Róisín Shortall
Question:15 Ms Shortall asked the Minister for Justice, Equality and Law Reform the measures, if any, which are available for the treatment of drug addicts in our prisons. [17213/97]
Other Questions - Treatment for Drug Offenders.
I understand from listening to Deputy Shortall over the years that she has a genuine commitment to this area. The most effective strategy in dealing with drug addicted offenders is a combination of appropriate treatment, education and rehabilitation. To this end there are specially designed information programmes addressing the risks associated with the misuse of drugs in all our prisons. The majority of offenders with drugs problems are located in institutions in the Dublin area and in particular in Mountjoy Prison.
The medical treatment of drug addicts, in common with the provision of all medical services in the prisons system, is co-ordinated by the Director of Prison Medical Services. The director liaises regularly with the health boards to ensure a level of primary health care for prisoners which is equivalent to that available in the community. Developments in medical services for drug addicts in the community are closely monitored with a view to their application in prisons where practicable. I am pleased to note there has been an ongoing high degree of co-operation between the Eastern Health Board, including the agencies under its aegis, and my Department. An example of this is the assistance received in the provision of the necessary professional services for a drug treatment facility in Mountjoy Prison which was established some time ago. I hope this co-operation between the prisons and the Eastern Health Board, in the interest of tackling this community wide problem, will continue and where feasible expand.
The Mountjoy drug treatment facility has been in operation for some time at the prison's health care unit. This facility provides for humane detoxification and a therapy programme. The unit is the first of its kind in a prison environment in the State and is modelled on similar hospital based units in the community. My Department is examining the feasibility of further expanding the range of treatment options available to prisoners.
There are a number of options open where inmates have completed the detoxification programme. They can continue to serve their sentence in the general prison population. If they are considered suitable they can be granted temporary release to continue treatment with an outside agency or they can opt for a transfer to the drug free unit.
The drug free unit operates at the training unit which is adjacent to Mountjoy Prison and has accommodation for 96 prisoners. This facility enables the prison authorities to accommodate prisoners who do not have a background of drug abuse in a drug-free and secure environment within the prison system. It also provides a sympathetic, but closely monitored, setting in which prisoners who are coming to terms with their addiction and who have achieved stable drug-free status can serve out their sentences in an environment free from the temptations and risks associated with illicit drugs in the general prison population. The regime in the training unit will provide inmates with valuable opportunities in the form of a wide range of gainful work and training related activities to assist in the rehabilitation process. Prisoners in the Mountjoy treatment facility and in the drug free unit are closely monitored by regular and random urine testing.
However, the position with regard to female prisoners is, unsatisfactory. This is due to a large extent to the extreme overcrowding in the Mountjoy women's prison. This issue is under continuous review between officials of my Department and the Eastern Health Board. I hope an interim solution will emerge. In any event, I am satisfied this issue can be resolved in the context of the move to the new purpose built women's prison which will be ready towards the end of 1998.
We should stop fooling ourselves about this problem. Mountjoy Prison is dominated by a drugs culture and successive Governments and authorities have failed to develop an effective response to the drug problem in prisons. Drug free units were set up last year. Will the Minister of State distinguish between a drugs free unit and a drugs treatment unit? Reputable reports on Mountjoy Prison indicate the majority of inmates are abusing opiates. We are failing to address this problem. Why do not the prison authorities consult the Eastern Health Board in the context of providing the type of drug treatment services that are available in the community? Much progress has been made in recent years in developing drug treatment services in the community.
There is an immediate constituency in our prisons requiring drug treatment. Why is the service in our prisons less adequate than in the community? The Eastern Health Board is more than willing to be involved on an agency basis, but the prison authorities will not face up to the serious problem that exists in relation to drug abuse. We should stop fooling ourselves. The Minister of State should indicate what steps she intends to take to provide drug treatment services and not simply drug free units in our prisons? Ideally, all our prisons should be drug free, but how will we tackle the common problem of heroin addicted prisoners? What services do we provide for those people other than giving them an opportunity to try a drug free existence? That is inadequate for most drug addicts. What treatment do we propose to provide? No treatment has been provided up to now. As far as I understand from what the Minister of State suggested, the Minister has no proposals to tackle this desperate matter.
A question please, Deputy.
What proposals, if any, has the Minister to provide a drug free treatment service for the 60 per cent plus prisoners in Mountjoy Prison who are heroin addicts? It is a disgrace that nothing has happened and I ask the Minister of State to give this matter her urgent attention.
I am very much aware of the need for counselling for offenders who are trying to give up illicit drugs. Counselling is being provided by members of the Probation and Welfare Service with an input from a number of community agencies, but it is generally accepted that their efforts should be complemented by a dedicated addiction counsellor. To that end I have asked the prisons division of the Department and the director of prison medical services, who has an important role in this area, to address this issue as a matter of urgency. I am hopeful suitable arrangements can be entered into with the Eastern Health Board to address this need in the future.
In regard to Mountjoy Prison and the Eastern Health Board area, the Eastern Health Board has been more than co-operative in this regard. We must also bear in mind that we are working with the medical adviser of the director of prison medical services on the medical treatment of drug addicts.
The question raised by Deputy Shortall on the distinction between the Mountjoy treatment facility and the drug free unit is important. I clarify for the Deputy that the Mountjoy drug treatment facility has been in operation for some time at the prison's health care unit. It is a separate unit and provides a humane detoxification and therapy programme. It is the first of its kind in a prison environment in this State and is modelled on similar hospital based units in the community. The Department is currently examining the feasibility of further expanding the range of treatment options available to prisoners under the medical director in consultation with the Eastern Health Board to ensure, as pointed out by the Deputy, that what is available in the community should be available to inmates in Mountjoy Prison. Separately, the drug free unit is in operation as a training unit. It is a separate unit adjacent to the main prison and has accommodation for 96 prisoners. That facility enables the prison authorities to accommodate those prisoners who do not have a background of drug abuse in a totally drug free and secure environment within the prison system. It also provides a sympathetic yet closely monitored setting in which prisoners, who are in the process of coming to terms with their addiction and who have achieved stable drug free status, can serve out their sentences in an environment free from the temptations and risks associated with illicit drugs in the general prison population. The regime in the training unit will provide inmates with valuable opportunities in the form of a wide range of gainful work and training related activities to assist in the rehabilitation process. As the Deputy rightly pointed out, this unit is distinct, different and separate.
Do drug treatment services include methadone maintenance and methadone detoxification programmes? We are talking about something that requires much more than simply counselling.
We have spent ten minutes on this question. Three or four other Deputies are offering. We want to deal with a number of questions.
I appreciate that, but this is at the kernel of our penal system and crime problem. Unless we get this right we can forget about providing a service.
The purpose of Question Time is to elicit information from the Minister, not to make statements.
We are not getting that information.
The medical treatment of drug addicts, in common with the provision of all medical services in the prison system, is co-ordinated by the director of prison medical services. It is operated under the expert advice of medical staff, such as the director of medical services in Mountjoy, who liaises with the Eastern Health Board, of which Deputy Shorthall is chairperson. We can question medical advice but treatment is given under the medical expertise of the director.
Is methadone maintenance or methadone detox available in Mountjoy?
I do not have the details of what is available but I can obtain that information for the Deputy.
The Minister of State mentioned medical directors. There is an old saying, "When doctors differ, patients die". I appreciate the Minister of State would not normally take this question and I extend my sympathy to the Minister for Justice on his loss. However, is she not aware that the regime in prison is not the same as that outside as regards drug treatment? She should consider that methadone has been proven as a treatment which provides some hope to addicts. This is not presented to them in Mountjoy in the same way it might be outside the prison. Will the Minister ensure that the medical policy in Mountjoy is altered and expanded so methadone is provided as an option to ensure that people whose lives can be transformed by this method of treatment are enabled to be cured of their addiction? On the drug free unit, is the Minister satisfied that people who qualify to enter the unit can avail of the opportunity? I know of some people who have tried to get into the unit but have been unable to. It may be a question of space. Can the Minister inform us about the adequacy of places and the people who may be waiting in line to enter the unit?
I can obtain that information for the Deputy because it is an important question. On admission to the drug free unit, it is important to recognise that prisoners in the unit are closely monitored by regular and random urine testing. I can clarify if there is a long waiting list. If so, it is a cause for concern. I will also query the availability of methadone as an option. I am advised there are specially designed information programmes in the prison addressing the risks associated with the misuse of drugs. As Deputy McManus correctly pointed out, there is a different regime from that in the community.
In the light of the seriousness of the problems highlighted by Deputy Shortall and the establishment of the interdepartmental committee and task force on drugs, will there be an urgent focus on this area? Will there be an input from prison staff dealing with the problem? What ongoing research will the committee or the Department of Justice undertake on the monitoring and combating of the problem? What models of other prison systems and treatment centres will be examined? Will the findings of the committee be published?
There is ongoing research and models from other institutions are being examined. This important aspect of the drugs problem will be taken into account by the interdepartmental committee on drugs.
Will prison staff have a direct input into that committee?
Yes, it is important that they would have such an input.
(Dublin West): Does the Minister of State agree that the resources being made available to try to solve the problems of heroin addiction in the prison are hopelessly inadequate? Did she not admit as much when she referred to primary health care in the prison being equivalent to that available in the community? Is the Minister of State aware that there are thousands of heroin addicts crying out for help who cannot find a place in a programme which would help them to come off heroin and begin to get their lives back together? Has the Minister of State not heard the Governor of Mountjoy speaking of the need to view heroin addiction in the prison in an overall context? Prisoners who have served their terms and are released back into the community are faced with long-term unemployment, bad housing and other problems and have no proper aftercare. That ensures this vicious circle continues.
This is an area of concern but I stress that there has been an ongoing and high degree of co-operation between the Eastern Health Board and the Department in this important area. I am aware that there are concerns in the wider community on this issue but we are dealing here with concerns in relation to the problem in Mountjoy prison. I am advised that the necessary professional services are available in the drug treatment facility in Mountjoy; that facility is being actively monitored with regard to any possible improvements which could be made. A special treatment facility has been in operation in the health care unit of Mountjoy prison for some time and is having an important effect. People's participation in the programme is very important. The facility provides humane detoxification and therapy programmes.
Will the Minister give details of the drug problem in State prisons other than Mountjoy? What monitoring is in place and what treatments are available in those prisons?
The only information I have to hand is that specially designed information programmes stressing the risks associated with the misuse of drugs are in place in all our prisons. I can obtain further information for the Deputy if he requires it.