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Dáil Éireann debate -
Tuesday, 3 Apr 2001

Vol. 533 No. 6

Adjournment Debate. - Alcohol Abuse Treatment Services.

I thank the Leas-Cheann Comhairle for allowing me to raise this serious issue and the Minister of State for coming to the House to reply. There is an urgent need for proper treatment facilities to be made available for those suffering from severe alcoholism in all parts of Ireland, but especially in the North Eastern Health Board area. Anyone from my county of Monaghan who seeks help must do so in Newry, Galway, the midlands or, if he or she can afford it, by attending a special clinic in Dublin or elsewhere.

Ireland is now recognised internationally as having a serious drink culture and even during the recent visit by former US President Clinton, his wife and daughter we highlighted that fact to the international media by virtue of the main function being held on the Guinness premises while the Taoiseach also hosted the president in his local public house. I have nothing against a social drink and the relaxation and enjoyment that many people derive from the pubs, clubs, hotels and other venues in which they meet. However, the fact that the Government takes in approximately £1.25 billion annually in excise duty and VAT on the sale of alcohol products must justify a small sum being spent to help those who succumb to the disease of alcoholism.

One person in the health service stated recently that there was more help available for people with drink problems than there is currently. Is it fair that a person who was hospitalised as a result of an overdose, which was directly related to alcoholism, should be sent home the next day and told to pull herself together and go back to work two days later? She left work that day at 3 p.m. and went drinking. She had to be taken into care by a friend who was suffering from cancer.

Many homes and families have been broken by alcohol abuse and where families split up, serious damage is often done to young children. Serious problems are created for health board staff, social welfare personnel and housing authorities, never mind the cost to the nation. Would it not be more cost efficient to provide facilities to help those people to deal with their problems and, thus, protect the family structure and, even more importantly, save young children from a much more difficult future with only one parent?

Anyone listening to "Liveline" last week would have realised how widespread and serious is the problem and that something must be done. I listened to the programme as I travelled to the House and some of the stories were extremely frightening. St. Davnet's Hospital is located in County Monaghan and many patients who suffered from alcohol abuse were treated there years ago. That unit is responsible for many success stories. Why can such a unit not be used now that drinking is a much more serious problem? Family members and friends can visit patients in these units and they can be operated at a minimal cost.

I was one of the few Members who questioned the legislation introduced by the Minister for Justice, Equality and Law Reform which extended pub opening hours. It has meant that more young people spend their nights in pubs that close too late to justify going to dances and discos. I am aware of children aged 12 and 14 who have been found under the influence of drink and recently we witnessed students under the influence during their street protests.

We are encouraging alcoholism. Listening to people who attend at my clinics, similar to those who attend the Minister of State's clinics, it is clear that, while they still love the family member affected by alcohol abuse and want them to receive treatment and be free of their addiction, the lack of proper treatment service at local level means they feel abandoned and let down by the State. People in this scenario often opt to approach members of the legal profession to obtain barring orders or separation agreements. The Department of Social, Community and Family Affairs, health boards and local authorities bear the cost.

Can the Minister of State justify the lack of services? Can some of the £1.25 billion in tax revenue be used to help these people?

I thank the Deputy for raising this matter. National policy on the treatment of alcohol abuse, as set out in "Planning for the Future", stipulates that the emphasis in the management of alcohol related problems should be on community based intervention rather than on specialist in-patient treatment. The main therapeutic tools in the treatment of alcohol dependence are psychotherapy, counselling, family and marital therapy, either individually or in group settings. Therapy may take place in a residential or a day setting. As alcohol related problems occur, in many instances, in local and family settings, the community based response can be direct and early, thereby reducing the associated levels of physical, psychological and social problems.

Health boards are also considering ways in which services provided by voluntary and/or private facilities might integrate with the health boards' services. Most health boards have made local arrangements to enable access to specialist in-patient treatment facilities in the small number of cases where the need arises in this connection. Examples of such facilities include The Rutland Centre, Dublin, Cuan Mhuire, Limerick, Cuan Mhuire, Kildare, Tabor Lodge in Cork, Aiseirí, Wexford, and the Aislinn Centre in Kilkenny.

What about the Border area?

The provision of services for the treatment of alcohol related problems in the north-east has undergone major changes in recent years. Following on the board's strategy document on alcoholism and addiction, the development of services has been community based with particular emphasis on early intervention, close links with the primary care services and active liaison psychiatry. Detoxification is now predominantly home based and supervised by general practitioners. Admissions to general medical wards take place in a small number of cases where it is clinically indicated. Occasional admissions to St. Davnet's Hospital take place where there are major behavioural problems or in the context of psychiatric morbidity.

A new community service is based in the Monaghan health care unit which also serves the Cavan community and community services are made available throughout the board area. Counselling services for alcohol addiction are available in Louth and Meath. The North Eastern Health Board also has arrangements in place for the provision of specialist in-patient treatment services for its clients in the Rutland Centre in Dublin.

The approach to alcohol related problems should be based on prevention rather than on treatment. In this regard a new campaign aimed at young high risk drinkers was launched in February. This campaign emphasises the choices open to young people and promotes a healthier lifestyle. The Alcohol Awareness Campaign carries the slogan "Less Is More – It's your Choice". It promotes alternative activities to drinking and encourages people to examine their whole lifestyle. The messages of the campaign are communicated through media reporting, local community initiatives, youth organisations, and the highlighting of best practice examples of how to tackle the problem of under-age drinking.

An important element of the campaign was the development of a dedicated website, www.coolchoices.ie. The site provides factual information for young people on alcohol, myths about drinking, and facts and tips for teenagers. There is a particular focus on binge drinking and its consequences for health, relationships, life options and opportunities. Nationwide activities and initiatives will be sign posted on the site and there will be links to other websites of interest to young people. The site is currently being evaluated.

As part of the Less is More campaign, the health promotion unit held a seminar which was attended by more than 100 stakeholders – health professionals, youth groups, teachers, parents, community groups, vintners and the Garda. The purpose of this was to demonstrate examples of best practice in dealing with issues such as under-age drinking at a local level. Further activities planned for this year include college campus initiatives, an international conference and further development of the website. The health promotion unit is also involved in a number of other alcohol related initiatives. These include education programmes, training for publicans and their staff and research on advertising.

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