(Limerick East): Drug misuse is a country-wide problem while heroin addiction is confined largely to the Dublin area. Treatment services for heroin addicts are currently provided by the Eastern Health Board at its centres at Baggot Street, Ballyfermot and Amiens Street. Such services include methadone maintenance, counselling, HIV testing and free condoms. A similar range of services is provided by the drug treatment centre in Trinity Court, Pearse Street. Approximately 700 patients are on methadone maintenance programmes at these four centres and a further 700 patients are on methadone maintenance with general practitioners in the Dublin area. Approximately 720 patients are on the waiting lists at the Eastern Health Board centres and Trinity Court.
To address the problem posed by drug misuse the Government decided, on 20 February last, on the implementation of a range of measures aimed at reducing the demand for drugs. These measures included the following: (a) that no steps should be taken to legalise or decriminalise the use of so-called "soft drugs" such as cannabis; (b) there should be further development of education and prevention programmes in conjunction with the Department of Education and other relevant agencies; this will include the development of a multi-media awareness and prevention campaign, a programme aimed specifically at deprived areas and the other educational programmes outlined in the Department of Education Action Plan; (c) a task force under the aegis of the Interdepartmental Policy Committee on Local Development will examine the root social factors which give rise to drug misuse in the Dublin inner city area, recommend how best local community groups can be harnessed to prevent misuse and how partnership arrangements with parents on prevention strategies should be structured; (d) new management and evaluation procedures should be put in place for the services of the Eastern Health Board area, these procedures should be ongoing and directed to examine best international practice for application in Ireland; (e) treatment programmes should continue to be developed and have as their objective in the short-term control of the drug misuser's addiction within the context of the long-term aim of a return of the drug misuser to a drug-free lifestyle. Methadone maintenance programmes should continue as a valid and successful element in treatment services and the role of general practitioners in providing this service is to be strengthened; (f) the Eastern Health Board Regional Co-ordinating Committee is to make proposals on the provision of appropriate services for persons who smoke heroin; (g) adequate detoxification programmes are to be developed and health boards are to be responsible for the development of appropriate counselling, treatment and rehabilitation programmes, including those provided by voluntary bodies and therapeutic communities, to lead to a drug-free lifestyle; (h) local co-ordination committees representing all local interests should be established at health board level to develop and monitor education and prevention measures and service provision and the demand reduction sub-committee of the National Co-ordinating Committee on Drug Abuse should largely comprise representatives from these local committees; (i) a new unit is to be established to ensure that all businesses involved with controlled drugs comply fully with the terms of the Misuse of Drugs Acts, 1977 and 1984, and the UN Convention on Narcotic Drugs and Psychotropic Substances; (j) liaison arrangements between the health services and the prison services should be put in place to ensure that co-ordinated treatment regimes for prisoners are in place. It is further agreed that the National Co-ordinating Committee be given specific responsibility to achieve maximum co-ordination; and (k) there should be a greater emphasis on providing basic information on the extent and type of drug misuse and more research should be undertaken as to best approaches to demand reduction services. An extra £3.5 million is being made available this year towards implementation of these measures.
Arising from the decisions each health board was requested to prepare a plan in respect of its area which would provide an effective response to the problem. These plans are being finalised at present and the Eastern Health Board has produced proposals which will involve a major development of its existing services in Dublin. The proposals which are being implemented at present will result in the provision of an additional 1,100 places for methadone treatment for drug misusers by the end of 1996.
The board will also improve the range of other services available by increasing the number of in-patient detoxification beds available, allowing for more outpatient detoxification, extending the number of rehabilitation places, providing early intervention programmes for young heroin smokers, establishing a telephone helpline and organising parenting programmes for drug using parents in the north and south inner city. I am confident that with the implementation of these proposals significant progress can be made in reaching the vast majority of drug misusers currently in need of services.
It is difficult to be precise about the amount of funding allocated to drug treatment but it is estimated that a sum in excess of £13 million was expended in 1995. This included services for HIV-AIDS because our HIV-AIDS and drug treatment strategies are closely interlinked. This would not include out-patient and in-patient treatment provided at general and psychiatric hospitals or services provided by general practitioners as part of overall patient care.