Vol. 459 No. 3
19 Miss Quill asked the Minister for Health the proposals, if any, he intends to introduce in response to the report by Doctor Kathleen O'Higgins of the Health Research Board on the work of the drug treatment clinics; and if he will make a statement on the matter. [18275/95]
(Limerick East): I am aware of the recent report from the Health Research Board which provides an analysis of some socio-demographic characteristics of drug misusers in the Dublin area in 1994.
The main findings of the report indicate an increase of 5 per cent in the number presenting for treatment; the number of persons presenting for treatment for the first time increased by 34 per cent; almost 80 per cent of those in treatment were male; more than 80 per cent were unemployed; 60 per cent had left school with the minimum education; 92 per cent of those in treatment were in the 15 to 39 age bracket; 27 per cent of those receiving treatment lived in the north or south inner city; and 82 per cent of the clientele stated that an opiate was their primary drug of misuse;
These statistics indicate that the profile of a drug misuser is very likely to be of a young male, unemployed, with limited education, living in the inner city area and with opiates as the primary drug of abuse. This is a very worrying and tragic picture. In addition, these facts suggest that the response to the drug problem has to be very wide ranging and involves many other agencies and organisations in addition to the health services.
A further issue of concern which was not dealt with in the Health Research Board report is the high levels of crime associated with drugs and initiatives in this respect have been announced by my colleague, the Minister for Justice.
As far as the health services are concerned there is a need to develop as a matter of urgency a comprehensive network of services in Dublin to respond to this growing problem.
The most recent report from the Eastern Health Board indicates that approximately 800 people are awaiting treatment. The board in consultation with my Department is addressing this issue as a matter of urgency. A major component of the plan to eliminate these waiting lists is the establishment of community drug centres in local areas where the need for these centres has been identified. The most effective way to treat drug misusers is in their own locality where possible. I am aware of opposition from local communities to the establishment of these centres. I have asked the Eastern Health Board to approach the establishment of these centres with the utmost sensitivity and with the fullest consultation with the local community and I would appeal to such communities to help facilitate the provision of treatment facilities to drug misusers in their areas.
In the fight against drugs the most effective weapon is education and prevention. In drug misuse prevention programmes, such as "On My Own Two Feet", which was made available to second level schools in 1994, young people are given information on all drugs, but they are also trained to develop their assertiveness and decision-making skills so that they can resist drug offer situations. The evaluation of this programme has proven it to be effective in changing young people's attitudes to drug misuse. It is too early, however, to say how effective the programme is at influencing behaviour.
Media campaigns can also be effective at getting a hard hitting message across to the public. For this reason my Department's health promotion unit is working on possible themes for a major awareness campaign which will run early next year. Because the nature and cause of drug misuse are complex, interventions, whether they involve education and training or clinical treatment, can be limited in their effectiveness without a concerted effort by all agencies, both statutory and voluntary, in addressing the problem.
I thank the Minister for his reply and agree that the report confirms we have a major drug problem, particularly in respect of teenagers who are increasingly caught up in the drugs culture. I am concerned about the health element of the problem in the context of the number of young people who present themselves for treatment. The report states the 30 per cent of drug addicts who present for treatment have stopped injecting. What response is the Minister framing in respect of the remaining 70 per cent who presented for treatment but were unsuccessful in kicking the habit? Does he agree that residential treatment centres would be more appropriate for stubborn cases. Young people could be taken out of the drug culture, put into residential treatment centres and then go back into the community where, with the help of proper support systems, they could be assisted in finally breaking the habit. Does the Minister agree that residential treatment would be more appropriate for the 70 per cent of addicts who presented for treatment but were not cured?
(Limerick East): As the Deputy is aware, the hard drugs problem affects mainly the greater Dublin area. It also affects most UK and other major cities in the world. One cannot take a remedy from a shelf and claim it will solve the problem in any area and it is in that context we are approaching the problem. Methodone treatment appears to be effective in the Dublin area.
In only 30 per cent of cases.
(Limerick East): If we could expand that treatment through community clinics and wider dispensation by general practioners, we could then attack the waiting list problem. Residential accommodation is also required. We doubled the number of detoxification beds in Dublin this year by opening new facilities in Cherry Orchard Hospital. Some of the addicts who avail of the six week detoxification programme revert to their old habits. Similar arguments could be made about whether the treatment of alcoholism should be done on a residential or community basis. One system may work in some cases and not in others. Under both systems there would be breakdowns and regressions. We can only endeavour to push the matter forward, ensure that facilities are available for those who require them and operate best practice. I appeal to local communities to allow us operate what is essentially a health programme. While I acknowledge the Deputy is inquiring about the health strategies available to drug addicts, it should be noted that the main problem arises on the supply side in that drug pushers and dealers actively encourage young people to become addicted to enable them broaden their customer base.
I agree that we must first deal with the pushers but I must ask the Minister to accept that, in the context of dealing with health matters, we are talking about drug addicts, many of whom have done irreversible damage to their health and life prospects. What provision does he propose to make in next year's budget to increase the number of residential and day centres throughout the country? The drug problem is not exclusive to any area.
(Limerick East): The problem of hard drug abuse, particularly heroin, affects mainly the greater Dublin area. I am not claiming that people in other parts of the country do not take hard drugs, but in so far as the question of a significant number of addicts living in a locality is concerned, the problem affects mainly the Dublin area. We are also concerned with the health problems associated with ecstasy and cannabis, the abuse of which is more common in other parts of the country.
I have negotiated proposals with the Eastern Health Board and the management structure of the group dealing with the problem has been changed. Through the Eastern Health Board we have good contacts with local communities and I have devised a programme for which I will seek funding in the Estimates to enable us expand the services in 1996.
I am pleased the Minister proposes to make a budgetary provision in this area because substantial funding will be required. Does he propose to make similar provisions for all health board areas, particularly having regard to the problem with ecstasy? As of now we do not have scientific evidence as to the damage that drug is causing to people's health. Does the Minister propose to investigate the damage it is causing to health as well as the need for treatment centres for teenagers caught up in the rave culture involving ecstasy?
(Limerick East): The best contribution anyone can make in public life to young people abusing substances is to educate them to make the right choices. It is not possible to devise a regime that would compel people to behave properly, even in their own interests. Early in the new year we propose to put in place a health promotion programme which will focus on the drugs problem in general but particularly on ecstasy, so that young people are aware of the damage it can cause to their health. I agree the problem is widespread and not one affecting only large cities. Children, parents and teachers must be given information to enable them educate young people to make proper decisions about substance abuse.
The time available for dealing with Priority Questions is exhausted. I can, however, hear the replies to Questions Nos. 20 and 21.
