Public Health, Well-being and National Drugs Strategy: Statements

I welcome this opportunity to update the House on the important policy areas that fall under my remit as Minister of State with responsibility for public health, well-being and the national drugs strategy. My opening statement will deal with how these policy areas support the response to the Covid-19 pandemic. My closing statement will set out my policy priorities for the remainder of 2020 and into 2021.

Covid-19 is having a major impact on every aspect of our society both in Ireland and across the globe. Real progress has been made in suppressing the virus thanks to the great efforts of our healthcare workers and our citizens. By working together, we have saved lives and limited the impact of this disease on our society. However, we must all do everything to avoid the virus spreading further as we head into winter. The Covid-19 pandemic has put public health and well-being centre stage in Government policymaking and the lives of our citizens. Physical and mental well-being have always been important, but are now more vital than ever as we adapt to living with the changed world caused by the Covid-19 pandemic.

As outlined in the programme for Government, the State has a major role to play in promoting good physical and mental health. I believe that a healthy lifestyle is a key foundation for a better quality of life and is key to reducing the risks from infectious and chronic disease. Empowering people and communities to shift our focus more towards prevention is a key element of the Sláintecare strategy delivered through Healthy Ireland, a framework I am proud to head up.

Healthy Ireland is our national action plan to help people to live healthier and longer lives, prevent illness, and reduce health inequalities. Since Healthy Ireland was launched in 2013, further policies have been developed under its umbrella to address specific public health priorities and reduce the risk of ill-health. These include the national obesity policy and action plan, the national physical action plan and the national sexual health strategy. Further support for implementation also includes a national Healthy Ireland citizen engagement and communications campaign, the Healthy Ireland fund, and support for our evidence base through the outcomes framework and Healthy Ireland survey.

Most important, we have built strong networks with a wide range of collaborators, encompassing other Departments, Government agencies, local authorities and the research sector to further Healthy Ireland's aims and objectives. Over recent months the communications and citizen engagement campaign was repurposed as a wider cross-Government well-being campaign, In This Together, to promote resources and initiatives from across Government to support health and well-being during the pandemic. This campaign and activity of support in the context of the pandemic will continue in the months ahead to help maintain our individual and collective well-being.

During this pandemic, we have learned that it is within our power to protect ourselves and others from Covid-19 if we follow public health advice. It has been widely reported that the risks of serious illness from Covid-19 are increased substantially if we have certain health conditions, including heart disease, diabetes, respiratory diseases or cancers. The personal actions we take to reduce the risk of developing these conditions are well known and include quitting smoking and keeping our alcohol consumption low. These are simple actions, but I appreciate they are not easy. The fear, worry and uncertainty felt by many in the recent difficult months may have made it even more difficult to look at our tobacco and alcohol use. However, it has never been more important to do so. That is why it is now more urgent than ever that the Government and I, as Minister of State, do whatever we can to help people make healthier choices in their everyday lives.

Smoking remains the biggest single cause of addiction, ill-health and death in Ireland, with an estimated 6,000 people dying each year from tobacco-related diseases. One in every two smokers will die of a disease that is attributable to smoking, such as cancer, heart disease or respiratory disease. This dark reality cannot be highlighted enough and it is why I have chosen to discuss it again in our national Parliament today. The World Health Organization, WHO, has warned that smokers are more likely to develop severe disease with Covid-19 than non-smokers. This is because those with impaired lung function due to smoking find it harder to fight off the virus. Now is the time to quit smoking and now is the time to do what we can to help those who want to quit.

Ireland has a reputation as a world leader in tobacco control and has set a target to have a smoking prevalence of less than 5% by 2025. The two principles underlying the tobacco-free Ireland policy are protection of children and the denormalisation of smoking. The public health tobacco and nicotine-inhaling products Bill, currently being drafted, is designed to further deliver on those promises. I look forward to the day it is brought before the House. I hope we can work together to enact it and ensure the harmful effects of cigarettes are kept from our children and that smoking is viewed by all as the serious health risk that it is.

The health harms attributed to alcohol consumption include diabetes, cardiovascular disease and some cancers. Like the diseases associated with smoking, these illnesses were highlighted by the Covid-19 pandemic. The Public Health (Alcohol) Act 2018 is beginning to take effect in Ireland. Shops are already separating their alcohol from other groceries to be ready for the November deadline for that change. I pay tribute to retailers for their willingness to take on these actions at a time so many other changes are affecting their businesses financially.

I reaffirm to the House that I am strongly committed to introducing minimum unit pricing so that the cheapest and yet stronger alcohol will no longer be available at such low prices to our younger people and to those who drink to harmful excess. I am working hard on this issue and I look forward to working with our colleagues in Northern Ireland to share the experience of enacting this very important health measure on both sides of the Border without further delay.

Covid-19 has reinforced the need to treat drug and alcohol misuse as a public health issue. The national drugs strategy, Reducing Harm, Support Recovery, provides the roadmap to a health-led approach to drug and alcohol misuse, which supports harm reduction and treating people with compassion and respect.

Covid-19 posed a major threat for people with drug addiction, especially those who are homeless and not in treatment. I recently met staff from the HSE's addiction services to hear at first hand about the changes in the delivery of opioid-substitution treatment during Covid-19. Specific resource documents were developed to ensure that all people in receipt of opioid-substitution treatment could continue safely on the treatment during the pandemic and that anyone who required such treatment would receive it. I am pleased to report that existing patients continued the opioid-substitution treatment throughout the pandemic and an additional 755 people were brought into the treatment, an increase of 7%.

As a result, the impact of Covid-19 on people who use drugs has been greatly minimised. HSE addiction services have saved lives, although perhaps not in hospitals, by ensuring that people with underlying health conditions did not end up in intensive care in the first place.

The programme for Government contains a commitment to retaining the specific actions taken to support increased and improved access to opiate substitution treatment during the Covid-19 pandemic. I am determined to mainstream the gains that have been achieved within the health services.

One of the downsides of Covid-19 has been the circulation and use of new drugs throughout the county. One such drug that worries me is called nitrous oxide. The HSE and drug and alcohol task forces have been proactive in communicating to parents and youth workers the dangers associated with nitrous oxide. I have also confirmed that the sale of nitrous oxide is prohibited under existing legislation. My colleague, Deputy Higgins, has also been proactive in promoting the risks associated with this drug. As Minister of State with responsibility for this area, I am conscious that more action may be required. This is why I have asked the HSE to commence greater research on this drug to enable my Department to make evidence-based choices.

I am aware that drug and alcohol services have had to adapt in new ways to continue working to support people affected by substance misuse. My Department is currently undertaking an assessment of the impact of Covid-19 on drug and alcohol services to identify lessons for policy and practice. This assessment will be presented to the national oversight committee, which I chair, for discussions with all stakeholders in the strategy, including the Department of the Taoiseach. Work is under way to prepare for the restoration of drug and alcohol services in a planned and appropriate manner in line with public health advice. This includes guidance on one-to-one and group supports. My Department has established a working group with drug and alcohol service providers to identify the guidance and supports required. I have also approved emergency funding to offset the costs of delivering drug and alcohol services in a Covid environment.

I am aware of concerns that recently introduced regulations that restrict indoor events to no more than six attendees would impact on the operation of drug and alcohol support groups. These groups provide a key lifeline for people struggling with addiction and support their recovery and rehabilitation. As announced earlier this week, it has been clarified to me that drug and alcohol support group meetings are not impacted by the restrictions and can continue to operate, subject to adherence to public health guidance relating to physical distance and other protective measures. I advise that these support groups proceed with an extra degree of caution and put in place strict protective measures as individuals with addiction problems are more vulnerable to the risks of Covid-19.

Responsibility for the health needs of socially excluded groups such as people who are homeless, Travellers, the Roma community and residents of direct provision centres also comes under my ministerial brief. Covid-19 has brought into focus the significant health inequalities faced by these groups due to social and housing conditions. At the beginning of the pandemic, a range of preventative and precautionary measures were introduced, which were aimed at minimising the risk of infection among service users and staff in congregated settings. The impact of Covid-19 was greatly minimised by an intensive and collaborative response from Departments, the HSE and civil society. A good example of this approach is the measures adopted for people who are homeless. As a result of these efforts, the number of outbreaks of Covid-19 in homelessness services has been minimised, with only 15 cases associated with four clusters. We need to maintain these supports for homeless people and other socially excluded groups as Covid-19 remains a threat to public health.

I hope that the Deputies present now have a deeper appreciation of the increased importance of public health policies as a result of Covid-19 and of how these policies, Healthy Ireland, tobacco and alcohol policies, the national drugs strategy and Inclusion Health have helped to minimise the impact of Covid-19 on the population, especially those who are socially excluded. I look forward to the contributions to this debate.

The Minister of State raised the first issue I wished to raise with him, which is good. However, I still find the response unbelievable. I raised the issue of 12-step meetings with him. I refer to meetings of groups such as Alcoholics Anonymous, Gamblers Anonymous, Narcotics Anonymous and others as well as other meetings for people in recovery. The key word here is "recovery".

I wrote to the Minister of State on 20 August on behalf of the people who attend these meetings and I believe they are essential services. Unfortunately, I had to write to the Minister for Health and the Taoiseach when I did not get a response. The Minister of State did, however, reply to me on 26 August. I then sent his response on to the members of these recovery groups and explained that, according to him, they were not allowed to meet because such meetings would not comply with the limit of six people meeting in indoor settings. They believed it was insulting to suggest they would not have the capability to organise meetings with social distancing. The Minister of State said that information about the effects of alcohol and health tips to cut down could be accessed on the HSE website, askaboutalcohol.ie. Is it sufficient to send people who are in recovery and who need these meetings to a website?

Another point he made to me was that the HSE had produced a poster. We are talking about a poster when hundreds of meetings nationally were closed down because he did not ensure they could stay open. People who have been in recovery for ten, 20, 30, 40 years or more and who are stalwarts in their communities and know how to advise people were prevented from meeting for three weeks. The Minister of State's response to my emails was flippant and dismissive. I asked him whether these people should be granted an exemption. In his letter ,he said that this may not be the time to introduce exceptions to the public health advice. The funny thing about this is that, last Friday, I received a phone call from someone who told me that a Fianna Fáil backbench Deputy had told Alcoholics Anonymous that it could go ahead with its meetings. Alcoholics Anonymous then released a press statement to say that, until it got proper public health advice, its meetings would not go ahead. On Monday, we were given clarity in a letter and, on Tuesday, it was announced that all 12-step meetings for people in recovery could go ahead. This was three weeks later. The Minister for Health also said that those meetings were never meant to be stopped and that they were considered essential services.

I wrote to the Minister for Health and to the Taoiseach's office. Is there a lack of communication between Fine Gael and Fianna Fáil? Is there a lack of caring? Did the Minister for State ask the Minister for Health whether these meetings could go ahead? The Minister obviously did not read my emails. I am even doubtful whether the Minister of State read my emails in light of his response. It is an absolute disgrace that people who are in recovery could not meet for three weeks because of a communication issue between two Ministers, which probably arose because they are members of two different political parties.

It is not good enough. Nor is it good enough to announce three weeks later that these groups could have met all along. I forwarded the Minister of State's response to all the groups who had contacted me.

There is so much more I want to say and so many more issues I want to raise today. The national drugs strategy has a 50-point action plan that was intended to run between 2017 and 2020. In response to a parliamentary question I tabled in June, I was informed there were 35 actions in progress, four completed and 11 more to be started. A briefing paper for the Minister for Health received under a freedom of information request stated that at the end of 2019, all of these figures were the same, that is, 35 actions in progress, four completed and 11 not yet started. Was no work done on the national drugs strategy in 2019? I have raised this issue and my concerns on it. We should have reports every three or six months, not yearly. That is the problem here, namely, no one is keeping an account of this strategy. I recently met representatives of one group, the Alcohol Forum, who were excited to be included because of the work they do on alcohol addiction. They are at point 1.1.1 in the strategy and it has not even been started yet. I am conscious of the time and other speakers.

The Minister of State did not mention the whole issue of dual diagnosis and I found that exceptional. It is mentioned in the national drugs strategy, the mental health strategy and is part of the programme for Government. Currently we have only a small number of underfunded pilot projects. I now ask that the Government forget about pilot projects. We want a national scheme rolled out. We want a "no wrong door" policy introduced.

I will conclude by saying I am proud to be Sinn Féin spokesperson on addiction, recovery and well-being because I am proud to be able to give a voice to people and communities who are often not heard. I will be holding the Minister of State and the Government to account because someone needs to stand up for those people who do not have a voice. I want to work with the Minister of State but thus far, his performance has been dismal. He really needs to up his game when it comes to the drugs strategy and the health of our nation.

In his opening statement, the Minister of State mentioned that persons running recovery support meetings should proceed with extra caution because people with addiction problems are more vulnerable. That really worries me because the people attending these meetings are in recovery. They have managed to get themselves into a situation where they need the meetings for support but they are no more vulnerable than the Minister of State or me. They could be people who have gone 20, 30 or 40 years since they last had a drink or gambled. They are no more vulnerable than the Minister of State or me and yet the first time he mentions them, he chooses to pigeonhole them, to call them vulnerable, to say they are somehow other. That might explain the difficulties that Teachta Gould has had in dealing with the Minister of State and getting him to actually understand what the issues are. It is a little bit like how the Minister of State did not understand that nitrous oxide was a problem outside Dublin. That was, by the way, very insulting to Dublin people but also to people in Limerick, Cork, Galway and everywhere else who are dealing with it because they see clearly that while the Minister of State might have an interest in some aspects of his job, this does not seem to be a priority for him.

According to the HSE, there are only 665 treatment and detoxification beds across the community. That is down from 787 in February 2017. We lost the Keltoi residential treatment centre recently and we do not have a date for it opening. An assurance has been given by the Minister of State's office that it is going to be opened. I mean no disrespect to the Minister of State but without as date, that assurance is utterly meaningless. I cannot stay for the Minister of State's closing remarks but I will be watching. I hope he uses his time to give a date for the reopening of the Keltoi facility.

Covid-19 has fundamentally changed how we do things because it has to. We know that. Social distancing and the public health guidance has meant that many treatment facilities are facing unchanged overheads and massively reduced capacity. As such we need a commitment from the Minister of State that he is going to be able to shore up that funding to ensure the small amount of facilities available can remain open. There are many facilities which have kept their clients on longer than perhaps would be the normal practice because they recognise how vulnerable they are and they know their clients need that. I commend those facilities on doing it but they are swimming against the tide and the Minister of State needs to see that. They have the impression that the Minister of State is not helping them. The Minister of State has not been in the role very long and some of the statements he has made thus far would give them cause to be very concerned.

In the Minister of State's closing statement he should give a date for the reopening of the Keltoi facility, if he can.

We are in a pandemic situation; we have a virus that is making people unwell and is killing people. I wish that other aspects of Irish society and public policy were dealt with in the same manner which the Government has dealt with this issue and indeed other issues such as Brexit. There is nothing the Government would not do or say, no intervention it would not make and no resources it would fail to find in order to deal with the Brexit issue or indeed with this pandemic.

There is another scourge in this country which kills people, ruins families, makes people incredibly ill, shortens their lifespans and ends their lives in public toilets, stairwells, parks and playgrounds. We have the third-highest overdose rate in Europe and yet we do not have the same political response to it because, in effect, the value placed on those lives is less. I know that to be the case because the very people who suffer from addiction and who are in recovery trying to rebuild their lives are called names. They are called names by politicians and by the media. They are called junkies, druggies and zombies. I once heard one commentator on RTÉ Radio 1 refer to a cohort of people in the court system as having a "Dublin 1 complexion". Last year we had a senior Minister sending out literature to her constituents celebrating the fact that a health facility in her constituency would not be a methadone clinic, because clearly those in recovery are beneath her, her office and her help. Furthermore, we criminalise them, we criminalise their addiction and their medical need. We think we can sort out the drugs issue in Ireland through criminal sanction. It does not work and it has not worked. It has not actually worked anywhere. The idea of a war on drugs is a colossal middle-class lie because a war on drugs is a war on people and a certain type of person.

I say to the Minister of State that the issue of decriminalisation of the person has to be at the forefront of his agenda. Whenever someone in politics or in a lobby group or in public commentary uses the word "decriminalisation", people immediately assume something completely different. They assume we are talking about legalisation of substances or decriminalisation of cannabis. We are not. We are talking about decriminalisation of the person, because the opposite of addiction is not being sober. The opposite of addiction is connection, that is, connection with life and with people, connection itself.

Yesterday and today, we have had debates on ensuring we can open public houses that sell a drug that kills 100 people a year through fatal overdose. Each year, 100 people die of a fatal overdose of alcohol, which is two a week. These Houses have been used to further the agenda of those who want to distribute that drug. That is fair enough. Nobody would ever suggest that the best way to deal with alcoholism, and the best way to stop 100 people dying a year, would be to stop selling it or to criminalise those who take it but that is exactly what we do with every other substance which is a drug.

Will the Minister prioritise decriminalisation as a national policy? I also want him to prioritise the stated programme for Government commitment on the establishment of a citizens' assembly on drugs. It is a commitment in the programme for Government that can be delivered. It has to happen immediately because if we are in a situation whereby we have the third-highest overdose rate in Europe and people are dying on the streets throughout the country, then it is something that must take much higher priority. If it were to be treated in the same way as Brexit or Covid-19 we would have a much fairer and decent society that looks at the most vulnerable and does not call them names, dehumanise them or have Cabinet Ministers undermining them but has them looking at the Parliament to be filled with people of compassion who want to help support them in their recovery.

I wish the Minister of State well in his new role. These are very challenging times and the Minister of State has been in place for approximately eight weeks so, like us all, he has a lot to learn. I know from working with him previously that he will work extremely hard and this has to be the focus. We all have to realise we all have to play a part and do what we can.

All things have changed because of the coronavirus, even drug use. In June, the European Monitoring Centre for Drugs and Drug Addiction, EMCDDA, found an overall decline in some forms of drug use in Europe during the first three months of the pandemic. It suggested the stay at home orders, the closure of night-time economies and the disruption of the street drugs market, coupled with a global shortage of drugs, contributed to this but we cannot rely on the pandemic to solve drug problems. Despite the pandemic, drug-related deaths have continued to show an upward trend. We should be alarmed at the high level of addiction deaths and there have been calls to acknowledge it as a public health crisis. This is something I am concerned about and we cannot allow it to happen. We have to make sure we provide the best help and funding we can to make sure we do not end up with what looks like could be a crisis.

Throughout the country, service providers dealing with people suffering due to drug use or addiction face closure because of the lack of funding and increased demand. Local and regional drug and alcohol task forces in communities need funding. The use of drugs is on the rise and people need to be educated about the links between drug use and long-term mental health issues. I firmly believe that education can open a lot of doors. I am a firm believer in going into our schools and educating. Educating people on what drugs can do to them is one of the most important steps the Minister of State can take. This is not only with regard to the people taking them but also their families. Many families who have come to my clinics have been affected by a loved one taking drugs. They feel there is no support for them. We need to look at the bigger picture. If we see greater investment in local task forces we can achieve change. At joint policing committee meetings throughout the country, time and again the drugs trade is cited as one of the most challenging problems in society and the committees ask for more resources. Has the onset of Covid damaged plans to fund this type of investment?

I am sure I am not alone in noticing an increase in antisocial behaviour in towns and villages. A lady who rang me yesterday was concerned about the people doing this. Sometimes we can see open drug dealing, and multiple daytime fights can be related. It seems to be on the rise. Families are scared. They are scared of Covid and scared that lawlessness will creep in. We know members of the Garda are working hard on the streets. It is about working together.

According to those dealing with this blight on our society, there are more and more drugs out there. In 2018, 55 new psychoactive substances were detected for the first time in Europe, bringing the total monitored by the EMCDDA to 730. Even with the downturn in use during lockdown, there is a sense that drugs are taking over again. We cannot allow this to happen.

As it is health and not criminal justice that will be at the core of the State's response to the possession of drugs for personal use, for better outcomes and better pathways to recovery, are we properly funding family resource centres and resourcing task forces to achieve better outcomes in our drug strategies? Local and regional drug and alcohol task forces play an essential role in communities throughout the country by providing a targeted response to emerging trends in drug and alcohol use but they cannot continue to do this good work if they are overstretched and underfunded. Their work very often extends beyond dealing with addiction and, in fact, deals with the antisocial behaviour of public drug use and drug litter also. They are under enormous pressure. The bottom line is that if their progress is to continue to make a meaningful difference to people's lives in our communities nationwide they must be supported financially.

Previous speakers have mentioned alcohol and substance recovery groups. This issue has been brought to my attention and it is very important. They are essential services. We always have to look after people who need help, whether through meetings or funding. There are many people who have come out of recovery and have done so well. It is important that we take on board everything that has been said during this debate and that we do our best to make sure we help everyone we can. Funding is key. If we can get funding into the areas where it is needed, we can do a lot of great work.

I thank the Minister of State for his introductory statement. While I appreciate he is only a few short weeks in his job I want to highlight what is very clearly a gap between his description of the services and supports the Government is providing and the reality in many constituencies, urban and rural, throughout the State. As the Minister of State knows, I represent Dublin Mid-West and I was a former member of the Clondalkin drug and alcohol task force. Before speaking here today, I spoke to a number of managers of local drugs services and members of the task force. I want to reflect for the Minister of State what is happening on the ground at present in my constituency so he can consider it with regard to his work. Like all drug and alcohol task forces, there has been no increase in funding since 2008. In fact, in my area the task force's catchment area has more than doubled to stretch beyond Clondalkin to include Lucan, Palmerstown, Newcastle and Rathcoole. The same level of funding for a larger catchment area effectively represents a cut and there has been no increase in core funding or staff funding.

We have also seen a knock-on effect from the very good work that has been done in the north inner city by local communities, the Garda and the HSE. This is a return to increased drug activity and drug sales in many parts of the suburbs, including in my constituency. This has also led to an increase in the involvement of minors in an ever-expanding drugs economy. I agree with earlier speakers that this is, in the first instance, a health issue but where we have the active grooming of minors to become involved in the drugs economy, it has to be made a criminal offence and those involved in such grooming need to be targeted. Crucially, of course, we need to see greater investment in health and youth services and diversionary activities.

We have also seen a significant impact on front-line drug and alcohol services as a result of Covid.

For example, it has cost one project I spoke to today €8,000 to make its small premises Covid-compliant to enable it to continue to provide services. It has not got a single extra cent of funding from the HSE. A small amount of funding from the local authority and the local task force has covered some of that cost, but this is acting as a real impediment to it doing its work. There is also a real concern that because of the additional financial pressures on Government because of Covid-19, just as community and voluntary sector services were the first to suffer severe cuts after the recession in 2008, these vital front-line services, which are providing such important supports to those in addiction, those recovering from addiction and their families, may suffer cuts in the short to medium term. I would be very interested to hear the Minister of State's view today or in the future as to whether that is the case.

While I appreciate that this is not within the Minister of State's remit, we have a real problem with the under-resourcing of the Garda. We have a single Garda division dealing with drugs for all of my constituency, in Clondalkin and Ballyfermot, and that is simply nowhere close to enough. We also have an under-resourcing of community gardaí and the diversionary services.

The Minister of State is welcome to come to my constituency anytime and meet the workers and communities on the front line. They will give him a very different picture from the one he has pointed to today. If he comes to my constituency and listens to the people who know what is really happening on the streets, it will better inform him to ensure he does the best possible job by our communities and front-line services in tackling the issues of alcohol and drug misuse into the future.

Does the Minister of State remember his first truly political engagement? When I was walking today through the north inner city to get down here, I was reminiscing upon mine. It was about 2008, I was in first year in university and I was taking an interest in my community for the first time. I went to an incredible community leader named Fergus McCabe to tell him I would like to get more involved. He suggested I go on the North Inner City Drugs and Alcohol Task Force. A great guy, he was a big help to me along the way. I went on to the task force in 2008 as a community representative. I sat around the table with the project workers, representatives from the HSE and politicians. The issues that were coming up in 2008 were an inability to access funds, a lack of recovery beds and a poor understanding of the connection between mental health, by which I mean trauma-informed mental ill health, and the reasons people get involved in addiction. Twelve years later, when I call around to the various drugs projects and talk to people involved in trying to hold back what is an epidemic that has been ongoing in my constituency and constituencies such as mine for the past 40 years, those are the exact same problems that are happening now, 12 years on from when I was on that drugs task force and probably 40 years on from when drugs first penetrated the north inner city, around the corner from here. The definition of insanity is doing the same thing over and over again and expecting different results, yet here we are today talking about the same strategies that have failed. There is a lot in the national drugs strategy that is empathetic and meritorious, but three years into it what has really changed? What has changed for the service provider or the user? The issues are exactly the same.

I listened to the Minister of State's speech on public health and the national drugs strategy for 15 minutes. I cannot comprehend how a Minister of State with responsibility for these issues, in a statement lasting 15 minutes, did not mention the words "trauma" or "poverty". If we step away from those two issues and take them away from our understanding of the reasons people engage in this, we are doing those people a disservice, one that has been replicated for 40 years. The Minister of State talked about Healthy Ireland in his initial address. If he walks down the canal and talks to the poor people in the throes of addiction about Healthy Ireland, he might as well be speaking a different language. Those people have been impacted by trauma and that is what has them engaged in poisoning themselves in the manner in which other people have poisoned themselves in my constituency and constituencies such as mine for the past 40 years. Unless we address that in a real, practical, scientific, evidence-based, rational way that steps away from moralising, we will be back here again in 12 years' time talking about the exact same things. I want the Minister of State to do well - I really do - and I want to help him do well, but I will not sit here while we replicate the mistakes of the past and that is all that seems to be happening here.

What is the strategy? Is it once again to continue with this strange war on drugs? That will fail consistently. It always has and always will. Should we talk about another type of attrition that seems to happen whereby we falsely believe that if we can help enough people to recover, they will offset the fact that there is a conveyor belt of other people coming through? The Minister of State knows we are lying to ourselves about that. We do not have enough recovery beds for that policy to be successful. In addition, there is any number of people out there willing to engage in this destructive form of self-harm because the alternative is to live in trauma. If we do not address that, we are doing an incredible disservice to those people.

There is evidence of how we can stop people getting involved in this pursuit. There are models of prevention that work elsewhere. The fact that we are not yet adopting here in Ireland Portugal's model of decriminalisation and "healthcare first" is shocking. There is also the Icelandic model. Twenty years ago Iceland too had a problem with its young people getting engaged in drug addiction. Iceland responded by investing in opportunity for its young people. It provided them access to sport, culture and music. It has not only drastically reduced the number of its young people engaged in negative drug-taking behaviour, but also had offshoots of that in being successful in sport and culture, more than holding its own for a little nation. There is absolutely no reason we cannot do that, with the exception of one big reason: the moralising and the fear to embrace the fact that what we have been doing for 40 years is wrong. Until we address and accept that, until we accept the fact that it is wrong to criminalise a person who injects himself or herself with a poison or takes a poison because he or she is dealing with trauma, and until we step away from that, we will just keep replicating those mistakes. We are complicit in that, as is the State.

Generations of successive Ministers who have engaged with this issue have failed to a certain degree and until we accept the science and the reality we will continue failing. I want to help the Minister of State, but let us do this in a rational way. Let us learn from the mistakes of the past. Let us talk to the leaders in these communities. Let them devise the plan and let us invest in it. It will be costly but will be paid back twentyfold.

I thank the Minister of State for confirming that AA meetings are now being permitted under social restrictions. I raised this issue with the Minister, Deputy Donnelly, on behalf of Councillor Kenneth Egan, who is an advocate and a champion for those in recovery.

A dangerous new trend is emerging in my constituency. Parents are contacting me about their children using edible cannabis, a trend identified to me by the Clondalkin Drugs Task Force. Avoiding the foul taste of tobacco, young people are attracted to gummy bears and chocolate laced with cannabis. This is problematic for a number of reasons. First, the sugary taste of sweets and chocolates is clearly more attractive to children, who may never experiment with cannabis if they were forced to smoke it. Second, it takes far longer for people to feel the impact of cannabis when eating it. While the impact of smoking it is immediate, the impact of eating it is not felt for up to an hour. Teenagers may eat a square of chocolate laced with cannabis, feel no impact and then eat the rest of the chocolate bar. As a result, they may accidentally overconsume dangerous amounts of drugs and by the time the effects are felt the teenager is in it over his or her head. What is really terrifying is that there is no antidote to overconsumption of cannabis. Teenagers are forced to wait for the cannabis to clear through their system. The effects of edible cannabis last far longer, as long as 12 hours, than smoked cannabis. If the cannabis triggers psychosis or hallucinations, that leads to hell for the teenager. This is why edible cannabis puts a disproportionate number of people in hospital. A study in Colorado shows that edible cannabis makes up only 1% of cannabis sales there but makes up 11% of cannabis-related hospital admissions. That is worth reflecting on. Eating cannabis makes a person ten times more likely to end up in hospital than smoking it. Of the three cannabis-related deaths in Colorado, all were as a result of edible cannabis. While nobody died from overdosing on the cannabis itself, there was a suicide, a death as a result of a fall and a death as a result of a murder where the defendant claimed the cannabis made him do it.

Already, cannabis use among teenagers has almost doubled in the past few years. Almost one in five Irish 16 year olds are now using cannabis. The emergence of tasty, sugary sweets laced with cannabis will only further increase its use amongst teenagers. Let me be clear on why we need to act now on edible cannabis: in American states where cannabis is legal, edibles account for 11% of the market. We do not want that happening here. We already know that one in six people who start taking cannabis as children become dependent on it and heavy use of cannabis increases the risk of youth suicide threefold. The risk of developing a psychotic illness such as schizophrenia is especially high amongst those who start using cannabis as teenagers. Heavy use of it as teenagers can lead to a drop of six points in IQ. I welcome the Government's commitment to move towards a health-led approach to tackling drugs. In particular, I welcome the fact that one of the Government's five strategic goals is to minimise the harm caused by the use and misuse of substances. Will the Minister of State consider raising awareness of the dangers of edible cannabis among young people to minimise the harm that cannabis is causing in our society?

I know the Minister of State has acted quickly to instruct his Department to gather evidence about the new trend of nitrous oxide. I thank him for everything he has done to shine a light on this issue. I am pleased to report a reduction in evidence of nitrous oxide, in terms of the prevalence of discarded canisters in my local parks. I would like to hear the Minister outline when his Department expects to have gathered evidence, as he has asked them to do, and what the next steps will be.

I wish the Minister of State the best of luck in his new role. Unfortunately, as I also said to the previous occupant of the position, I do not think he will be successful because he is not allocating the proper funding that is needed. The previous Minister of State went out to a huge number of communities. She was in my community of Limerick for a while and met a huge number of groups. Unfortunately, I do not think any of the knowledge or information she sourced from talking to people ended up in the Minister of State's speech today. It is very disappointing. I wonder who wrote the speech. If the Minister goes on that track, we will be here this time next year again talking about the exact same thing with no progress.

I request that we have a discussion on the national drug strategy more than once a year. I have contributed to every one of them since I was elected in 2016. I am a member of the Mid-West Regional Drugs and Alcohol Forum in Limerick and have been for about ten years. I have never seen the level of drug addiction and misuse in Limerick that I have seen in the last while. Covid has exposed it to a lot of people who were not aware of what was going on in their local communities. It became very visible when people were not on the streets. There is a large number of groups in Limerick doing great jobs. Ana Liffey has been on the streets through Covid. The Northstar Family Support Project is doing a really good job in difficult situations. I spoke to many people involved in a number of services over the last number of days because I told them I would be speaking here today. The biggest issue is that in 2008 and 2009 funding was cut to the regional drugs and alcohol forum by over 50%. That has not been reinstated. There were a few announcements last year of additional funding of €1 million for all the task forces and when it was divided up between the number of task forces and people had gone through the hoops and loops to apply for the funding, it did not reach down or make any difference on the ground.

We have a crisis in my city with crack cocaine and a huge increase in the use of cocaine itself. Gardaí will confirm that. They are doing a good job but they are totally under-resourced. We have criminals selling drugs 24-7 openly. There is drug paraphernalia across the streets. There has never been anything like it. I have never seen as much drug use. Consumption is very visible and people see it. It seems that no Government cares about the drugs issue. It is at the bottom of the list and is the last thing to be looked at. We see that in the programme for Government. I do not see any commitment in there to increase the funding to regional drug and alcohol forums. We are not just a forum. We fund a lot of groups across the mid-west region, in Limerick city, north Tipperary and Clare. There are heroin problems in Roscrea, County Tipperary, and Kilrush, County Clare. The groups we support do the best they can. The previous Minister of State sat down and listened to them but it is not reflected in what we heard on the Dáil floor this afternoon. I am deeply concerned if that is the way the Minister of State is starting off. I ask the Minister of State not to go that way and to look at the stats and talk to people on the ground in the drugs task forces. We are the ones who deal with people on a daily basis. There is a bit of a bubble in the Ministry and the Minister of State needs to look at it. Otherwise, we will be here with no outcomes, success or progress.

My heart goes out to the communities. They have seen a huge increase in drug addiction and drug problems and no resources to deal with it. It is not fair.

I wish the Minister of State well and hope he will be progressive and bold in his job in the next years. The Government needs to be bold because this is like Groundhog Day. We are talking about things we talked about two or three years ago in this Chamber. People have been talking about this issue for decades. It is welcome that we are talking about a health-led approach rather than a criminal justice approach, which simply does not work. Last year's alternative approaches to possession of drugs for personal use were welcome but they did not go far enough. I understand the sentiment of that report will be sent to the Citizens' Assembly. I have a problem with this because we are legislators. Last February, 160 of us were elected by the people of Ireland to legislate. The Citizens' Assembly does good work but we are here to make laws.

The current system simply does not work. Bringing people through the courts for possession of small amounts drugs is a waste of time. Bringing somebody through the criminal justice system for €50 or €100 worth of cannabis is a waste of police time, the State's time and everybody’s time. There needs to be a health-led approach. The benchmark is Portugal. In 2001, it embarked on the decriminalisation road. It is a difficult road to go down. Drug use and abuse is difficult, as I have seen in my own community. Drugs can take over a community and they take over people's lives. It is extremely difficult to deal with in the community and on a personal level. That is compounded by the class nature of society and by austerity and cutbacks to youth services. International evidence and research shows that if there is investment in people and in communities there will be less people turning to drugs. Why would people turn to heroin in the first place? It is the most horrible drug in the world. However, people are desperate sometimes. In situations of alienation, they turn to that because of the class nature of society. That is not abstract. Across the world, heroin gets into communities. Heroin is the devil that attracts poor and marginalised communities. That is where it manifests itself. There is an alternative economy in society. It is hugely lucrative and violent. In the last ten to 15 years, the violence attributed to drug use and the drug market is ever more violent because it is so lucrative that it is impossible to put down, even if there were 20,000 gardaí on the street. Once people want a substance, they will get it. Once there is a market for it and a demand, people will use it. We have to be grown up about this conversation.

People will use and abuse drugs. Those people are from every part of society. Our heads are in the sand if we keep bringing people through the criminal justice system and locking them up. It is simply a waste of time. We have to be bold and take a different approach to addiction and to why people turn to addiction. If I am still around in ten or 15 years' time, we will still be talking about this issue of the cruelty of bringing people who suffer from addiction through the criminal justice system.

We have to adopt a new approach which is nuanced. There has to be an approach of legalising certain drugs and decriminalising the person as opposed to the drugs themselves, which will be a different argument. As I said, international evidence across the board shows that when there is a health-led approach, there are better outcomes because this issue comes down to saving lives. If lives can be saved by taking people out of the criminal justice system, then we will be on the right road. It will not be easy by any means. It is extremely difficult in circumstances of drug addiction and abuse. The approach from the previous Governments has been a failure. We should be honest about that. What is happening is like Groundhog Day, so we have to adopt a different approach. That approach should be similar to some of those I have just outlined.

I welcome the fact that the programme for Government mentions convening the Citizens' Assembly to look at the overall problem we, as a society, have with illegal narcotics and the drug debt, intimidation, violence and criminality associated with them. There is also the impact addiction has on communities and families and a lack of services. Regional task forces that are operating on the basis of the same funding levels as obtained in 2007 have already been mentioned. We are now in a different economic and health situation but we went through a period when there was a cocaine boom and when, then years ago or earlier, organisations were still operating with limited funding that did not wash its face. This will not suffice or work.

I have pointed out to the Minister and the Minister of State a problem we have, namely, that we do not have somebody sitting at Cabinet who is responsible for the overall problem of drugs. We know that a multi-agency response is required. This matter requires action in the areas of health, justice, education, children and, possibly, others. We are failing on this issue. I wish the Minister of State well but I am not particularly hopeful on the basis of his contribution.

I accept that there are good things in the Healthy Ireland initiative and other such initiatives but these will not deal with the level of criminality that obtains. We need to look at novel approaches and it has always been said to me by a number of experts that Ireland is small. The Citizens' Assembly will examine what we can do on either a 26 or a 32-county basis. In context of the latter, I accept that there are difficulties regarding Brexit and what I would term perfidious Albion. We also need to look at the Portuguese model and other models for solutions. We also need to look, on a Europe-wide basis, for a solution to this problem because it is far too big. If we go back to the Government before last, the Minister of State's predecessor, Catherine Byrne, admitted, at a meeting with Gerry Adams and me, that until someone responsible for the issue was sitting at Cabinet and could call the shots on funding, nothing would happen.

I have been like a broken record talking about the amount of times the Garda is arresting people who are involved in petty crime, probably to pay off drug debts. Neither the Garda nor anyone else is able to access the services that are required in those scenarios. Therefore, the Garda does the people involved and puts them through the system. They get released and then it happens all over again. It is a waste of everybody's time and we do not get anywhere. We need a Department of Justice and Equality and a Garda response. I understand that this does not fall within the remit of the Minister of State but therein lies the problem I raised earlier. We cannot allow the drug debt intimidation that is impacting on a huge number of families and communities to continue. The number of young people who are being groomed and put into drug operations has already been mentioned. This happens because we have a youth justice system that is not fit for purpose. All of this needs to be considered and we need the Minister of State, alongside other Ministers, to step up to the plate and do what is necessary because we are failing the people out there.

I wish the Minister of State well in his role. It is not an easy role but it is a vital one. It is also important to say that he should grab this opportunity and treat it like the opportunity of a lifetime. His actions could radically alter the lives of hundreds and thousands of people in towns and villages throughout the country.

Drugs are affecting nearly every walk of life. People's brothers, relations, work colleagues, etc., are all being affected by drugs and drugs are affecting every part of Ireland. Inner cities are being affected, as are towns and villages. When I am out canvassing and doing my constituency work, even in the smallest villages where there is only one street with a couple of shops, there are people involved in the taking and selling of drugs in broad daylight. It is incredible how widespread and serious the drug crisis has become in Ireland. In an 11-year period up until 2016, some 697 people died as a result of drug use. That is the population of a town similar to Ballinasloe being deleted in the space of ten years as a result of drugs. Half of those in that age group are under 40 and some 75% of the people who are dying from drug use are male.

It is the fact that it is happening in broad daylight that is having such a societal effect. In my home town - and I do not take any pride in saying this - drug dealers and users come in on the buses, deal in the market square, take drugs in the nooks and crannies of that square or go to the local parks in daylight and take drugs there. During one morning sitting in my constituency office, I looked out the window and saw two men involved in a drug deal. Two elderly women were walking past on the way to 10 a.m. mass in the town. It was like two parts of Ireland passing each other at the same time.

The trouble is that there is little response from this Government to this issue. There is a half-hearted policing response and then there is some level of service response and the funding that has gone into that service response has fallen in recent years. If one ever wants to know what the priorities of Government are or get behind the words it uses in order to find out how it really feels about a particular issue, one need only look at the bottom line and the funding allocated. The funding in this area fell dramatically. In my county of Meath, we have no teen rehabilitation beds and no detox services for young people. If one of those kids who is doing the deals in the centre of the town wanted to make a decision to come off the drugs, if he or she could get his or her head focused and oriented in that direction, he or she has no choice of services to help do that. The Government has told those people it will not help them in this situation. We had a wonderful organisation called the Aisling Group, which operated out of Meath and throughout the country. Due to the lack of funding, it was forced to close. We need compassion and understanding when we are dealing with the issue of drugs. However, compassion and understanding must be backed up with adequate funding resources and dedication from the State. We need to translate those words into actions.

On policing, we need a health response to the issue of drugs but we also need a justice response because many criminals are making huge amounts of money. Meath has the lowest number of gardaí per capita in the country, and that has been the case for several years. As a result, it is possible to go 30 or 40 miles through parts of the county on a Sunday morning and it is almost certain that only three or four, or possibly five, gardaí will be available. If two of them are called out to an arrest, there will be hardly enough remaining to answer the phone, let alone go out and deal with the crimes to which I refer. I wish the Minister of State well, but we really need to get to grips with funding in this area.

I will touch on two other related areas. The Government's national drugs strategy commits it to "Build capacity within drug and alcohol services to develop a patient safety approach in line with the HIQA National Standards for Safer Better Healthcare". I am referring to standardised services. This, however, is an incredible situation, because, right now, myself and the Acting Chairman, Deputy Durkan, could decide to set up a residential drug rehabilitation centre. We could deliver any service that we want to those individuals who come to us, and the State will take no interest and provide no oversight or guidelines.

The Church of Scientology has set up a residential drug rehabilitation centre, Narconon, in Ballivor in County Meath. The HSE has stated that there is no scientific proof for the efficacy of the services being delivered at this centre. I asked if representatives from HIQA will be sent in to see if the individuals in the rehabilitation centre are okay. We must remember that these are people who are addicted to drugs and many of them will also have psychiatric difficulties. However, HIQA will not send in representatives to see what is happening. I was told that it does not have a responsibility in this area and neither does the HSE. I have spoken to the Minister about this issue. We must ensure that there is some level of oversight in drug rehabilitation residential centres.

Communication also needs to be working. In May this year, Aontú submitted an information request to the Department of Children and Youth Affairs regarding the level of engagement it had with organisations like Cluain Mhuire Centre for Living, the Rutland Centre, Merchants Quay Ireland, the Ana Liffey Drug Project, Jigsaw etc. during the Covid-19 crisis. The Department responded by stating that it had not engaged in any correspondence with these organisations during the pandemic. I hope the Minister of State agrees that this is unacceptable. We do not want to be looking at another lockdown anywhere else in the country. We must ensure that we can live with this shocking illness, but we also need to ensure that key services for those in trouble, such as drug rehabilitation services, are working hand in glove with the Government.

The next speaking slot is for the Government parties. Would a Deputy from the Government parties like to contribute? It appears not, so we move to the speaking slot for the Rural Independent Group. I call Deputy Michael Collins. Is the Deputy sharing time?

No, I am on my own.

The Deputy is taking all the time himself.

I am. Is the Minister of State aware of the closure yesterday, out of the blue, of the Cara Lodge Residential Treatment Centre, run by the Matt Talbot Adolescent Services in Ahiohill in Clonakilty in west Cork? This was a free residential centre with a programme for 14 to 18-year-old males with substance misuse issues. The centre had a capacity for six young people and they could remain there for up to 12 weeks. It was an ideal setting in a tranquil part of west Cork. It gave those young people the space they needed to make decisions, aided and assisted by professional staff who, in so many cases, cared for them until they regained their full health. Many past residents of the centre have acknowledged that they would not be here today except for this centre in Ahiohill in west Cork.

I was informed today by loyal staff in west Cork of the shocking way in which they were told of the closure. One minute they were heading to get further training yesterday morning and the next they were stopped and told that it was all over and that they should go home. Some of those staff have given up to 20 years loyal service in this centre. They are highly trained and delivered a structured and diverse treatment programme. The closure of this centre and the loss of 19 jobs in west Cork is a major blow to places such as Clonakilty, Bandon, Ballinascarty, Ahiohill, Enniskeane, Ballineen and beyond. The loss of 19 jobs in west Cork is similar to the loss of 150 jobs in Dublin. It appears that these staff are being very shoddily treated as well, with just statutory redundancy being provided.

We have two problems. Young people desperately need such a centre and the staff desperately need their jobs. Did the HSE have a role in what happened? I cannot answer that question. There were supposed to have been reports, but they are not being published. We need reports to be published immediately. This building in Ahiohill was kindly donated to a Christian Brother, Brother Rock, several years ago and he subsequently passed it on. The public surely has the right to ask the board what the plan is for this building. More importantly, however, will the Minister of State intervene in this situation and meet with the board, and let us do all that we can in west Cork to save this vital service and save these jobs?

While I have the floor, I will comment on the necessity of examining the issue of medicinal cannabis licences. Deputy Gino Kenny is a far better expert in discussing this matter than I am. The Deputy has done Trojan work in the area over the years. The successful use of medicinal cannabis has been well documented by Vera Twomey. She has not only championed the cause of her daughter, Ava, but has also been a champion for tens of thousands of other people suffering with severe pain. The worry for those very few who have access to medicinal cannabis from the Netherlands is that the licence is being deemed temporary. That is an extremely worrying word for those patients who desperately require this life-saving product.

I ask the Minister of State to intervene and make this licence permanent for those already covered by it. People could then get back to their normal lives and would not have to worry about access to this product being stopped. Addressing this situation should not stop there, however. The Minister of State could go one step further. Thousands of people in pain need medicinal cannabis, and it is being denied to them. The previous Government did everything in its power to deny access to desperately ill people. Only for people like Vera Twomey, no one would have access to medicinal cannabis in Ireland. However, no mother should be made to walk hundreds of miles, sleep outside the Dáil, or be forced to travel the length and breadth of our country to fight for a medicine that should be freely available, in the same way as any other medicine in any pharmacy. The Minister of State is new to his role and we will know in the months to come if he can be different to his predecessors, who have failed miserably on this issue. I ask that this matter be placed at the top of the Minister of State's agenda.

This debate is about public health, and I do not want to let the opportunity pass without speaking about Bantry General Hospital. I mentioned the issue of a full-time anaesthesiologist in that hospital several times to the Minister for Health, Deputy Donnelly, and to his predecessor, Deputy Harris. It is a vitally important position. In the last six months, we have been told that an increasing number of people who have a fall on the Beara, Mizen, and Sheepshead peninsulas, as well as in surrounding areas such as Bantry and Skibbereen, have been told by the National Ambulance Service that they must go to Cork University Hospital. This is outrageous and cannot continue. We need to know if a full-time anaesthesiologist is being appointed to Bantry General Hospital.

In my final few seconds, I must take issue with what Deputy Ó Ríordáin said earlier. He referred to so much time being spent on talking about pubs and drinking. We put forward a motion, in the same way that his party could have put forward a motion, against the statutory instrument signed last week by the Minister for Health. The leader of the Labour Party said it was bonkers. Deputy Ó Ríordáin was critical of the time we spent discussing the issue. Another Deputy from his party discussed the issue here yesterday and spent time praising public houses. Deputy Ó Ríordáin can certainly put forward Bills against drug use if he wants to and if he is strong enough within his own party - maybe he is not - to do so. He should not, however, criticise others who have democracy on their side and who have good intentions in trying to open public houses to try and get our country back up and running again.

Our next speaker is from the independent Independent Group. I call Deputy Joan Collins.

I also support the Minister of State in his new position. Many people involved with the drugs and alcohol task forces will be watching closely to see how he will deal with his brief. I am a political representative on the Canal Communities local drugs and alcohol task force and it welcomes and looks forward to working with him.

During the previous term, I put down a Private Members' motion representing the CityWide position on the national drug strategy and task forces. The then Minister for State said that she would be prepared to go into committee and discuss those matters in more detail because there was support for them in the House as a result of the review. However, that did not happen before the election came. CityWide sent an email just after the general election which contained a drugs crisis campaign briefing document for Deputies of the 33rd Dáil. That document outlines six actions to tackle Ireland's drug problems and encourages a whole-of-Government response, for which CityWide has always been calling. CityWide hoped that a Minister of State with responsibility for drugs would be appointed, which has happened. It had also hoped that the Minister of State would have a seat at the Cabinet table, as has happened in the past. The organisation feels that an all-party and all-Cabinet approach must be taken to drug strategy.

In the email to which I refer, CityWide raised the need for strong co-ordination and co-operation in delivering the national drug strategy actions, involving 17 different Departments, agencies and sectors, and to ensure accountability across all sectors. It also suggested that the Department of the Taoiseach needs to have high-level representation on the national drug strategy committees. That was the first point.

The second point in the CityWide drugs campaign is that budgets need to be restored to community drug projects. The point has been made many times that there has been no increase in the budgets for drug task forces since 2008 and no restoration happened whatsoever. It has been particularly difficult during the pandemic. One of the arms of the Canal Communities national drugs strategy task force saw what was happening on the ground and contacted the HSE to request that a unit be brought to Dolphin House so that people could be tested for Covid-19. That is a positive initiative because those people have their ears to and eyes on the ground in communities, see what is happening and are able to respond to it quickly.

The CityWide campaign also calls for support for local and regional drug task forces to meet the need on the ground. It encourages support for strong, proactive community representation on task forces and suggests that statutory engagement is made obligatory for Departments and agencies. CityWide also suggests making a concerted effort to respond to drug-related intimidation. We know that is happening throughout the country.

The campaign also recommends that an oversight group is set up to engage with all relevant partners to monitor the implementation of the health regulation approach. It further recommends community participation and calls for immediate investment in a new community development initiative to support community participation on drugs issues.

Those are the main points that CityWide is putting forward. I do not know if the Minster of State has met representatives from CityWide. I hope he has, although I know he has only been in the job for eight weeks. If he has not done that yet, it would be good if he made linking in with the community via CityWide a priority. The Minister of State might indicate if he has been in touch with them or whether he will meet them. I talked to those CityWide representatives before my contribution today. One of the first questions that the Canal Communities task force wanted to ask was what is the Minister of State's vision for the task forces and community national drug strategy? What is his opinion on the review that is taking place?

Senator Ruane is the co-ordinator of the Canal Communities drugs and alcohol task force. I know she has met with the Minister of State and talked about some of the issues on the ground. I hope I will also have the opportunity to meet the Minister of State.

There is another important issue. As the Minister of State already mentioned, his brief includes public health and housing. On Tuesday morning, at a meeting of the strategic policy committee for housing, Brendan Kenny of Dublin City Council announced that there is a shortage of 300 beds for homeless people as we come into the winter. That is extremely dangerous for the people concerned, and I hope the Minister of State will be able to intervene to assist councils and the Dublin Region Homeless Executive to find 300 beds. We cannot have a situation in which homeless people, some of whom have serious drug addictions, are unable to access emergency accommodation during a pandemic and winter. I ask the Minister of State to respond to that.

How many minutes? Do I have ten or 15 minutes?

We will start with ten minutes and if the Minister of State is doing well, we might give him points. We will see.

I thank the Deputies for their contributions to this discussion on public health and the national drug strategy. I have noted many of the points that have been raised and will consider them and their implementation as part of my brief in the coming months. I will also try to reply to Deputies who have raised specific questions, if I can. I have many policies that I want to outline but I will not be able to do so in the time allowed. I want to answer a lot of the queries that have been asked and speak to the advice that many of my colleagues have offered in their responses.

I thank Deputy Gould for his advice. He talked about dealing with people in recovery. He received clarification on the matter and I got official clarification from my Department on 4 September. In the meantime, any information sent out to Deputies who asked parliamentary questions was the applicable information at the time. No information was sent out to mislead anybody. I can only say that I am delighted that those vulnerable groups are now able to meet because the recommendations regarding limiting meetings to fewer than six people does not pertain to them. However, those people are vulnerable because of underlying health issues and any meetings should be approached with the guidelines from NPHET about social distancing in mind. NPHET, not Ministers, provides the advice to the Government. The relevant official advice became available on 4 September. There might be other channels of communication but that is the official advice.

Deputy O'Reilly discussed the Keltoi situation and the prospect of its reopening. I understand that a review has been commissioned by the HSE and a date for reopening will be confirmed when that review is completed. The facility is now being used for self-isolation for homeless people and vulnerable groups. I will respond to her as quickly as possible. She also mentioned nitrous oxide and I must put up my hands and admit that I was not aware of the incidence of the use of nitrous oxide, or laughing gas, two months ago. Since then, I asked my officials to do a survey and get the information back to us as quickly as possible. I am delighted that Senator Higgins has raised this important issue. We can only use an evidence-based approach and that is what we have done. When I have a date for the reopening of the facility the Deputy mentioned, I will come back to her as quickly as possible.

Deputy Ó Ríordáin talked about a health-led approach. He is right that we need to take a much more compassionate approach to people who use drugs and their recovery. We have talked about legalisation. The Deputy also referred to alcohol. We have had a love affair with alcohol, which is also a drug. The Deputy also called for the convening of the Citizens' Assembly to consider the issue of drugs. That is a matter for the Department of the Taoiseach. I have already written twice to that Department to seek an update on its plans for the Citizens' Assembly in this regard.

Deputy Murnane O'Connor talked about the local task force and antisocial behaviour. Funding for local task forces is vital.

Sometimes we think these task forces only deal with drugs. They are drug and alcohol task forces. While the situation in major cities is difficult, given heroin, cocaine, cannabis and opioid use, they are drug and alcohol task forces.

I was in the north west and 70% of the people using the task force resources there were doing so because of alcohol. I am sure that the figure for drugs in Dublin is probably 80%. We have to be cognisant of the fact that there are two different operations.

I refer to Deputy Eoin Ó Broin 's contribution. He mentioned minors. He is absolutely right. It is part of the programme for Government that legislation would be introduced to deal with the coercion of minors into the supply and sale of drugs. I hope that such legislation is brought in. It is a very pertinent argument. He, like many other Deputies, invited me to meet local task forces. I am only too delighted to do that if I can be of any help. It would inform me, my Department and officials. I ask Deputy Joan Collins and any other Deputies who wish to do so to please write to me. We have visited a few already.

Deputy Gannon talked about doing the same thing over and over again. I can feel his frustration 12 years on from his involvement in a local drugs task force and the trauma and poverty involved. He referred to Portugal. Ireland is not the same as Portugal. We examined the regime in Portugal but it does not have the same legal system as Ireland. We have decided on a health diversion approach, which is in the national drug strategy and is the template we are using.

I attended a very sad event in St. Michan's Church in Halston Street. Deputy Gannon was there. It brought home to me the scourge of what has happened in Dublin and many other cities and what is now happening around the country. All of the names of the young men and women who died from overdoses in the past ten to 15 years were read out. It would bring a tear to one's eye. I thank those who organised the event for the invitation, which brought home to me an issue that has ruined communities and families. The service was poignant.

Deputy Higgins talked about sweets laced with cannabis and the fact that people are ten times more likely to end up in hospital. It is an issue of which we need to be aware. Deputies Quinlivan and Gino Kenny talked about the criminal justice system and the possession of drugs, as well as alternatives. They highlighted the fact that heroin is in rural areas.

Deputy Tóibín talked 697 people who died and the drug situation in Ballivor. He said he is not too sure about the centre. Perhaps we could investigate the situation regarding Scientology.

Deputy Michael Collins talked about the closure of Cara Lodge in west Cork. We will investigate it. Deputy Joan Collins mentioned the CityWide campaign. We had discussions with it and were delighted to have an informed conversation with Deputy Ó Ríordáin and Senator Ruane. It was helpful. I look forward to meeting each and every Deputy for a cup of coffee. I am happy to listen to any groups they want to bring in. There are a lot of issues we have to deal with.

I am looking forward to bringing in minimum unit pricing in respect of alcohol. We await the report and review from Northern Ireland. Perhaps the two constituencies could move together. One aspect of minimum unit pricing I have just found out about is that when it was introduced in Glasgow, the preliminary findings were that there was a reduction of 8% in the amount of alcohol purchased per household and a decrease of 21% in the number of deaths related to alcohol. People have said I did not give enough attention to my drugs policy. I am dealing with health, well-being and public health.

I thank the Acting Chairman for his indulgence. I look forward to working with all stakeholders to do the best we can. All I can do is be the best I can. I need each and every stakeholder, Deputy, Senator and official in my Department to help us tackle this very difficult problem.