information which would enable them to clamp down on the big dealers. In addition, Dublin Corporation should be involved as its policy on dealing with anti-social behaviour and intimidation can play a vital role in tackling the crime of drugs dealing.

Given that the drug problem in Dublin is now at crisis point there is an urgent need for a major political initiative to establish and drive the fight against the drugs problem. Without doubt the drugs problem now poses the most serious threat to the city of Dublin.

Minister for Health (Mr. Noonan,

Limerick East): I thank Deputy Shortall for raising this important matter on the Adjournment of the Dáil and for giving me the opportunity to outline Government policy for dealing with the scourge of drug misuse.

The policy in the area of drug misuse is based on the Government Strategy to Prevent Drug Misuse which was published in 1991 and was based on the recommendations of the national coordinating committee on drug abuse. The strategy recognised that the problem is complex and difficult one to which there is no easy or instant solution. It proposed, a multi-disciplinary approach requiring action in the areas of supply reduction, demand reduction and increased access to treatment and rehabilitation programmes, together with co-ordination mechanisms geared towards their effective implementation. The strategy, while recognising the validity of a multiplicity of treatment and prevention programmes, advocated a drug free lifestyle as the ideal. It is also recognised that various drug treatment options are required to deal with the needs of individual drug misusers. Such options would include methadone maintenance, needle exchange, detoxification and rehabilitation provided by statutory agencies working in close collaboraton with the voluntary sector.

Because of the high incidence of intravenous drug use among those who are HIV positive, the strategies for dealing with drug misuse and HIV/AIDS are closely interlinked. Methadone maintenance programmes have been introduced as a means of stablising the behaviour of drug misusers and preventing the spread of HIV through the use of contaminated needles.

Since 1992 special funding has been allocated each year to allow for the development of extensive prevention and treatment services by the Eastern Health Board, which together with the Drug Treatment Centre in Pearse Street and voluntary organisations, provides such services in the Dublin area where the majority of drug misusers reside.

To date three satellite clinics have been established by the Eastern Health Board at Baggot Street, Ballyfermot, and Amiens Street. The clinics provide a range of primary services for drug misusers, including methadone maintenance, needle exchange, urinalysis, HIV testing and counselling and free condoms.

A total of 420 drug misusers are on methadone maintenance programmes at the satellite clinics and a further 190 patients receive methadone at the Drug Treatment Centre, Pearse Street. The satellite clinics have become victims of their own success to some extent, since although they treat over 400 patients, they have substantial waiting lists. I regard it as an urgent priority to provide services for those on the waiting list.

In line with the policy of treating drug misusers in their own community to the greatest extent possible, general practitioners are being encouraged to take on responsibility for the treatment, including the provision of methadone, of drug misusers. At present, about 240 patients are on methadone maintenance with general practitioners. Some general practitioners are reluctant to become involved in this area and this is perhaps understandable. The Protocol for the Prescribing of Methadone, which was circulated last year provides a framework of support for general practitioners willing to become involved. Any practitioner who was so willing would be asked to take on a stabilised patient from a satellite clinic and continue with the treatment. The services of the satellite clinic would continue to be available, where required, together with the right to refer the patient back should any problems develop. The discharge of patients in this way from the satellite clinics would free-up spaces for patients on the waiting list who are currently not in receipt of any service.

In line with the policy of continuing with the development of services I have allocated additional funding to the Eastern Health Board for the establishment of two additional satellite clinics during 1995. Other plans on progress to further develop Eastern Health Board services during 1995 are as follows: the opening of a ten bed detoxification unit at Cherry Orchard Hospital; the expansion of the rehabilitation service for drug misusers; the establishment by the Eastern Health Board of a committee which will co-ordinate services at a local level in the Dublin area. This committee will be representative of the Eastern Health Board, the Garda, the prison service, the education sector and voluntary organisations.

I am confident that the combination of measures I have outlined will go a long way towards tackling the problem of drug misuse in Dublin.

Ms Shortall

A very disappointing reply.