I am glad to avail of this opportunity to make a statement to the House on the occasion of the publication of the annual report on the state of the drugs problem in the European Union by the European Monitoring Centre for drugs and drug addiction, or EMC, for short. I will address what the Government is doing about the problem but first I want to give the House some information on the EMC and its role and functions.
The centre was established by European Union regulation in 1994 with its headquarters in Lisbon. Its task is to provide objective, reliable and comparable information at European Union level concerning drugs and drug addiction and its consequences. It gathers information on the demand for drugs and measures to reduce the demand; national and European Union strategies and policies; international co-operation and the geopolitics of supply; control of trade in narcotic drugs, psychotropic substances and precursor chemicals and implications of the drug phenomenon for producer, consumer and transit countries.
The centre is governed by a management board which has representation from each member state and nominees of the European Commission and the Parliament. It is headed by a director who is supported by administrative and technical staff. The centre's main source of information is a network of focal points located in each member state. The Irish focal point is the Health Research Board.
All the information produced by the centre helps provide the EU and the member states with an overall view of the drug and drug addiction problem. The data obtained in different countries is not completely comparable as methods of evaluation are not standardised, but the EMC is working on developing instruments of measurement and evaluation to address this problem. For this reason we must be careful when comparing Irish figures with those of other member states.
The tasks of the centre are the collection and analysis of existing data, the improvement of data-comparison methods; the dissemination of data and co-operation with European and international bodies and organisations and with nonUnion countries.
The centre adopts a three-year work programme. Each year the management board adopts the centre's annual work programme on the basis of a draft submitted by the director. Part of the requirements of the EMC is that it produces an annual report on its activities. In 1996 it produced its first report on the state of the drugs problem in the European Union. Today marks the publication of the second report. The figures it contains are mainly in respect of 1996.
The key elements of the 1997 report are: cannabis continues to be the most commonly misused illegal drug in the European Union. Depending on the country, from 5 per cent-8 per cent to 20 per cent-30 per cent of the population have tried it. Amphetamines are the next most commonly misused illegal drugs with up to 3 per cent of adults acknowledging that they have tried them. Ecstasy and LSD are more popular among young people and their use is linked to a youth culture based around discos and the rave scene.
Although less than 1 per cent of adults have tried heroin, it is the drug which gives rise to the greatest social and public health problems. It is estimated that there are between 750,000 and one million heroin addicts in the European Union. These heroin addicts face a risk of death which may be 20 to 30 times higher than that for those in the general population.
Among drug users, sharing contaminated infected equipment is the main transmission route for HIV and hepatitis C. The rate of hepatitis C infection among intravenous drug users is worryingly high. This suggests that risk behaviour is continuing, albeit at a lower rate. It is estimated that there could be up to 500,000 drug users with hepatitis C in the European Union.
Since 1980 all but a few countries report increasing numbers of drug offences. Drug users constitute a significant proportion of the prison population in several countries. On a slightly more positive note, the rate of HIV infection in Europe appears to be stabilising or reducing.
A recent European school survey project on alcohol and other drugs, ESPAD, indicated that 37 per cent of the 2,000 16 year olds surveyed in Ireland had at some stage tried cannabis. While on a par with the United Kingdom, this was high by comparison with other EU member states. This figure should be qualified by noting that of this group 10 per cent had used cannabis 20 times or more. The prevalence of the use of cannabis among the group in the past 12 months was 33 per cent and in the previous 30 days 19 per cent.
The mean age of those in treatment for drug misuse in Ireland at 23.6 years is the lowest in the European Union. The average age in most countries is 27 to 29 years. The number in treatment under 25 at 65.3 per cent is also the lowest in the European Union. These figures may reflect the fact that hard drug use in Ireland began later than in other EU member states. In addition, Ireland has a young population with approximately 47.3 per cent of the population under the age of 25.
The report does not give a figure for the number using hard drugs in Ireland but the ministerial task force suggested a figure of 8,000 confined in the main to Dublin city. The Health Research Board report on treated drug misuse in Ireland in 1995 gave a figure of 3,400 in the greater Dublin area and 766 in the remainder of the country receiving treatment. It must be emphasised that these are the numbers receiving treatment and that the numbers misusing drugs are greatly in excess of these figures.
I wish to outline the approach being taken by Government to respond to the threat posed by drug misuse. In 1991 a Government strategy to prevent drug misuse was published. This strategy emphasised the necessity for a multi-agency approach in addressing the problem. Since 1992 additional funding has been made available to health boards each year for the provision of drugs and AIDS services. The misuse of drugs has however continued to grow.
The drugs problem in Ireland manifests itself in two ways — the misuse of heroin which is a problem unique to the Dublin area and the misuse of other drugs such as cannabis and ecstasy which is a nationwide phenomenon. Although, as the EMC report indicates, a relatively small number are engaged in the misuse of heroin, the consequences in terms of social order and public health can be serious. A major part of our effort therefore is concentrated on addressing the misuse of heroin.
In February 1996 the then Government approved proposals on new demand reduction measures to prevent drug misuse. The objectives of the proposals were based on two key elements: reducing the number turning to drug misuse through information, education and prevention programmes; and providing a range of treatment options for those addicted to drugs, the ultimate objective of which must be a return to a drug free lifestyle, although this may not be a realistic goal in every instance in the short-term at least.
Following this a ministerial task force on measures to reduce the demand for drugs was established and it produced its first report in October 1996. The report identified a response to the heroin problem as a priority. Its recommendations on service provision were: speedy establishment of information databases by the health boards to establish the extent of addiction; health boards to move to eliminate drug treatment waiting lists with the Eastern Health Board waiting list to be eliminated in 1997; particular attention to the needs of young misusers in priority areas with priority status for community employment applications offering integrated services for recovering addicts; a series of education and prevention steps, including stronger truancy measures and anti-drug programmes for all primary schools in priority areas; an estate improvement programme for severely run-down urban housing estates; local authorities to develop sports and recreation activities in priority areas within the national sports strategy framework.
In addition, new structures were put in place involving the establishment of a Cabinet subcommittee on drugs, a national drugs strategy team and 13 local drugs task forces in areas where the hard drugs problem was most acute. Twelve of these are in Dublin and the other on the north side of Cork city. A sum of £10 million was made available for the implementation of service development plans in the task force areas as well as £1 million for services in health boards outside Dublin and £3 million for estate improvements by local authorities.
When this Government assumed office it decided that the work already in progress should not alone continue but be given a new impetus. The figures published in this report confirm what everyone in Ireland is aware of, that despite the commitment of successive Governments, the tireless work of a great many in the voluntary sector and significant investment much more needs to be done.
The brief of the Cabinet subcommittee therefore was expanded to include social inclusion and local development as well as drugs. The drugs problem is a manifestation of wider problems of economic and social deprivation that contribute to a sense of exclusion for some sectors of our society. This is borne out by the Health Research Board report on treated drug misuse in 1995. It is noteworthy that of the 3,600 cases treated in the greater Dublin area 63 per cent had left school at or before the official school leaving age of 15 years and 87 per cent were unemployed.
The response to the drugs problem therefore must be part of a wider response which will also tackle the issues of poverty, deprivation and social exclusion. The Government is focused on dealing with this problem. A Minister of State was appointed at the Department of Tourism, Sport and Recreation with special responsibility for local development and the national drugs strategy team. The Minister of State concerned, Deputy Flood, will be making a statement to the House on progress made in his area of responsibility.
The ministerial task force published its second report in May 1997. This report dealt with drugs other than heroin and found that the misuse of such drugs is a nationwide phenomenon, the misuse of ecstasy and cannabis being the most common. Its key recommendations were: to establish a youth services development fund with contributions from the Exchequer and the corporate sector to develop youth services in the most disadvantaged areas; and to develop a number of other initiatives aimed at meeting the needs of young people in disadvantaged areas where drug misuse is most prevalent.
The Department of Health and Children and other agencies continue with the implementation of the recommendations of the two ministerial task force reports. I wish to outline the progress made in the development of treatment, prevention, education and other services. I will start with information and research. All health boards are working on the establishment of information databases which will provide accurate timely data on the subject of drug misuse. Earlier this year at a meeting of all health boards their representatives were briefed on developments at European level regarding the standardisation of data to render it comparable from one area to another. As a result, a working group has drawn up a range of data sets, for example, treatment data, schoolbased surveys, national surveys, drug-related deaths and other demand reduction measures which will form the basis of a common set of data to be provided by all health boards at the earliest opportunity. It is expected that, by 1998, all health boards will be working toward establishing a proper information system.
On research, during 1997, 26 research projects were given a total of £1 million funding through Forbairt's "Science and Technology against Drugs Initiative", grant-aided by Europe for this purpose. Research includes investigation into the detection and analysis of illegal drugs, biochemistry and pharmacology, such as the neurotoxicity of various forms of "ecstasy" and social sciences studies. The results of these studies will prove useful to public health services, the Garda and forensic scientists.
A number of health boards have also undertaken research into the extent and nature of drug misuse.
One area I consider hugely important is addiction. During 1997 the Addiction Studies course in Trinity College, funded by the Department of Health, was given additional funding to double its input of students in the 1997-98 academic year. The college is developing a master's course in addiction studies.
On treatment services for those already caught up in the drugs scene, the Eastern Health Board developed a comprehensive service plan for 1997 aimed at eliminating waiting lists for treatment by the end of the year and at expanding all of its services, particularly rehabilitation. The board has commenced an emergency and assessment service in a number of its treatment centres. Treatment services are being expanded across the board, emphasis being placed on the provision of treatment to people in their local area.
There are six treatment centres and 15 satellite clinics providing services in the Eastern Health Board area. The mobile clinic provides services to drug misusers at Dr. Steevens Hospital and Empress Street in the north inner city. Work is continuing on the extension of mobile services to the Ballymun and Inchicore areas.
The methadone prescription-dispensing scheme continues to be expanded, evaluated and regulated. The total number of people on the central treatment list is 2,550 with the involvement of approximately 60 general practitioners and 50 pharmacies. A review group was established to examine the arrangements for prescribing and dispensing methadone and its recommendations are being implemented. I am satisfied that the full implementation of these recommendations will help to redress the present unsatisfactory elements of this service.
However, it is important to remember that although significant progress has been made in establishing a network of new services throughout the city and bringing new clients into treatment, estimates of the total number of drug misusers suggest that considerable further expansion of services is required to enable health services to adequately address the needs of drug misusers presenting for treatment. The Eastern Health Board service development plan for drugs misuse, published in March 1997, suggests that, in addition to the existing six treatment centres and 15 satellite centres, an additional 20 satellite centres are required. There is also a requirement for a drug treatment centre in the south inner city and on the north western side of the city. Therefore, much work needs to be done.
There has been much talk about the need to consult communities, in an endeavour to reach a consensus regarding the location of these satellite centres in addition to the couple of drug treatment centres also required. At some stage, the level of consultation must be fruitful. Sometimes consultation can lead to further prevarication without ever reaching agreement. If we are to embark on a consultative process it will have to be on the basis that there is agreement in principle that we will locate satellite centres within communities where the perceived need has been established.
I recognise the difficulties the Eastern Health Board faces in endeavouring to reach agreement and have these satellite centres established. It is clear to me, based on the level of the problem and the board's plans to endeavour to provide the types of services needed throughout the city, we need to make positive progress in this area, and to add to the already established 15 satellite centres. While I do not under-estimate the difficulties involved, I shall endeavour to work with everybody concerned to bring that about.
People approach me from various parts of the city contending there is considerable overloading in specific areas because satellite centres have not been established elsewhere. In fairness, local communities understand the extent and nature of the problem and what has to be done to solve it, and are prepared to contribute, recognising that members of their own communities are experiencing this unfortunate problem of addiction. At the same time, they make clear their concerns that, if progress is not made in establishing satellite centres where the need has been established they will be required to withstand a load perhaps disproportionate to the size of the problem in their local area.
I recognise that all public representatives must be as sensitive as possible in resolving these problems while ensuring that satellite centres are established and that we shall be unable to deal with the problem adequately if we cannot make progress in that area.
A freephone telephone helpline was initiated by the Eastern Health Board in July last. It is operating successfully in assisting people in crisis and, when necessary, referring them to the appropriate service. The helpline handles an average of 55 calls per week, once again showing the need for the health board to have adequate services in place to guarantee clients identified through such a helpline, can be provided with the right support as speedily as possible.
The Eastern Health Board is providing a total of £2.2 million to voluntary and community organisations to support the valuable work done in the area of drug misuse, prevention, treatment and support for drug misusers and their families. In addition, up to 30 community support workers will be employed by the board by the end of the year.
Because of the importance of rehabilitation, plans are being drawn up to expand the SAOL and SAOILSE rehabilitation programmes, operating in Amiens Street and Henrietta Street respectively. The board is awaiting contracts for the purchase of property in the inner city to provide an aftercare and rehabilitation unit. Plans are also being drawn up to extend Domville House in Ballymun for the same purpose.
Health board schemes are operated in close liaison with community employment schemes, FAS and other back-to-work schemes to maximise the chances of stable drug misusers obtaining employment and becoming socially reintegrated.
Significant expansion of the present rehabilitation services is required if the needs of persons coming off treatment programmes are to be addressed. Realistically, when people are weaned off heroin and have reached a stable state — but have no self-worth and no chance of acquiring a place in society — the chances of their returning to drug misuse are very high. For this reason, the Eastern Health Board, in conjunction with other agencies, will prioritise resources on rehabilitation in 1998 and provide as many people as possible with the support and care necessary to resume productive active lives. This development of further rehabilitation facilities for stabilised drug users will be a priority of mine as Minister for Health.
My Department continues its implementation of the recommendations of the two reports of the ministerial task force on measures to reduce the demand for drugs. In the fight against drugs, education is the first line of defence.
In conjunction with the Department of Education and the many voluntary and community agencies, my Department is working on a number of initiatives aimed at preventing young people turning to drugs in the first instance. Some of these initiatives are as follows: the health promotion unit of my Department liaises with the Department of Education on its development of resource materials for primary schools. The programme has been successfully piloted and work is continuing on its wider implementation. Special emphasis is being placed on the delivery of the programme in schools in priority areas. This programme follows the successful dissemination of a similar programme "On My Own Two Feet" to second level schools since 1994.
Health boards, through their health promotion officers, provide a range of services including parenting programmes and modules for youth clubs and other agencies dealing with young people. The Health Promotion Unit, in conjunction with the Cork social and health education project of the Southern Health Board, has developed a parenting programme on drugs and family communication. The programme focuses on the skills and personal attributes that help family members to deal with problems caused by drugs. The course has been widely used in the Southern Health Board and wider dissemination is planned. The Health Promotion Unit has also funded Community Awareness of Drugs, a voluntary organisation with offices in Dame Court, Dublin 2, to develop a parenting for prevention programme. The unit's "Drugs Questions — Local Answers" programme, which is being disseminated throughout the country, helps local communities to address the drugs problems in their locality.
In the Eastern Health Board area, six education officers have been appointed and four others will be in place by the end of the year. The board launched an anti-heroin campaign in May. The education officers are engaged in the development of a programme for youth leaders, a community drug awareness programme and an inter-agency drug awareness programme already operates successfully in the north east inner city. It is also working with the National Parents' Council on the development of a parenting for prevention programme. Plans are being drawn up for a conference on the use of ecstasy later this month and for a directory of information, education and preventative initiatives in the EHB area.
The Health Promotion Unit has run a national drug awareness campaign in April and September this year with the message "Drugs destroy lives, not just of users, but people close to them too", using cinema, television, radio and billboard sites, mainly in the Dublin area.
Voluntary organisations play a key role in supporting statutory agencies in providing a range of preventative and treatment services. It is acknowledged that the most successful way to provide treatment for those misusing drugs is in their own community. It has been demonstrated that, with proper supervision and control, those centres work effectively with the minimum of interference to the local community. The success of the proposals to provide further treatment centres depends on the co-operation of the local communities. In its service plan for 1997 the Eastern Health Board identified the areas where it is proposed to establish drug treatment facilities which will be developed in full consultation with local communities and voluntary groups. The ministerial task force recommended continued support for the work of such organisations whose work complements the work of State agencies. All regional health boards give funding and support to these organisations.
I have dealt up to now with what is known as the demand reduction aspect of the drug problem. The EMC report deals with other aspects, such as strategies on supply reduction, the joint actions being taken by the European Union and the overall international environment for co-operation. As Members will be aware, the drug phenomenon requires an integrated response at national level, where demand reduction measures go hand in hand with supply reduction strategies.
In so far as supply reduction is concerned, a range of legislative measures have been put in place aimed at cutting off the supply and ensuring that those who profit from the misery of others are brought to justice. It is important to remember that significant strides have been made, nationally and internationally, to deprive the merchants of evil of the drug trade of their illgotten gains. The establishment of the Criminal Assets Bureau in 1996 represents a major step forward in the fight against such people who amass vast wealth at the expense of other people's lives and happiness. Legislation has been introduced to give the Garda the powers necessary for effective action. The Proceeds of Crime Act, 1996, enables the Criminal Assets Bureau to take the action necessary to identify, freeze and eventually seize the assets acquired as a result of crime. The Criminal Justice (Drug Trafficking) Act, 1996, provides for periods of detention of up to seven days. Other key legislative measures include the Disclosure of Information for Taxation and Other Purposes Act, 1996, which provides for more effective exchange of information between the Garda and the Revenue Commissioners; the Licensing (Combating Drug Abuse) Act, 1997, which provides more powers for the Garda to deal with drug abuse in dance halls and pubs and the Criminal Justice (Miscellaneous Provisions) Act, 1997, which reduces the amount of time spent by gardaí on court related duties, thus helping to ensure a greater presence of uniformed gardaí in our communities. The Non-Fatal Offences Against the Person Act, 1997, has focused on remedies to deal with new life threatening menaces such as syringe attacks.
As we all know, drug traffickers know no borders. They carry on their illicit trade on an international scale. It is only through effective action at national level, complemented by wider measures at European and international level, that we can hope to tackle the perpetrators of these despicable crimes. In late 1996 Ireland ratified the UN Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances and the Council of Europe Convention on Laundering, Search, Seizure and Confiscation of the Proceeds of Crime. These conventions require participating states to afford each other extensive criminal law co-operation, as well as to put in place certain domestic criminal law provisions. Ireland's role in the field of international co-operation has significantly improved and expanded since signing up to the conventions.
Ireland is working at EU level to improve co-operation among member states in responding to drugs issues. In this context, my colleague, the Minister for Justice, Equality and Law Reform has asked me to express his congratulations to the Garda and appreciation of their vigilance which resulted in the weekend seizures of drugs at Enfield, County Meath, and Dublin Airport. Both operations stemmed from joint investigations between the Garda and other EU countries, clearly highlighting the benefits of international co-operation.
I reiterate that the fight against drugs is one in which a number of Government Departments and State agencies have a role. I have resolved to play my part in stopping the increase in drug abuse. It is an essential part of my job that the health services continue to develop their role, particularly in the areas where the drug problem is most acute. This must be matched by a commitment from other agencies, statutory and voluntary. The Government must work with local communities to build up social and economic infrastructures where people are encouraged to turn from drug misuse as a way of coping with life. It is at community level that real success can be achieved. There must be a particular focus on rehabilitation and viable life options for former drug users, encouraging them to once again take an active part in society.
So-called recreational drug misuse is also a worrying phenomenon which is widespread throughout the country. Our primary defence here is the education system, both formal and informal, where, through life skills programmes such as the "On My Own Two Feet" substance abuse programme, young people can be equipped with the skills and knowledge to make informed decisions about the use of drugs in their lives. Such programmes deal not just with illegal drugs but with the legal ones of tobacco and alcohol which cause so much damage in society. I know my colleague, the Minister of State with responsibility for youth affairs, Deputy O'Dea, will address the House on this aspect of the problem during the debate.
The extent of drug misuse in Ireland, as identified in the EMC and ESPAD reports, highlights the need to intensify our efforts at prevention and treatment levels. The health services have responded by putting structures and services in place to address the problem. I compliment them, particularly the Eastern Health Board — its members, its management and its staff — on their efforts to date. In doing so, I make it abundantly clear that I recognise we all have a lot more to do. We have developed the foundations for appropriate responses to the drug problem, and we must now continue to build on this with the aim of reducing the extent of drug misuse in the years to come.
