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Thursday, 22 Sep 2011

Illegal Drug Use: Discussion (Resumed)

I welcome the Minister of State, Deputy Shortall, her officials and the members of the National Advisory Committee on Drugs to our meeting, which is part of a series of meetings dealing with the issue of drugs and illegal drug taking in our society. I congratulate the Minister of State and welcome her as our new Minister. I wish her well in her brief. We look forward to hearing from her. As she is aware, a concern has been expressed at some of our meetings regarding the fact that the Minister for drugs is no longer a member of the Cabinet. Also, as part of the deliberations concern has been expressed regarding the volume of alcohol consumption in society. This morning, prior to the meeting, I noticed that Diageo has started using Facebook and other social media to advertise its products. I hope the members of the advisory committee will discuss that also with this committee. The representatives are very welcome and we look forward to hearing from them.

Before calling the Minister of State I remind everyone of the position regarding privilege, mindful of our discussion earlier. Witnesses are protected by absolute privilege in respect of the evidence they are to give this committee. However, if they are directed by the committee to cease giving evidence in relation to a particular matter and they continue to so do, they are entitled thereafter only to a qualified privilege in respect of their evidence. They are directed that only evidence connected with the subject matter of these proceedings is to be given and they are asked to respect the parliamentary practice to the effect that, where possible, they should not criticise nor make charges against any person(s) or entity by name or in such a way as to make him, her or it identifiable. Members are reminded of the long-standing parliamentary practice to the effect that Members should not comment or criticise or make charges against a person outside the House or an official either by name or in such a way as to make him or her identifiable. I call the Minister of State, Deputy Shortall.

At the outset I want to introduce my officials. On my right is Michael Conroy who is the principal officer in the drugs policy unit in the Department of Health. Beside him is Susan Scally, principal officer in the drugs programme unit in the Department of Health. On my extreme left is Brian Murphy who is the national primary care and social inclusion manager in the Health Service Executive and immediately on my left is Joe Doyle, the national rehabilitation co-ordinator in the HSE.

I very much welcome the opportunity to come before the committee to talk about the drugs problem. I very much welcome the engagement of the committee in this important issue, which unfortunately affects so much of our country. I would hope this is the opening session in regard to our engagement around this issue and that we might continue that engagement and conversation into the future in that we would return to the committee to talk to members at a later stage. I hope that we might examine ways of involving members of the committee more in the evolution of policy in this area in regard to both drugs and alcohol. I welcome the interest of members and look forward to dealing as best I can with their questions.

Like many members of the committee I have been concerned about the issue of problem drug use for many years and have been active in trying to address the consequences that arise from such use in our communities. Therefore, I very much welcome the opportunity I have been given in terms of fulfilling a role as Minister of State with responsibility in this area. I am determined to make significant strides forward in deterring young people from becoming involved with drugs and in improving the treatment and rehabilitation opportunities for those people who have drug related problems.

The overall strategic objective of the National Drugs Strategy 2009-16 is to tackle the harm caused to individuals and society by the misuse of drugs through a concerted focus on the five pillars on which we address this problem, that is, supply reduction, prevention, treatment, rehabilitation and research. The Government is committed to providing renewed impetus to the fight against drugs and to ensuring the effectiveness of any initiatives taken. The strategy sets out a series of actions to be taken to ensure that the overall aims and objectives are met by the various sectors in the period up to 2016. Progress at a national level is reviewed through the oversight forum on drugs, which I chair, and drugs task forces play a key role at regional and local level. I emphasise the need for all parties to the strategy to renew their commitment to the achievement of the key objectives set out in the strategy.

It is particularly important to have accurate information on the extent of drug use and the drug prevalence survey, which is carried out at four-yearly intervals in line with stringent international standards, is the best source of such information. Field work for the 2010-11 survey has been completed and I am looking forward to the first results bulletin becoming available in November. This will give the key findings on drug use and will outline comparisons with the two previous surveys undertaken in 2006-07 and 2002-03. This information will subsequently inform policy for the coming period.

Regarding supply reduction, the Garda Síochána and Revenue's customs service continue their efforts to reduce the supply of drugs into Ireland and the production of drugs within the country. The agencies co-operate very well together and also with other law enforcement agencies across Europe.

Cannabis grow houses have recently become a feature of the drugs trade. While many have been uncovered this development is a concern, especially as the cannabis now available is of a much stronger nature than that of earlier years. Such grow houses are also a common problem across much of Europe.

A year ago the activities of head shops in Ireland were a matter of great concern to the general public in view of the accessibility of psychoactive substances, the number of people frequenting these shops, the health risks involved and the possibility of use of these products acting as a gateway to the use of illicit drugs. Regulations under the Misuse of Drugs Acts were introduced in May of last year making the possession and sale of a wide range of psychoactive substances illegal and subject to criminal sanctions. The Minister for Justice and Law Reform subsequently introduced legislation making it a criminal offence to sell or supply substances that are not prohibited under the Misuse of Drugs Act but that have psychoactive effects on humans. The number of headshops has dropped from 102 to 12 and An Garda Síochána confirms that no psychoactive substances are being sold in the remaining outlets. Meanwhile, work is well advanced in my Department on the introduction of regulations under the Misuse of Drugs Acts to control a further extensive range of products.

I am concerned about the levels of usage of some prescription drugs, whether sourced in Ireland or bought over the Internet from abroad. As a first step, I have asked the HSE to carry out an examination of the prescribing patterns for benzodiazepines.

The further development of prevention measures aimed primarily at those deemed to be most at risk of becoming involved in illegal drug use, and at the younger population generally, is a critical element of the national drugs strategy. Along with this, it is necessary to develop awareness among the general population with respect to problem drug use, alcohol use and the misuse of prescription drugs.

As emphasised in the programme for Government, I see the school setting as being particularly important. The challenge is to ensure programmes continue to be updated to reflect current realities at any given time and to deliver them in the most effective way across the whole school environment. In that way, all our children will be better equipped to handle the real dangers they will face. In that regard, I can confirm that the Department of Education and Skills has recently set up a group to ensure the ongoing relevance of the messages being delivered in schools. I am determined that we will really impact on the treatment and rehabilitation of problem drug users during my time in office and I am already making some progress in this regard.

There are approximately 14,500 known opiate users in Ireland, of whom 9,300 are in receipt of methadone maintenance treatment. In total, over 12,500 people are in receipt of drug treatment. Clients can usually access methadone provision in Dublin within one month of assessment. The major focus recently has been on increasing the availability of services outside Dublin. Over the past 18 months, additional services have been put in place in Limerick, Tralee, Cork, Waterford, Kilkenny, Wexford and Dundalk. Further services are planned for Drogheda and the midlands. Enhanced detoxification facilities have also come on stream recently in counties Carlow, Kilkenny, Cork and Limerick.

A review of the methadone treatment protocol, entitled The Introduction of the Opioid Treatment Protocol, was published in December 2010. The review made a number of recommendations for improving services in the following areas: more involvement of GPs, more clients per GP and the placing of maximum emphasis on moving clients towards recovery, which I hope will be the hallmark of our approach to the drugs problem in the coming years; more opportunities for detoxification with appropriate follow-up; addressing service provision outside the main urban areas; use of drugs other than methadone, such as suboxone; and opiate substitute prescribing in Garda stations. I support these recommendations and will be following up with the HSE in regard to expediting their implementation.

Approval has recently been granted for the proposed provision of needle exchange services in approximately 65 community pharmacies at various locations outside Dublin, with part funding being provided by the Elton John Aids Foundation. A national liaison pharmacist has been appointed to oversee this programme, the roll-out of which will begin next month. Needle exchange services in Dublin are provided through HSE clinics, and through voluntary sector providers, so this initiative will facilitate broad national coverage.

I am particularly focused on ensuring increased emphasis on moving people on from drug treatment to a drug-free life where that is achievable. It is my belief that there has been insufficient focus on this ambitious goal. In short, we must present drug users with the opportunities to achieve a life of drugs.

The HSE has a national rehabilitation co-ordinator in place and the National Drug Rehabilitation Implementation Committee is working to progress the overall rehab response to empower people to access the social, economic and cultural benefits of life in line with their needs and aspirations. Recently, national protocols for inter-agency working and common assessment guidelines were agreed for all treatment providers and I hope that these will facilitate more successful outcomes. I will endeavour to ensure clients will be strategically case-managed towards successful exit from treatment, with step-down facilities and appropriate follow-on support being provided.

There is widespread concern, which I am sure all members share, in regard to the use and misuse of alcohol. This is primarily a public health issue, requiring a whole-population approach for successful implementation. The central aim is to reduce the amount of alcohol we drink. At the same time, harmful alcohol use is often associated with polydrug use and many of the treatment and rehabilitation services providers deliver services to both groups. Also, alcohol can act as a gateway to the use of illicit drugs for some people. Against this background, the Government will develop a national substance misuse strategy incorporating alcohol and drugs. A steering group, chaired by my Department and including representatives of other relevant Departments and agencies, in addition to the community and voluntary sectors and the drinks industry, is working on the finalisation of its recommendation on a new strategy and I expect to receive its report next month. These recommendations will then be considered before proposals aimed at tackling the problems of alcohol and drugs in a cohesive way are brought to Government later this year.

In conclusion, I stress that the Government is determined to tackle the issue of problem drug use over the coming years. The problems are major and resources are scarce, as members all know. Even so, in excess of €250 million will be spent this year across Departments and agencies in dealing with the drugs problem. I look forward to working with my ministerial colleagues and in partnership across the statutory, community and voluntary sectors to ensure real and lasting progress is made for the benefit of individuals, their families and their communities. I very much welcome the input of this committee regarding evolving policy in this area.

I thank the Minister of State for her statement and her commitment to involve this committee in the evolution of policy. I welcome Ms Scally and Mr. Conroy.

I thank the Minister of State and wish her luck. I know she is committed to trying to address drug abuse. Many members, including me, feel strongly about schools comprising a front line when young people start experimenting with drugs. They start off on a recreational basis and then move to heavier use, abuse and addiction. We do not have a lead agency that schools can contact if they feel there is a child who is vulnerable or a child who is absent from school more often than he should be, or if there is considerable truancy. When one considers the early stages of drug abuse, one notes that, in the education system, there may be disengagement among pupils, homework not being done, non-attendance or perhaps a rise in aggression levels. Many teachers tell one it is evident when a pupil is on drugs or alcohol but they wonder who they should contact. Does one telephone the Garda? To where does one go?

The Department of Health says it wants to continue to deliver the message that drug and alcohol abuse is dangerous and to try to discourage young people from taking them. There is a fall-down in the early stages, however, when intervention would be most beneficial. That is in the context of early-stage recreational drug use, which later evolves into heavy drug abuse. Of all areas into which resources should be devoted, teachers should be able to make a confidential report in order that contacts can be made with the vulnerable child. As there could be many reasons for a child's drug abuse and vulnerability, including domestic issues, many agencies could be brought together in this context, but this is a key area when addressing the issue.

On the issue of GPs, I note the programme agreed with the troika includes a commitment to liberalise the ability of GPs to access patients under the GMS scheme. As matters stand, are GPs obligated to provide methadone treatment or can they refuse to so do? Doctors who engage in the GMS scheme should be obligated contractually to educate themselves and fulfil their duties in respect of drug addiction, treatments and so on. I genuinely believe this because there is an element of cherry picking at present. Moreover, some surgeries and clinics are perceived to be places to which drug addicts go to assist in their rehabilitation and this perception damages their clientele base. However, were they all on a level playing pitch, there at least would be an obligation in this regard. This suggestion may be worth considering.

In the context of drug addiction, most people can accept that alcohol probably frequently is a gateway to many things. However a couple of years ago, the previous Government made a decision on below-cost selling. The reason it happened baffles me to this day and I was part of the decision-making process. At the same time, however, the cost of cigarettes was increased through taxation to discourage people from smoking because everyone knew they are bad for one's health. On the following day, however, Members walked into the Dáil and reduced the cost of alcohol. Consequently, young people can walk into supermarkets and off-licences nationwide, draw out slabs of drink on their shoulders or on trolleys to go down to the corner of a local street or to a local house or wherever and get absolutely intoxicated. I cannot understand the reason we allow this to happen. It baffles me to this day that our young people can access what we know to be the most dangerous substance at that stage, which can lead people on to many paths, yet we make no effort to control or curb it. Instead, through Government policy, the consumption of alcohol is encouraged.

I am not a puritanical person on this issue and am quite partial to it myself but I simply cannot get over this fact. One can visit any community in any part of the country and in certain areas therein, in corners of estates or in parks, one will find an almost industrial level of dumping of cans and bottles by young people. As a society, we simply appear to dismiss this, gloss over it and pass along. This is the biggest issue facing us in respect of the abuse of drugs, truancy in schools, dropping out from the mainstream, drug addiction, teenage pregnancies and sexually transmitted diseases. Often, all evidence suggests alcohol plays a central role in this regard but we have done nothing. At the same time, the price of cigarettes has been increased because we know they are bad for us. This simply flies in the face of logic and something must be done.

I can buy 20 bottles for €15 in my local supermarket. However, were I to cross the road to visit a pub in which some control is exercised over the consumption of alcohol, I must pay €5. This does not make sense. Everyone knows this is happening, yet nothing is being done about it. While this may be because members are concerned about inflation and the pressure on families with regard to rising prices, alcohol should not be perceived as an essential ingredient in the household basket for the calculation of price inflation and so on. It is damaging young people. I acknowledge the Minister of State is committed but this decision must be reconsidered and reversed. I do not make this point because publicans have contacted me but because I can find an industrial level of dumping of bottles a short distance from off-licences and supermarkets around my constituency.

Moreover, this is not being done by people who are 18 years of age but by those who are 12, 13 and 14 years old. In this society, a person who is 18 years of age can legally buy drink in an off-licence. While an 18 year old boy can legally buy whatever he likes, which is fine, very often his friends could be 16 or 17 years old or, if a girl, 14 or whatever. In other words, one encounters those who are 13 and 14 years of age within the cohort of an 18 year old. I often have suggested consideration should be given to raising the age one may purchase alcohol in off-licences for off-premises consumption because there is no control over such consumption. One should be 21 before one can buy alcohol in an off-licence. This might at least discourage the massive consumption of alcohol by young people. This is a problem with which members must get to grips because although they will discuss methadone treatment programmes and how society continually is chasing increased drug abuse, they do so in the knowledge that alcohol is the gateway to a great deal of it. Nevertheless, nothing is being done as a society or by the Government to control or reduce its consumption by young people.

I welcome the Minister of State for whom I have two questions of my own, as well as a number of brief questions arising from the presentations to the joint committee by The Base, the Merchants Quay Project and the Rutland Centre. First, I wish to take up an issue raised by the Minister of State, namely, the use of prescription drugs and benzodiazepines or benzos. I am a member of a community-based drugs initiative in Waterford and this issue has been on the agenda for some time. I wish to put on the table some figures that were presented to me and that I gleaned from research. They were published in 2010 on foot of figures received from the national drug treatment reporting system regarding the number of people who were treated and the number of deaths of people who suffered from the use or overprescription of benzos. Between 2003 and 2008, the annual number of treated cases reporting benzo as a problem substance increased by just over 63%, from 1,050 to 1,719. Moreover, the number of cases in which benzo was reported as the main problem substance increased by 120%, from 76 in 2003 to 167 in 2008. A more shocking figure is that between 1998 and 2007, benzos were implicated in 649 deaths by poisoning. The Minister of State mentioned the need to conduct some research to get some hard facts and figures in respect of the number of prescriptions that are being made by the HSE. In the course of so doing, it would be interesting if figures for repeat prescriptions could be obtained to get a sense of how many people might be addicted or whether figures are available on the number of people who are addicted. It is a growing problem that must be dealt with. Can such figures be obtained from the HSE? If so, can such figures be provided to the joint committee to enable members to consider strategies and policies that can be put in place to deal with it?

The Minister of State also mentioned the subject of my second question, which pertains to GPs linking into the national drugs strategy. While this is not a reflection on all GPs, my experience of being involved in this issue in Waterford suggests many GPs simply do not engage with community-based drug programmes. The Minister of State mentioned recovery, which is an area in which a gap exists. I am a major supporter of the national drugs strategy and its various pillars because it is multifaceted and brings together all the agencies and stakeholders. One of the most important stakeholder groups in this regard is the GPs. While this is the point at which many drug users present, collaboration does not take place between those who work on the ground in the field of drugs and those who are at the coalface of helping and assisting drug users, who get such assistance from some GPs. The Minister of State should indicate what strategies can be put in place to do with this issue.

I also have some brief questions arising from the presentations made recently to members. I note the Merchants Quay Project mentioned long waiting lists for methadone treatment and that there are only 50 detox beds in this State. Does the Minister of State agree there is a need to increase the number of detox beds in this State and is it a priority? It makes social and economic sense to me.

I received a number of telephone calls yesterday from a heroin addict who was in a desperate position. The addict was seeking access to treatment and called to one of the community-based drugs programmes. Unfortunately, however, he was unable to receive the necessary treatment. We are dealing with vulnerable people who come for treatment at various stages. Sometimes when they are ready to ask for help, that treatment is not available because they have to go on long waiting lists. They may thus miss a window of opportunity, so it is important to increase those resources. All the groups that came before this committee do very good work, as the Minister of State will agree. We have excellent local, regional and national drugs task forces which are all doing great work. In addition, individuals employed by those agencies are doing good work in their communities, but in many areas they are working on a shoestring budget because they have been subject to cuts in recent years. All of them have said we need to be conscious of that in forthcoming budgets, in order that we do not make savings that could end up costing the State more in the long term, both socially and economically. We must ensure that treatment facilities, such as counselling and prevention, are properly resourced in order that we can tackle the problems involved. The Minister of State should take this on board as a genuine concern of mine, that hopefully we will not see cuts in these areas that could impact on the kind of services these agencies and organisations need to give to vulnerable people.

I welcome the Minister of State and wish her luck in her new role. I am sure it is unusual for her to be on the Government side, but I will not go as hard on her as she would normally have gone on Ministers when she was in Opposition.

If we had plenty of money we could do a lot about the drugs issue. There are simple straightforward things, however, that can be done without costing money and which could even save money. Deputy Kelleher mentioned the issue of alcohol. Three years ago, his own Government reintroduced a ban on below cost selling of alcohol but the then Minister for Justice, Equality and Law Reform failed to sign it into law. That still remains the situation, so why has it not been signed into law even though both Houses of the Oireachtas have passed the legislation? Surely it makes sense to introduce a ban on below cost selling of alcohol. If anyone questions the impact it is having, they need only look at the newspapers, especially on Sundays, to see large advertisements by national and multinational supermarkets flogging alcohol below cost price. This matter needs to be tackled. The legislation is there but the ministerial order has not been signed.

I welcome the fact that the Minister of State is bringing forward further regulations concerning the Misuse of Drugs Act. Will she examine the possibility of banning the importation and sale of cannabis seeds? In her contribution, she mentioned the grow houses that have been found in my constituency and elsewhere, yet we still have not banned imports or the sale of cannabis seeds. The United States has introduced such a ban, yet we are turning a blind eye to it. We should also examine Internet sales of drugs.

I am glad the Minister of State has a role in primary care as well as drugs. In all the contributions to the committee the consistent point is the connection between mental health issues and substance abuse. A European study showed that each year 38% of the EU's population have some mental health disorder, which is nearly four in every ten people across Europe. Only one third of them seek help. Those who seek help, rather than getting access to the required supports, end up with a GP who virtually becomes a drug pusher, prescribing and re-prescribing benzodiazepines. Senator Cullinane has cited figures on such drug abuse.

A report on prescribing benzodiazepines was published nine years ago and was supposed to have been implemented by now. The Minister of State said that, as a first step, she has asked the HSE to carry out an examination of the prescribing patterns of those particular drugs. Why has it been left to the Minister of State to do such an analysis? What has happened over the past eight years and, more particularly, over the past three years?

This country is in a recession and we are closing hospital beds because we do not have the money to keep them open. Meanwhile, we are spending a fortune on prescribing these drugs, yet this evaluation is only taking place now. Surely it should have taken place some time ago, not only to protect the vulnerable people concerned but also to protect taxpayers. Significant sums of money are being handed over to drug companies who manufacture these drugs. I ask the Minister of State to elaborate on these matters.

I will ask the Minister of State to deal with those three contributions.

There are a number of common themes running through the contributions. I share the concerns of members about those two major issues: alcohol and the widespread use of benzodiazepines. As regards treatment services being provided through the HSE, members of the committee will know that I have responsibility for primary care as well as the drugs strategy. Both areas of responsibility sit easily together as there is a lot of common ground involved. I would like to see much more involvement by GPs in providing treatment for drug users. There have been difficulties in that area and I am addressing them at the moment. I have met a number of the GP co-ordinators and we are examining that area. I want to involve more GPs, both at level 1 and level 2. There are issues concerning how the scheme works and how people are recompensed for their work. The fee structure often works against users making progress through the system, so they can get stuck as a result.

I am concerned about people getting stuck on methadone without having an adequate progression through the system. That is why I want to put the focus back on recovery, to ensure that people are enabled to the greatest possible extent to live a drug-free life. Both at the level of treatment centres and also with GPs, I do not want people going into methadone treatment and becoming stuck there indefinitely.

We are examining ways of ensuring there is that kind of progression by involving more GPs. I see no reason a large number of drug users' regular GPs cannot provide treatment for their drug problem, just as they treat them for any other health problem they may have. A certain cohort of drug users would be regarded as quite chaotic and would not be suitable for treatment in local GPs' surgeries. Many drug users, however, should be treated by GPs and, therefore, I want to see those GPs' services being expanded. I am working on that at the moment.

Alcohol is a major problem in this country and, as a society, we need to face up to it. This is not a marginal issue, nor something that only children in disadvantaged areas have a problem with. It is a problem for society at large and, as a society, we all drink too much. I hope that as part of the new strategy to tackle this problem we will set targets on reducing consumption levels across the population. Each and every one of us needs to address this matter across the social spectrum, urban and rural, male and female and including all age groups. I look forward to receiving the report of the steering group that has been examining this area for almost two years. I expect to receive it within the coming weeks. I will then take that draft strategy to Government with recommendations for an action plan.

I hope to bring forward specific proposals on three key areas of concern, the first of which is pricing. Since the groceries order was lifted in 2006, we have seen that alcohol is available so cheaply. In fact, there were figures used by the Alcohol Action charity recently which really brought it home to people. In terms of the maximum recommended intake per week to maintain a low rise in relation to alcohol, a woman can get to that point for a mere €6.30 a week and a man can get to the limit of his low risk threshold on €10 a week. That is merely a measure of just how cheap alcohol has become. This is an issue that must be tackled.

There was an earlier commitment to addressing it on the basis of below cost selling. That is easier said than done because there are all kinds of other factors that come into play that determine the price of alcohol where, for example, the large multiples are buying in bulk and get discounts. It is quite difficult to establish the actual cost and whether outlets are selling below cost.

For that reason, the steering group has been concentrating instead on the notion of minimum pricing related to the volume of alcohol in any particular drink. That is not straightforward either and we are seeking legal advice on that at present. Personally, I would be very committed to going that route if it were legally sound. That is the basis on which we are proceeding to address that problem. It is a key issue in the abuse of alcohol that it has become so affordable, especially for young people.

In tackling this problem, the other key area is the explosion in the number of outlets for alcohol. One can buy alcohol in every corner shop and every filling station. The big concern about that is that alcohol is displayed along with the sweets, biscuits, bread or milk and it normalises the idea of alcohol as a product. Alcohol is not a normal product for sale in a supermarket like food, milk, minerals or whatever. It is a potentially dangerous product and for that reason, it needs to be treated differently to other products. It was a retrograde step to liberalise the licensing laws in the way we did, which opened up the question of availability. Availability is a key aspect, not only in terms of normalising our attitude to alcohol but also in terms of making it much more accessible to young people.

The other area is clearly the availability of alcohol to those under age. There are a couple of factors here. We need to tackle the issue of distance selling where a "Prime Time" programme last year demonstrated how in Swords, County Dublin, teenagers were able to ring up both local off-licences and supermarkets to order alcohol over the phone and have that delivered and paid for with cash on the doorstep without any difficulty. That practice, I understand anecdotally, is a widespread problem. That needs to be tackled.

We also need to tackle the question of under age sales and there needs to be greater enforcement of the law in that area. I want a clear message going out to the law enforcement agencies that this Government is serious about tackling the problem of alcohol abuse, especially among young people.

The third area in that regard is, as Deputy Kelleher mentioned, the question of those over 18 buying alcohol for those aged 13 or 14 waiting outside. I am not satisfied that there has been adequate enforcement of the law in that area. It needs to be made clear to people that they are committing an offence by buying alcohol for the purpose of passing it on to those who are under age. I would like to see us being much more vigorous in that regard and there will be proposals on that in the new strategy.

The question of alcohol abuse and the place of alcohol in society is being taken extremely seriously, both by myself and by my Government colleagues. I hope to be in a position before the end of the year to bring forward significant proposals in that regard. I would very much like this committee to consider the role it may play in supporting those proposals. I am happy to come back to the committee at a later stage and look at some of the draft proposals. I hope to get to a point where we would have cross-party support for taking this issue seriously and doing something of real consequence about it in order that we can remove this terrible blight on society in terms of the dreadful damage alcohol does to individuals, families and the health and general welfare of people. It is costing us dearly in human terms but it also economically in terms of the pressures that alcohol abuse puts on the health service, lost days at work and loss of productivity. We have no choice but to address it. I hope I will have the support of the committee on a cross-party basis in addressing it in a serious way.

Benzodiazepines are another area about which I am very concerned. As the committee will be aware, the majority of those presenting for drug treatment are polydrug users. Often, it is cannabis or heroin in conjunction with benzodiazepines, and alcohol is a factor in many cases. This is something that was brought to my attention in my constituency. The Ballymun drugs task force identified this as a serious problem in recent years and it engaged in a project in which it worked with local general practitioners in the primary care centre. They came up with a scheme whereby two counsellors were employed to work in the primary care centre to facilitate GPs who where presented with patients who had difficulties with abuse of benzodiazepines so that there was an alternative course of treatment available and they could refer the person to the counsellor who was working in the same building. That had positive results.

As well as my experience in my constituency where it has been brought to my attention on a number of occasions, in meeting various groups dealing with the drugs issue and in visiting different communities over recent months, it has arisen time and again that there is a serious problem of overuse, overprescribing and over-reliance on benzodiazepines. With that in mind, I have taken an initiative on the question of prescribing. As part of my remit as Minister of State with responsibility for primary care, I have responsibility for medicines and I am looking at the question of prescribing patterns across a range of medicines and drugs. I will start that examination in respect of benzodiazepines. I have decided to take an initiative on the information available to us on persons on medical cards who are prescribed benzodiazepines as well as persons who avail of the community drugs scheme. As the committee will be aware, all of those data are available in the primary care reimbursement centre in Finglas. There are rich data available on exactly what is happening in prescribing for most of the population.

I hope, starting next month, that an in-house team within the PCRS will investigate those figures, look in detail at prescribing patterns in respect of benzodiazepines, and identify problem areas, problem practices, problem GPs in terms of their prescribing patterns and where patterns are out of line with national norms and best international practice. At that point, when we have the data to see the extent of the problem, we will take it to the next step further where that team will meet GPs where there are difficulties, address it at that level and work with those GPs to bring their prescribing patterns into line with best practice. I am starting that in October. I hope that in a matter of months we will have results from that and a clear picture. I have been hearing all of this anecdotally. I want to see the hard facts in terms of the scale of the problem and then decide on the action we will take. The preparation of that work is under way. It has been scoped for me and I hope it will start in October.

The question of waiting lists is a concern. Official figures from last December have been circulated. In the Dublin area, waiting times are approximately one month. That is an improvement but a month is still too long. If a person using heroin, in particular, has had a chaotic lifestyle and gets to the critical point of deciding he or she wants to do something about his problem, we need to be in a position to provide that service within days. I am aiming for two weeks. It is down to a month in most places and I would like further progress on that. Outside the Dublin area, progress has been made over recent years with a number of new services and clinics coming on stream. I referred to them in my opening contribution. They are producing results in the context of progress being made. Some tidying up had to be done in regard to the waiting lists because there was duplication. We have preliminary updated figures that show an improvement and I hope we can validate the figures and make them available. Progress is being made in this area. It entails acceptance of new treatment facilities and the recruitment of more GPs.

Schools play an important part. As with alcohol, availability is a key issue and we must tackle the availability of drugs. It is difficult to counteract a situation where schoolchildren pass dealers on the way to school or witness dealing taking place openly in their local shopping centre or on a street corner. It is difficult to counteract that through education programmes. Tackling the supply of drugs in the number one priority. We need to ensure schoolchildren receive good, soundly based education programmes related to personal development, the dangers of abusive substances and developing their self-confidence, and we need to ensure they remain in school. There are common threads in the profile of those most at risk of using heroin, in particular, such as poverty, family dysfunction and early school leaving. All those factors predispose people to abusing drugs. Education programmes in schools need to tackle the problem of low self-esteem and to provide education and employment opportunities for people as well as making them aware of the dangers of the abuse of alcohol and illicit drugs. Programmes are in place in schools and a group within the Department of Education and Skills is reviewing them to ensure they are up to date and relevant to where young people find themselves.

As Deputy Kelleher said, when a problem is identified in a school, the first indication something is wrong is the pupil being absent regularly, and that is a matter for the National Educational Welfare Board to address in the first instance. There are also counselling services within schools. The careers guidance and counselling office should be the first port of call, followed by working with the parents and then linking up with the available HSE services. In most areas, support and assistance are available where schools identify a problem. Whether they work through the local HSE office, the drugs task force or the social work service, they are linked to services quickly when abuse is established. That is the thrust of tackling the problem at that level. The younger the person with the drug problem and the sooner appropriate treatment can be provided, the better. The services supporting schools are reasonably good and we must continue with the awareness programmes.

With regard to cuts in services, we managed to maintain the budget reasonably intact for this year at €265 million. There are pressures on all budgets but there is an acceptance across government that we cannot afford to take our foot off the pedal on this issue. I hope we will retain the bulk of the budget for next year.

I thank the Minister and her officials for attending. Drugs are a serious issue. It started with heroin in the 1980s in Dublin but it has spread like cancer throughout society. Cannabis, heroin and cocaine are available in every town and village. While most of us have gone through life without seeing illicit drugs, the same cannot be said of our children and young people generally in our society. The value of illegal drugs amounts to hundreds of millions of euro and they are supplied by violent drug gangs. Despite the success of the Garda in seizing large volumes of drugs and arresting those dealing them, there is still no shortage of drugs on our streets. I believe a kilogram of cocaine can be bought in South America for €700 and sold on our streets for €70,000. There is no shortage of people willing to risk imprisonment or worse for such a profit. The two issues I am worried about are the supply of drugs and the demand for drugs. Will the Minister of State outline the policies to deal with those issues?

The Minister of State referred to the Elton John foundation. There are rumours that the programme is 12 months behind and he is threatening to pull the funding. Will she confirm the current position of the programme?

I thank the Minister of State for her presentation. Below cost selling of alcohol in supermarkets is a major problem, which has worsened progressively over recent years. In the late 1980s, three Bills were brought before the Oireachtas but only two were enacted. The third provided for separate areas with separate entrances within supermarkets for the sale of alcohol. These areas were to be manned by older people and this would have been a positive move. The reason the legislation was not passed was pressure from supermarkets. We must be careful this does not happen again. The fact that alcohol acts as a gateway to the use of illicit drugs is a huge problem.

Is MEAS the steering group to which the Minister of State referred? One or two organisations have walked away from it out of frustration. If minimum pricing is the route we can go legally, it is probably the best route to go. Will the Minister of State come back to the committee with the draft proposals?

I welcome the Minister of State and thank her for her insightful presentation. She is committed to this issue and I look forward to working with her in the weeks and months ahead.

I refer to an anecdote related to us by a member of staff at the Aislinn treatment centre in Kilkenny which illustrates the problem we have with alcohol in this country. A number of months ago, a "Prime Time" programme on head shops was broadcast. The reporters sat outside a head shop one night and counted the number of people who went into the shop to make a purchase. The family support worker from the Aislinn centre did something similar and sat outside an off licence in her town. She said there were three or four times the number of people purchasing alcohol than she expected. The Minister of State has addressed the issues relating to the availability of and access to alcohol. Her commitment to engage on the issue is welcome, because this anecdote illustrates the demand for alcohol. It is not just about access to alcohol, we need to consider how we will change our culture and attitude. We have an opportunity now to make some real differences in how we deal with young people's approach to alcohol and drugs. Somebody mentioned engaging with children in schools. While those programmes are good and the supports exist at second level, there is an opportunity for us to engage with children at a much younger age. I do not just refer to drugs and alcohol. I am talking about children having the ability to make good choices. That is what it comes down to in a number of areas and not just regarding drugs and alcohol. I am referring to relationships and their education.

From her constituency work, I know the Minister of State is familiar with the young ballymun programme which targets children as young as two and a half to five in preschool programmes to give children the opportunity to make good choices. I welcome the Minister of State saying today that she looks forward to working cross-departmentally in tackling the drugs and alcohol issue, but we need to adopt a different approach from what has gone before. What does the roll-out of treatment clinics throughout the country tell us? The problem is getting worse and the prevalence is increasing. Further to what Deputy Fitzpatrick said, what is the Garda doing? What is the Department of Health's involvement in liaising with the Garda in curtailing accessibility to drugs?

I welcome the HSE's investigation into the prescribing pattern of benzodiazepines and I look forward to reviewing that information. I hope that changes will be made if needed. Increasingly people are using the Internet to gain access to illicit substances, including benzodiazepines. Will we link with the officials in customs and Revenue who also have a major part to play? We need to think outside the box. It is not just the Departments of Health, and Education and Skills, but also Revenue. All of these are key stakeholders in the battle against illegal drugs and the importation of benzodiazepines and other substances over the Internet.

In recent weeks representatives of the Rutland Centre advised that medical cardholders have not been able to get access to treatment in the Rutland Centre in the past 12 months, which concerns me. People with medical cards usually have restricted income and because of the long waiting lists to get access to rehabilitation programmes, they are not getting the service they need when it is required. We may miss that opportunity to engage with somebody who wants to make a change in his or her life and offer the treatment he or she needs.

While the people who provide treatment have a very challenging job, it is also very challenging for the substance misuser trying to change his or her life. In trying to address the problem of drugs we need to think differently. From the work I have done before my election to the Dáil, I have found that after the person is taken away, treated and detoxified, he or she goes home and back to the same culture and group of friends. There is a major role in offering social supports and training opportunities for people. This is a very vulnerable group and children who might have come through the care system often find themselves at the wrong end of drug use. They represent a very marginalised group with no social supports to which to return. We need to ask those from the Departments to work with us on the issue and allocate resources to deal with these vulnerable people through FÁS, SOLAS, etc. They should be given priority for training and educational opportunities so that they can reinforce the positive changes in their lives.

Two other speakers, Deputies Catherine Byrne and Maloney, have indicated and I will take the five together.

I welcome the Minister of State as Minister of State with responsibility for drugs. It is unfortunate there is not a dedicated Minister sitting at the Cabinet table. The Minister of State will know I have long held that view. I believe the Minister of State, Deputy Shortall, is the right person in the right place at present, which is positive. I welcome her invitation for the committee to make proposals regarding policy. What she has said has given me considerable food for thought and I hope to be able to extend my interest in that regard.

I want to talk about education - the walk tall programme and SPHE. As a parent I regard them as outdated. It depends on the school in which it is being taught and the interest of the teacher on the day. It depends on whether it is part of the curriculum or it is just ten minutes at the end of the class when the teacher has nothing else to do. The programme has failed because there has not been a genuine interest in putting it in as part of the educational system with a set time with teachers who are trained and capable of getting the programme across. It is all about giving the children confidence in themselves.

A few years ago there was a bus which went around bringing science to schools. It was probably one of the best things I encountered during my children's time in school. When they came home from school they were excited about the bus coming and teaching about science. This may be a model for how we could inform young people about drug addiction. We should take them out of the classroom and bring them to a set place such as this, with the experts there to give them an understanding of the issues of drugs. I do not believe this has happened in the classroom and might be worth considering for the future.

A child's education starts at home. Unfortunately when some children - probably the majority of children - go home the sense of family and education does not exist. At the other end, some children with good parents get caught up in the whole hysteria of drugs and get involved in it. I am particularly concerned at how drugs and particularly alcohol are promoted outside of school, a matter to which I will return in a minute.

The Minister of State said the Department of Education and Skills was establishing a group. Who will be on the group? What role will it have? What links will it have in the school programmes with teachers, etc.?

This week the methadone treatment service in Rialto in my constituency has been discontinued. We lost the methadone treatment service in Inchicore approximately six months ago. The one in Rialto deals with approximately 26 local people and is on their doorstep. It can put people off if they have to travel for a methadone service. We should consider having more of these services within the community. I fully appreciate and understand about the GP services. It is good that GPs will be more involved, particularly in having a programme relating to drugs and helping to wean people off methadone.

The Minister of State did not mention families in her statement. In treating any addiction, the support of families is key. I see many grandparents taking on the mantle and acting as parents to their drug-addict grandchildren. There needs to be more emphasis on giving grandparents support in their communities being able to deal with their grandchildren who are addicted to drugs.

The Aislinn Adolescent Addiction Centre in Kilkenny was mentioned. I visited the centre when I was my party's spokesperson on drugs. It is the only service of its type that deals with under 18s, yet it survives because of the voluntary contributions it receives. It should be supported.

On the €250 million allocated across the State for different agencies, everything is now about value for money. Does the Minister of State intend to review the local and national drugs task forces, the partnerships and the other services? Many of the services are duplicated in communities and many do not connect with the wider community, instead just focusing on particular sections. That has probably been their downfall. The local drugs task forces were formed in the 1970s and their role got lost when they were handed a cheque book to give out money to different community groups. When that happened, they became a kind of empire. That is my warning.

Where do I see drugs in the future and where do I see my children? Tomorrow my baby is going to her debs. She is 18 years old. Like many families in the past couple of months, we have had a build-up. Never mind the leaving certificate examination which was a major hassle, the most important thing in our lives now is the debs and what the hair is going to be like, the make-up, the dresses and everything else. We had a debate around the kitchen table last week - I would not say it was a debate because it was one-sided - about what we would have at the party that was going to be held. I said: "Tea and sandwiches and the usual." I was trying to improvise. I was getting daggers from across the table about the alcohol issue. I said to her: "There won't be anybody here to see you, only family and friends. The rest will all be gone to their debs," because they are all her friends and all from the one school. I would say there was great disappointment in her face about the alcohol.

I am no fool. I have reared five children and all of them drink. Even though the mother and father do not, all of them take alcohol. What jumps out at me is that, when their friends come to the house before they go out on a Friday or Saturday evening, they bring alcohol with them. They do not just arrive to go out to drink. They actually bring alcohol that they have to consume and get into their bodies before they go out the door. Only on Saturday, I had a conversation with six of them. They were sitting around the kitchen table before they all left, dolled up, as I would say. We talked about the idea of going out topped up to an extent that it made it doubtful whether they would get into wherever they were going. If they do not get in, the night is over and they are unable to participate because of their earlier consumption of alcohol.

Thinking outside the box is important. As a parent, I do not believe we do this enough. When it costs €1.98 for a bottle of Coke but someone can buy a can of beer for 50 cent, there is something seriously wrong with what we are telling our children. When my kids go out to the cinema, it costs me €35 - they buy their tickets, popcorn and Coke and have to pay their bus fares there and back - yet they can walk into a supermarket and buy a crate of WKD or whatever else for €15 or €18. It beggars belief. I had a pleasant childhood. I was actively involved in my community. Many people were volunteers and gave of their time. They would come in after their hard day's work and go and open up the local youth club or community centre in the evening. That is not happening now. Few centres open in the evening. They are mostly locked up once the CE scheme workers go home. They lie empty all night, with no activity in them. When I was growing up, there were games in the evening; there was the local disco, and other clubs came to participate. There was stuff to bring people back into the community and give them an interest. That is not happening now. Despite the amount of money spent on community centres, youth clubs and outreach programmes, we do not seem to be tackling the problem. That is why we need to rethink.

On the point about promoters and concerts, when my kids go to concerts, it takes a bit of persuasion to get the money, but they eventually go. Requiring young adults to pay €60 to €70 to €100 for a ticket to go to a concert is absolutely off the wall. We need to look at this.

Last week I was talking to someone who goes to the theatre quite often and takes their children. I said I would have loved to be in a position to take my children to the theatre every week when they were growing up, but the price prevented this. The cost of going to the theatre or cinema and participating in some sports activities is out of control and there is no regulation of it. That could be changed to encourage young people to participate in other activities. The only thing they see as an option on Friday and Saturday nights is to go out on the town. I know the issue is probably not the Minister of State's responsibility, but we need to think outside the box and start considering how to encourage young people to be more active in their communities.

I compliment the GAA and the youth sports organisations in my community such as the young football and soccer teams. It is great to see a bunch of kids standing at the bus stop on a Saturday with their football boots in one hand and their little bags in the other, and they go off on the bus to play sports. Even though I came from a decent, stable family, if I had not been involved in sport when I was growing up, I could have lost my direction. I compliment people in communities who still decide when they come in from work in the evening to give a hand voluntarily.

Like others, I welcome the Minister of State and her staff and congratulate her on her post. From a previous conversation she and I had and her contribution this morning, I think we are at one on the subject of drugs in many respects. We agree that Irish society is in denial when it comes to the issue.

As a nation, we like our drugs which are very popular. We like the variety of drugs we have, whether it is cannabis, heroin, cocaine or crack cocaine which has been prevalent in recent times for people who have the money. Above all is our most popular drug, alcohol, the national drug. People in our society, including politicians, have great difficulty in accepting that alcohol is the national drug. I am not criticising only politicians because the media and other pillars of society are also guilty. One of the difficulties is that when we talk about drugs in the broad sense, we use the awful term "drugs and alcohol". Alcohol is a drug. It changes one's mood and mindset. If someone goes on to use cannabis, it does exactly the same thing and changes his or her mood, albeit in a different way, and the same applies to other drugs such as heroin and cocaine. One of the greatest challenges for the Minister of State is to change public opinion on the issue. We need to own up to the fact that the great distinction we make is invalid. We talk about drugs and alcohol, but alcohol is a drug. We can name the others if we want to, but they are all drugs. A scary statistic that is mirrored by our neighbours across the water in the United Kingdom is that alcohol is the first drug of choice for some 91% of drug users. For all the years we and the Minister of State's predecessors have been dealing with this matter, we have been running into difficulties because of alcohol's historical status in Ireland. We cannot find the courage to name alcohol as the most popular national drug.

People have shared with me an opinion that I hope forms part of the change. I will not criticise, but the previous Administration banned head shops with great haste. I am not an expert and do not know how many have died from or been permanently damaged by the abuse of substances sold in such shops. However, it is interesting that the previous Dáil and Seanad banned them almost overnight, albeit kicking and screaming, yet we will accept that one can drive into a petrol station to buy petrol and the most popular drug. Parents bringing their children to supermarkets to buy food, etc., will find before them the greatest variety of the national drug. I do not subscribe to the view that there is a place for alcohol in a supermarket. It is a drug. We debate the misuse of heroin, cocaine and so on, but the only real distinction is that we have not got around to legalising them. Were we to continue with this debate and, for some reason, legalise cannabis, it would not be found beside alcohol in petrol stations and supermarkets because there would be uproar. There is no place in these locations for the sale of the national drug. It sends a message, in particular to young people and children, that use of the national drug is okay.

Let us be light-hearted about it. If someone has a few pints, I will not object. To put it a certain way, I am a user and have no objection to someone having a few pints, but that is not the point. The point is that the message being sent to our children is that alcohol is harmless when it is not. I made a comment during the appearance of the representatives of the Rutland Centre at last week's meeting. If we spoke with people working in accident and emergency departments, they would tell us all about the national drug. Examine the court records listed in the provincial and national newspapers. A young student I know who conducted a survey on this subject found that 44% of all court cases related to alcohol or another drug. This is an astonishing figure. He maintains it is probably a world record, although I do not know whether that is true. We must do something about this frightening statistic and I hope we will be the first to do so.

The Minister of State's job is challenging. As part of a changing Ireland, the great pillars of society have diminished, but the drinks lobby remains powerful. It will be at the Minister of State's door. It likes to maintain the status quo because there is big money in alcohol. I hope the Minister of State will have the courage to change the situation to the benefit of society in general and not let the lobby have its way. If I wake up some morning next week to see the Minister of State’s title has been changed to read, “Minister of State with responsibility for alcohol and other drugs”, I will celebrate. I will not tell her how, but I will celebrate.

I thank the Chairman and everyone for their contributions. Deputy Fitzpatrick asked questions about supply and demand which form two of the five pillars of our approach to tackling the drugs problem nationally and locally through the drugs task forces. My presentation provided adequate information on both. The Deputy also asked about Elton John's charity's money for a needle exchange programme. There has been a delay in rolling out a needle exchange programme in community pharmacies, but the problem has been addressed. Community pharmacists will be in training next weekend. The programme's roll-out is due to start on 1 October. This is a welcome development.

Senator Henry raised the issue of separating alcohol products from other products in shops and supermarkets. This matter was the subject of section 9 of the Intoxicating Liquor Act 2008. Regrettably, it was not commenced. The previous Government opted to require a voluntary approach, whereby the industry would police the measure on a voluntary basis. I am not satisfied with this approach. The issue arose from the steering group's discussions. The majority of the group's members have been calling for the section's commencement, but their call has been resisted by the drinks industry. We will address the issue in the context of the final strategy. I am determined to address this issue of concern.

I was asked about the steering group's membership. The Mature Enjoyment of Alcohol in Society Limited, MEAS, is a member. The group was set up in 2009 and contains two representative bodies from the alcohol industry. This does not mean that the group's recommendations must be unanimous. There is a facility providing for a minority report. It was mentioned how people had walked away from the group, but I am unaware of anyone doing so. There have been delays in reaching final decisions and recommendations. The Department of Health chairs the group and has a keen interest in ensuring the issue of alcohol abuse is addressed. It took a serious approach and drove the recommendations to the limit, but there was resistance from within the group. I am confident, however, that we will have a good and robust set of proposals. If necessary, I will be in a position to add to them to draw up an action plan to be laid before the Government. I welcome the indications of support for such an approach from members around this room. It is beyond time that we tackled this issue seriously. We need to do so together and I would welcome cross-party support which is required.

Deputies Conway, Catherine Byrne and Maloney commented on our culture of tolerance of alcohol abuse and high volumes of alcohol being consumed. Our culture presents a serious problem. However, we also used to have a cultural problem with drink driving. Once the law was changed and enforced, that culture changed quickly. Most young people would not contemplate the irresponsible activity in which members of my generation would have engaged in their youth. It is not easy to change a culture, but it is possible to do so with a concerted effort, strong laws and enforcement.

We must all examine our behaviour. We have a tendency to place alcohol at the centre of our social lives. Our celebrations and family occasions generally involve it. Perhaps we need to re-examine our attitudes in this regard. We should let people know the considerable damage alcohol is doing to their health and well-being. Research increasingly indicates that alcohol plays a key role in a range of diseases and studies have recently raised questions about its involvement in various cancers. For example, diet and alcohol use are key factors in breast cancer, as well as other cancers. We need to get the information out to people and to show that we are serious about tackling this issue. I welcome the decision of the city council to hold an alcohol-free event in celebration of Dublin's great win on Sunday. We need to provide leadership in this area. If we are to change the culture around alcohol, there must be strong leadership from Government, community leaders and others. We need to take clear decisions which ensure we remove alcohol from the centre of our lives. Obviously, we also need to address the issue of advertising of alcohol, particularly outdoor advertising. A huge amount of money is spent on outdoor advertising of alcohol. That also needs to be addressed. It is a huge market. A lot of money is being made from the sale of alcohol in this country. In addition, a great deal of money is being spent on normalising alcohol and on it having a pervasive presence within society. I am concerned about the manner in which the alcohol industry is using more diverse ways of getting into Irish culture in terms of sponsorship of events and the association and highlighting of alcohol alongside other parts of society. That is an area that will be addressed in the strategy. I look forward to members support in that regard.

The issue of programmes in schools was raised. I refer Deputy Byrne to the review of progress in respect of implementation of the drugs strategy. A number of actions have been taken by the Department of Education and Skills in terms of the various programmes and the provision of training. The Deputy might like to have a look at that review, a copy of which I will circulate after the meeting. There has been good performance on that front. Deputy Byrne also expressed concern in regard to the drugs task forces. I am currently reviewing the role of the drugs task forces in respect of accountability and clarity of their role in terms of oversight of the projects they sponsor. There are 24 drugs task forces who between them run approximately 460 local projects. Many of those projects are breakfast clubs, after school homework clubs, drugs awareness at community level, community drug treatment services and so on. A lot of valuable work is being done in those projects. We need better evaluation to ensure good standards are in place. This will be part of the evaluation to be carried out.

There are real strengths in having this type of local response to the drug problem in areas where there is greatest prevalence. The local drugs task forces are in the 14 most disadvantaged areas, in terms of the greatest use of heroin in particular. The local drug task forces provide a local forum for the community, voluntary sector, statutory agencies and, in many cases, public representatives to work together to address the local problem in a meaningful and constructive way. I am examining the composition of the drugs task forces. I would like to see public representatives playing a greater role in the drugs task forces. There are two drugs task forces in my constituency. The Ballymun drugs task force, which is very successful, has always had active participation from the three local public representatives in that area. It is a pretty good model. I encourage members to get involved in their local drugs task forces. The drugs programme is so diffuse and diverse that we need that type of locally tailored response. Agencies at national level must also do what they are supposed to be doing. The structure that exists, in terms of the oversight forum, provides this.

There is often confusion between groups working under the banner of the drugs task forces and those that are community development projects, partnership companies and so on. It is important to distinguish between the work of the different sectors. There are concerns about various aspects of the different schemes. We are currently examining those to ensure coherence and a better level of accountability in that regard. I would be nervous about tarring all community bodies with the same brush. We need to acknowledge that there is now greater accountability and evaluation in that regard. We must distinguish between those that are good and those that could be much better.

The Rialto clinic was referred to. The early morning clinic has had to be dropped owing to withdrawal of GP services. Three other sessions per week are being operated from that centre. It is hoped, in the case of the early morning session which facilitated people who are working, that a local GP will take on provision of that service. A number of members, including Deputies Conway and Byrne, asked about the Rutland Centre and expressed concern in relation to medical cardholders. The HSE has advised the Department of Health that there have been no changes in the funding arrangements or policy in this area. As far as I understand it, the issue arises because there has been a reduction in referrals. There has been no change in policy in respect of medical cards. There has been a reduction in the number of referrals, which may be as a result of the opening up of alternative facilities. As it stands, the Rutland Centre has not been in contact with the HSE regarding this matter. The HSE will be happy to discuss the matter with the centre, if contacted about it.

As regards the composition of the group within the Department, the group was established following a commitment in the programme for Government that there would be renewed focus on the prevention programmes. The group comprises the Department of Education and Skills, the Health Service Executive and a representative from the Department of Health. The group has held one meeting and another meeting is due to be held. I think I have dealt with most of the issues raised.

Deputy Conway asked about rehabilitation. Mr. Doyle is the rehabilitation co-ordinator in the HSE. We have been talking for many years about the importance of rehabilitation, which provides progression out of dependence on any substance be it heroin, methadone and so on. Rehabilitation and counselling services are critical in this regard. There is a renewed focus on that. It is hoped to roll out rehabilitation opportunities for people as part of keeping the focus on recovery. There is no doubt but that in the past, sufficient energy was not put into rehabilitation. When drugs task forces and treatment centres were initially set up the focus was on getting people into treatment. That was the number one priority. We now need to move towards treatment and then progression. Rehabilitation is critical in that regard.

I thank the Minister of State and her officials, Ms Susan Scally and Mr. Michael Conroy, for attending. I apologise for forgetting to welcome Mr. Joe Doyle and Mr. Brian Murphy from the Health Service Executive. I thank them for attending. The Minister of State has given us a comprehensive and in-depth analysis of the work she is doing. I am reassured that, despite no Minister at Cabinet having responsibility for this issue, she is a strong voice for what we are doing. I welcome the Minister of State's commitment and dedicated work on addressing the drugs issue. We as a committee will work in a cross-party manner with her. The Minister of State has our full support. We look forward to her appearing before us again.

Unfortunately, the issue of alcohol has dominated our discussion this afternoon. We have, as a society and nation, failed in our approach to the use and sale of alcohol. We have glamorised it to the extent that it has now become a major problem in our society. I hope that as part of the deliberation the issue of social media can be considered. It has been used as a vehicle to glamorise alcohol. I will not go into detail but I welcome the commitment, comments and approach to the issue. The committee will welcome the witnesses back at some date in the future to discuss alcohol and other issues under their brief. I thank the delegation for coming before us.

I welcome the members of the national advisory committee on drugs, with chairperson, Dr. Des Corrigan. I also welcome Dr. Eamon Keenan, Ms Joan O'Flynn, Dr. Justine Horgan and Ms Mary Ellen McCann to the meeting and thank them for their patience in waiting. We have learned today that we can have too many people before us at once. That is a valuable lesson from our perspective.

Before Dr. Corrigan begins, I remind people of the standard procedures regarding privilege. Witnesses are protected by absolute privilege in respect of the evidence they are to give this committee. However, if they are directed by the committee to cease giving evidence in relation to a particular matter and they continue to so do, they are entitled thereafter only to a qualified privilege in respect of their evidence. They are directed that only evidence connected with the subject matter of these proceedings is to be given and they are asked to respect the parliamentary practice to the effect that, where possible, they should not criticise nor make charges against any persons or entity by name or in such a way as to make him, her or it identifiable. Members are reminded of the long-standing parliamentary practice and ruling of the Chair to the effect that members should not comment or criticise or make charges against a person outside the House or an official either by name or in such a way as to make him or her identifiable.

Dr. Des Corrigan

I thank the committee for the invitation to brief members on our work. As we have indicated in the written submission, we were established in July 2000 to advise the Government on the prevalence, prevention, treatment and consequences of problem drug taking, based on our research and other research available to us. We also look to identify gaps in the knowledge base surrounding problem drug taking in Ireland. Our mandate has been renewed twice since 2000, once in 2005 after an external evaluation and again in 2009 in the context of the 2009 to 2016 national drugs strategy. Our mandate expires at the end of December this year.

We have a multidisciplinary membership appointed by the Minister of State with responsibility for the drugs strategy. It comprises academics, such as Dr. Mary Ellen McCann, the vice chairperson, who is based in UCD. I am a former academic based in the school of pharmacy in Trinity College. We also have statutory representation from the Garda, the Health Research Board and the Health Service Executive, HSE. Dr. Eamon Keenan is a consultant psychiatrist with the addiction services within the HSE and the chair of our treatment and rehabilitation sub-committee. We also have representation from the voluntary, pharmaceutical and community sectors, as well as relevant Departments, including those dealing with education, health and justice.

Over the years we have tried to achieve a balanced approach to all the different aspects of the drugs phenomenon. We have tried to address prevalence issues, as required, as there is a national commitment to provide information to the EU drugs agency, the European Monitoring Centre for Drugs and Drug Addiction in Lisbon. We are responsible for two of the five key indicators regarding drug prevalence, the general population survey and the overall number of problem drug users. In the prevention area, one of the recent key elements has been a study on risk and protection factors for substance use in young people, which compared a group of early school leavers with a matched group from the same geographical area of young people still in school.

Another flagship programme has been the research outcome study in Ireland evaluating treatment, ROSIE, where the researchers on our behalf followed up over 400 people as they entered treatment for opiate addiction over three years, considering outcomes from the process. The outcomes in the case were comparable or superior to some of the international studies, such as those in Australia and the United Kingdom, with regard to retention in treatment. That is one of the key indicators of success for treatment outcomes, and the levels were far higher for Ireland - particularly for methadone - in comparison with Australia and the UK. We put this down to the availability of local services, which echoes the point made by Deputy Byrne about people having to travel for methadone. It is a crucial lesson from the study.

The ROSIE study is an indication that everybody gains when people are in treatment, as the individual, the family and the community see improvements. The researchers were not able to carry out an economic evaluation on our behalf but the fact that our outcomes were comparable to those where economic evaluations were done leads us to be believe figures would be similar. The statistics are remarkably consistent across the United States, Australia and the UK, showing that for one currency unit spent on drug treatment, at least three currency units are saved in criminal justice and imprisonment costs. There is a clear advantage for everyone through the reduction in crime and illicit drug use and improvements generally in individuals' lives in terms of their employment outcomes.

With regard to the future, we will have the first bulletin from the third general population survey on drug use. The Minister will launch that in November. We are still working on the data. What was unusual about the third population survey was that we expanded the questions on alcohol in it in anticipation of having an integrated strategy. One the advisory committee's strong recommendations to the Government about the new drugs strategy was that it needed to be integrated and that we need an alcohol and other drugs strategy. There will be a separate bulletin on alcohol and we anticipate that it will be published early in the new year.

The other different aspect of the population survey this time is that, in recognition of the quality of the work we do on the survey, the monitoring centre in Lisbon commissioned us to pilot questions that would, through the survey, measure the level of cannabis addiction and dependence. It will be interesting to see the results from that.

On 18 October there will be a seminar on the impact of parental drug use on children. This is based on desktop research that was conducted in-house. The seminar will bring together the child services to examine how they can look at and address the impact of the parents' substance misuse, both illicit drugs and alcohol, on the children with whom they are dealing and the drug services, and to examine how they can work with the children of the parents with whom they are dealing. It will examine some of the gaps in our knowledge about that. Again, in terms of anticipating the integrated strategy, that seminar is being co-sponsored by the NACD, the HSE social inclusion section and Alcohol Action Ireland. We are fortunate that two Ministers will be involved, Deputy Róisín Shortall, to give the drugs perspective, and the Minister for Children and Youth Affairs, Deputy Frances Fitzgerald. We are looking forward to that. It is a new initiative for us and we believe it has great potential to make a difference in how the services work and network together for the benefit of children.

I have probably said enough. If members of the committee have questions, we will be delighted to answer them as best we can.

I was interested to hear from the group and I have read the material the witnesses sent to us. I agree about local services. The Minister commented about the local drugs task forces and the national drugs task force. I was not criticising them but there are many organisations in the community and the work they are doing must be properly assessed. There is duplication in communities, with people bumping into each other, as it were. I believe the services that can be provided locally best serve the people who are at risk. There is no point asking people to take a half hour bus journey to get what they require. It also takes away from the impact of a community taking responsibility.

Much of the research conducted by the group helps people like me to make comments at various meetings and to judge how things are within the community. I am not an academic or good with figures. My background is in local community work. What I have seen from that work is a lack of education of young people, especially in school. There is a lack in terms of giving young people the confidence to be able to say "No" and the ability to approach and connect with services when things are not great at home. All that is very important at local level.

I thank Dr. Corrigan for his research and work. He mentioned that the committee will expire-----

Dr. Des Corrigan

Our mandate from the Government expires on 31 December but we are, as ever, hopeful that the mandate will be renewed.

I hope it will be too.

I welcome the witnesses. I apologise if they were waiting for longer than they ought to have been.

What most struck me in Dr. Corrigan's contribution was his statement that local services are vital to tackling drugs misuse. That gives us a direction on how we should proceed in tackling the drugs problem. I have a couple of broad questions which I hope he will be able to answer. For several years I have been a member of a child policing committee in the south-west Dublin area. At one of its meetings the Garda admitted that 90% of illegal drugs that come into this country escape the attention of its members. That was approximately a year ago so I do not know whether there has been any increase or decrease in its success. It raises the general question about the best way to tackle illegal drugs. People's views vary from being very hostile to any form of legalising drugs to the opposite view of making them legal and advising people not to use them. Does Dr. Corrigan have any advice in that regard?

I appreciate that the group is a national rather than international advisory group but in its work has it looked at practice in other countries and at whether some other countries have more successful means of tackling the drugs issue? I do not know a great deal about the issue but it has been mentioned to me that two countries, Portugal and Sweden, have had some degree of success. That might or might not be correct but I would appreciate it if Dr. Corrigan could throw any light on the matter.

Does Dr. Corrigan have a view on whether the use of the drugs court should be extended to dealing with crimes related to drugs? If the punishment helps people who misuse drugs to move away from that, it would be a better use of resources than putting them into prison.

Is there a model to measure outcomes rather than throughput of people through services? Given that we have a limited budget, if we are to get serious about tackling the drugs issue in Ireland, we must ensure the money is well spent. This is probably linked to what Deputy Byrne said. We must find out what these services are doing and whether they are being successful in tackling drugs misuse and preventing people becoming involved in it. The social services need to get better at measuring the outcomes of a service as opposed to how many people attended the service. Is a model being developed to examine that? If so, perhaps Dr. Corrigan will tell the committee about it.

On the issue of drugs misuse and how it should be considered, the committee was given a presentation last week which suggested that we should look at drugs use and the people who use drugs not necessarily from a criminal justice point of view but from a health point of view. What is Dr. Corrigan's view on that? There is the issue of including alcohol as part of the national drugs strategy. There was a reluctance in some quarters to have it included but we have included it. Given the discussion we had with the Minister of State, Deputy Shortall, we are aware we have a major problem with alcohol and would like to hear the approach of the national advisory committee on drugs to this.

Dr. Des Corrigan

Neither of the two issues raised by Deputy Dowds have been discussed at the NACD so I cannot speak on its behalf, especially about the drugs court. The legal status of different drugs has never been a priority for us at any stage. The NACD perspective on it is that in the population survey, we asked people whether they think people should be permitted to use cannabis for medical reasons and 70% of those surveyed agreed or strongly agreed. They were also asked whether people should be permitted to use cannabis for recreational purposes and almost exactly the same percentage disagreed. That is the only point I can make on legal status.

We do not know what the figures might be in the present survey; we have not seen the data. There was a hardening of opinion between 2002, the first time we did the survey, and 2007, the last time before the survey that has just be completed.

We are aware of the proposal to extend the geographical area of the drugs court but whether there is a case for extending it to those under 18 is worth investigating, and to divert people to treatment instead of incarcerating them. Dr. Keenan, the chair of our treatment committee, could talk about the outcomes mentioned by Deputy Conway.

Dr. Eamon Keenan

Dr. Corrigan mentioned the ROSIE - Research Outcome Study in Ireland Evaluating drug treatment - study that we commissioned. It is one of the major pieces of work the NACD has carried out. We were keen to look at different types of treatment modalities and the impact they would have on people's lives. As part of that study, more than 400 people were engaged in the process initially and then followed up at one year and at three years. It was a longitudinal study that looked at outcomes, using an instrument based on the Maudsley addiction profile, which looks at a number of domains in a person's life, including drug use, health, both physical and mental, involvement in criminal activity and family engagement. These are broad parameters of outcomes.

We were heartened by the high follow-up rate. These studies have been carried out in other countries and we had a much higher follow-up rate for the ROSIE study than other comparable studies. There were significant reductions in drug use at one year and this was maintained at three years, not just for heroin use but also for polydrug use. Benzodiazepines remain a problem, which was highlighted in the outcomes. There was a significant reduction in criminal activity and significant improvements in family life. From that point of view, in terms of treatment, we could confidently say the research shows treatment works and the outcomes for those individuals who participated significantly improved.

We were surprised at mixed results in some areas, particularly under the physical and mental health headings. On the surface one would think there would be significant improvements over time, but those results were mixed, and that bears further evaluation. We found there was a cohort of individuals within the study population who did not progress as well as we would like. That is why we on the treatment rehabilitation subcommittee are now examining the rehabilitation options for individuals. It is all very well to engage in a treatment process, get drug use stabilised, be reduced in criminal activity and have family circumstances improve, but we want to see an overall improvement that can only come about through rehabilitation. We have worked hard on looking at international literature on rehabilitation and hope that we will be able to commission a study next year to look at outcomes of rehabilitation and the models of rehabilitation that would be best used.

We are now in a situation where HSE expenditure is being looked at and it is vital that any expenditure is justified by outcomes. Outcome and the use of regular research instruments should be part of any service that provides input into drug or alcohol users. Simple questionnaires and following up on them demonstrate the benefits of input and the outcomes are visible. That must be part of all drug treatment services. This is an area groups like HIQA would be interested in.

The Chairman mentioned alcohol and we sat through some of the discussion on the topic. I was heartened to see the level of support from Deputies on addressing the issue of alcohol. For too long it has been ignored. I have been involved in the area for a long time and for many years drugs received significant input in terms of development of services, financial resources and the mobilisation of community, voluntary and statutory organisations. At the same time, alcohol was sidelined and this new strategy will bring alcohol to the fore. When we went around the country with the national strategy, we saw alcohol is the primary problem for the majority of communities in the country. It would be a shame if the influence of the drinks lobby would water down Government recommendations on a robust response around alcohol, especially in areas of reduction in advertising and sponsorship of sport.

In Dr. Keenan's reply to Deputy Conway he mentioned improved outcomes but did not give any figures. Are there any figures?

Dr. Eamon Keenan

We would be happy to provide the committee with the details of the report. About 29% of those who were engaged in the process were abstinent at the three year period. That showed significant improvement. It was interesting that the improvements achieved in the first year are much the same as the improvements in the third year. That first year of engagement with services is vital for long-term improvement. We will circulate the findings to committee members.

Dr. Des Corrigan

We would be very happy to give the committee copies of the three year ROSIE outcome report that looks at the abstinence modality and the methadone modality in significant detail. It would be important to learn that more people now see dependence and addiction as a chronic relapsing disorder. We should see it in that way rather than as a moral failing on the part of an individual. As we learn more about how the human brain works and how drugs affect it, it becomes clearer that we are dealing with a chronic relapsing disorder and we should see it like that.

Our meeting shows a growing recognition, as the Minister of State agreed, that Government must face up to the issue of alcohol in society. Is there not something inherently wrong when one sees alcohol advertised in the multiples at €15 per case when it costs far more to buy the same number of soft drinks or water?

Dr. Eamon Keenan

I completely agree. Selling alcohol at below cost is merely used as a market leader by supermarkets to get people to come into their retail outlet and buy other products. We must look at below cost selling, the price per unit of alcohol and the specific legislation governing where alcohol can be sold. Should alcohol be sold only in off-licences? Why should one have to walk past alcohol when one goes to buy bread?

Do members wish to comment?

I regret that I missed the first half of the presentation. Having listened to the presentations last week and today, the issues that come up repeatedly are the need to address the availability of alcohol, how young children perceive alcohol and the education programme on alcohol. This makes perfect sense.

In the professional opinion of the witnesses, what blockage is causing the Members of the Oireachtas not to address this issue? Although the Members of the current Dáil and Seanad are completely different from those of the past ten years, the problems and suggestions to deal with them are exactly the same.

Dr. Mary E. McCann

That is the significant question we need to ask. Having listened to the discussion, the issues are about the systems and the implementation of policy. We know from our work that the programmes for our schools are on the right track, follow best practice and have been evaluated as such, yet we know there is patchy implementation. We know we have very good services for children and a children's strategy, but we need to get better at ensuring all our services and systems can cross over and work together. That is the challenge we need to take.

Deputy Doherty is correct when she states that a lot of these suggestions have been around for a long time. It requires all organisations to ask themselves how we need to change to be able to contribute to the improvement of the outcomes for drug and alcohol abuse. It is still too easy to compartmentalise the elements for which organisations are responsible, but when it comes to an issue such as drug or alcohol use, it crosses all those boundaries. For example, under the heading of children, we must think of the health. education and care of children as well as the care of children whose families get into trouble. That crosses different boundaries and that is where our work needs to go. We know from our prevention work that what are needed are not only programmes but also systems that can work together, including the implementation of protocols and agreements that are in our rehabilitation document. That is where we need to go, but it is a big challenge. I do not think anyone has cracked that yet. We talk about inter-agency and multidisciplinary approaches. It happens very well in some places but does not happen very well in others. That is a big part of the answer to the Deputy's question. The other element is that very powerful lobbies are working against prevention policies.

I have been working in the prevention of alcohol abuse for 30 years. During all that time the communities have told us that alcohol abuse is a big issue for them, but the alcohol industry is a very powerful force and can lobby for itself. We need to be brave and to recognise how the impact of those forces can be lessened.

This year we had two important visitors, Queen Elizabeth II and President Obama. President Obama raised a glass and the Queen was brought to a particular establishment. Are we saying those two images will influence a coterie to consume alcohol? I fully agree with Deputy Billy Kelleher's point, and I can take a person to parts of my city where industrial disposal is required to remove the remnants of a weekend of alcohol consumption. The newspapers today have a flyer advertising 20 bottles of beer for €15. Is it being suggested that the lobby group is so powerful that Members cannot say enough is enough and acknowledge our national drink problem?

Dr. Mary E. McCann

Dr. Keenan wishes to respond, but we do have a national drink problem. I think we can say "no".

We do have a problem. Are we saying that the drinks lobby and all its different component parts are so powerful that they have policymakers and everyone else in the pockets - and I use that word in the liberal sense - and that they can influence policy?

Dr. Mary E. McCann

If one thinks of the situations the Chairman cited about the very important visitors and the images about Ireland that went around the world-----

It went viral.

Dr. Mary E. McCann

-----we in prevention work and the alcohol researchers on the health side would say that was not a good thing to happen for Ireland.

I agree with Dr. McCann on that point.

Dr. Mary E. McCann

Yet it happened, and with the blessing of the people who organised the schedule, and it seemed to be important. It is not a good thing for health purposes. It happened for other reasons.

In response to the question that the drinks lobby is so powerful that we cannot say no, certainly for a long number of years the health lobby has been trying to say that we must take on the issues of the identity of alcohol and the connection between the promotion of alcohol and the level of use in Ireland. Perhaps we are closer to taking it on than we ever have been.

Dr. Eamon Keenan

We have a problem and we need to take population health-based approach to dealing with it. It is not just a problem for individuals who consume too much alcohol. I think the message that is being given by certain lobbies of drinking alcohol responsibly minimises the effect that alcohol has in the community. I have teenage boys whom I know are rising me when they say consistently that the best advertisements on television are for drink. They will say they are good, wonderful and fantastic advertisements. They are clever advertisements and the companies have major financial resources to market their products. We should look at other counties that have dealt with this problem. France has banned the advertising of alcohol without any adverse effect, as the alcohol industry has not collapsed. When alcohol advertising is banned, the pervasive influences it can have on impressionable young people can be removed. I sit on the national substance misuse strategy group as a representative of the College of Psychiatry of Ireland. Previously, when I was a member of the steering group for the national drugs strategy, we did not have drug pushers sitting around the table promoting their product. The national substance misuse strategy group has representatives of the drinks industry sitting around the table.

On a personal level, the visits of the Queen and President Obama which were positive for the country were diminished by photographs of them featuring alcohol which were viewed across the globe. I received e-mails and telephone calls from friends living in other countries who were baffled as to the reason for these photo opportunities, especially given the beauty of the country.

I fully appreciate the reason medical professionals may not wish to get into a tangle as to the reason alcohol enjoys such status and has never been reined in here. As a practising politician, I recognise the names of all the medical professionals before us, despite not having met any of them. The only reason alcohol has such status in this country is the lack of political courage shown since the foundation of the State. I do not know if this will change under the current Government, but I hope it will because until now, not a single politician has dared raise his or her voice in opposition to the alcohol industry. This shows how powerful an industry it is.

The Minister of State referred to the review body. I assume the group to which Dr. Keenan referred is the same body. He expressed the position much more eloquently than I could when referring to the presence on the national substance misuse strategy group of two representatives of the alcohol industry. The drinks industry should not have any representatives on the group in question. If I had my way and if this committee has any sense, the individuals in question would be dumped off the group because the alcohol industry has no place on such a body. The United Kingdom also has an advisory body on alcohol. I only read one English newspaper and it reports that the British are about to do precisely what I have just proposed because they accept that representatives of the alcohol industry have no place sitting on a group advising on alcohol. To elaborate on the example used by Dr. Keenan, should I recruit a few pushers in my community? I know some pushers but do not like them. It is bizarre that the alcohol industry should have a say on a health issue.

I will illustrate this point by referring to an event held during a period in which I had the honour of serving as mayor of County Dublin. During that time I attended an awards ceremony in my official capacity to make a presentation to young people who had done great things in sport. I complimented the young persons on the hours they had invested in training and so forth and referred to all the temptations they faced and the fact that we in this country loved drugs. I said they faced temptations such as alcohol and other drugs. When the ceremony was over, a guy in an expensive suit made a beeline towards me - I thought he wanted my autograph - and introduced himself as the employee of a company which I do not propose to name. He then complained about my use of English. Although I knew exactly what he meant, I asked him to explain his comment. He told me I used the term "alcohol and other drugs". At one point he became somewhat heated and I thought he might have a heart attack, but he calmed down when the county manager spoke to him. This is an illustration of the arrogance of the drinks industry which believes it has everyone in its pocket. That is the nub of the issue. It has managed to achieve this objective because it has been highly influential since the foundation of the State. I hope the collection of individuals who make up this committee will perform a good service and help tame the alcohol industry. If we were to achieve that objective, we would make society a better place.

I do not want to be repetitive. I hope the views expressed on alcohol by members and broader society will be taken on board.

On vested interests, despite the simple correlation between road deaths and drink driving, a clear distinction was made between the two for years. Lobby groups such as publicans were taken on very strongly. Alcohol has been clearly identified as a cause of societal breakdown, drug addiction and anti-social behaviour. We all know that this is the case but seem incapable of taking the next leap required. We know smoking is bad for us and have increased the price of cigarettes as part of health policy. We know alcohol is equally bad for society, particularly in large quantities and for young people, yet the price is repeatedly reduced and it is becoming ever more freely available. I cannot understand why this is the case, although I accept that steps were taken in the context of the abolition of the groceries order and removal of the ban on low cost selling. I do not know if responsibility lies with powerful lobby groups. Why does society want to have alcohol available on every street corner?

My main concern is that alcohol is a gateway to illegal substance abuse. We should be under no illusions about the ability of young people to obtain alcohol easily and openly at an early age. Any 16 year old can chance his or her arm and will probably get alcohol in a shop. If it gets into the hands of a 16 year old, it will also get into the hands of his or her peers who may be a couple of years younger. In my community children of 12 and 13 years are regularly drinking alcohol. I am not a puritan, but this critical issue must be addressed. While we can discuss methadone treatment programmes and rehabilitation, that is the key issue.

I am amazed to learn that representatives of the drinks industry have been appointed to the national substance misuse strategy group. Tobacco companies would not be allowed to help draft policy on a health promotion group. The joint committee should take a strong position on this issue.

I do not know whether the photograph taken during the Queen's visit had much impact, given that alcohol is so freely available in any case. That is the issue with which we must get to grips. A long time ago I proposed that the age requirement for purchasing alcohol in an off-licence premises should be increased to 21 years. Perhaps that would break the generational problem of 18 year olds being able to legally purchase alcohol in an off-licence for friends who may be 15 or 16 years old or even in their early teens. It may be worthwhile to examine whether research is available on the use of such a policy elsewhere. I would prefer if people were inside a pub where some control is exercised over the amount consumed.

I congratulate Dublin City Council on the initiative it took last Monday night.

This is coming from a Cork man.

Making the homecoming for the all-Ireland champions an alcohol free event sends a strong message.

I fully concur with the views expressed on minimum pricing, an issue on which I am working. Would it be reasonable to set a minimum price for off-licence sales of, let us say, 50% of the cost of the same products in a pub? The price of alcohol in off-licence premises is much lower than this.

I apologise for my late arrival, but I was attending to business in the Chamber. The greatest problem with drink is what I describe as "beer pressure". When a gang of people get together, they often have nothing to do and the easiest way to relieve the boredom is to buy some drink. Beer is cheaper to buy than water and many believe it is a waste of money to buy water. At least, when they buy beer, they feel like they are drinking something.

It is important to try to get young people in schools involved in sport, drama or another activity because the more time they spend on activities, the less time they have on their hands. It has also to do with the influence of one's peers. I am a pioneer. When attending social events and so on there was such a thing as beer pressure. Nobody wants to be in one's company if one does not drink, in case one might hear and carry certain stories. There appears to be two different types of culture, either one drinks or one does not drink. It is important that we educate young people given the beer pressure. I have no doubt it is the same with drugs. I would like to hear the policy of the national advisory committee on drugs.

Dr. Des Corrigan

To answer Deputy Fitzpatrick, alcohol is not part of our remit as of now. We are hoping, in the context of an integrated strategy, that under a renewed mandate we would be a national advisory committee on alcohol and other drugs. We would then be in a position to advise Government about evidence-based policies. Internationally, it is well recognised what works in respect of alcohol - pricing has been identified as a crucial issue, licensing hours and the availability of alcohol, and drink driving legislation. In the context of Deputy Kelleher's point, when the minimum drinking age was raised in certain states in the US to 21, and an ID card was a necessity to buy it, there was a significant reduction in road traffic deaths. If one is seeking evidence based policies, that is an issue. In terms of the alcohol lobby, we have made it clear that if our mandate was to be renewed and expanded to include alcohol we would not, under any circumstances, want representation from the alcohol industry determining the research priorities on alcohol. That would not be acceptable to me in any shape or form.

Dr. Eamon Keenan

In regard to Deputy Dowds question on pricing, I cannot pick a figure but international evidence shows that pricing is a huge influence in respect of alcohol, as well as availability and age. I direct members of the committee to an excellent piece of work carried out in America by a researcher, Mr. Robin Room, who said alcohol is no ordinary commodity.

In regard to drug laws, are they from a different era? Are they out of date and is there a need for a change in legislation and in our approach to the issue, given that society is taking a different approach? We have banned head shops and did so fairly promptly. Should we change our approach to the whole issue of social media, drugs and alcohol?

Dr. Des Corrigan

As I mentioned earlier in response to Deputy Dowds, that is not an issue that has been identified for us so we do not have a NACD position. In terms of what happened with the head shops we recognise how successful the psychoactive substances Act has been and also the work of the Department of Health in scheduling a whole range of substances under the Misuse of Drugs Acts. I understand that another group of substances is about to be scheduled, subject to EU and Government approval. That is all I can say on that particular point.

I thank Dr. Keenan, Dr. Corrigan, Ms O'Flynn and Dr. Horgan for their interesting presentation and apologise for the length of time they had to wait. We learned a valuable lesson today in regard to the number of groups invited to appear before the committee at any one time. We hope the representatives will return at a later date.

The joint committee adjourned at 2.25 p.m. until 11.30 a.m. on Thursday, 29 September 2011.