Joint Committee on Health and Children debate -
Thursday, 9 Jul 2015

Legal Highs: Discussion

Co-Chairman Deputy Jerry Buttimer

I am Chairman of the Joint Committee on Health and Children. My colleague, Deputy David Stanton, chairs the Joint Committee on Justice, Defence and Equality. I welcome the members of both committees. During our first session we will discuss the case for banning so-called legal high drug stimulants. I welcome Mr. Packie Kelly, project co-ordinator for Teach na Daoine, family resource centre, in Monaghan town and Mr. Tim Murphy from the Cavan-Monaghan drug awareness project. I have known Mr. Kelly for a number of years and worked with him on a couple of projects.

I thank the clerks to the Joint Committee on Health and Children and the Joint Committee on Justice, Defence and Equality for their role in arranging this very important public meeting. My colleague, Deputy David Stanton wishes to make some opening remarks.

Co-Chairman Deputy David Stanton

On behalf of the members of the Joint Committee on Justice, Defence and Equality, I am very pleased that this joint meeting is taking place with the Joint Committee on Health and Children. This is our third joint meeting during this Dáil.

We are looking at the drugs issue from the point of view of the criminal justice system. Recently a committee delegation travelled to Portugal to examine the Portuguese model. Portugal has adopted a very interesting approach in that it has moved from looking at the issue from a criminal justice system to a health viewpoint. It treats addiction and the use of small amounts of drugs as a health and education issue. We are exploring this idea to see whether we should adopt a similar approach in Ireland. It would have the advantage of diverting Garda resources and time away from the courts. It would also mean that young people would not have a criminal record. They might be dissuaded - the word used in Portugal - from going down the path towards further use of illegal drugs.

We are inviting public submissions. The relevant information is on our website and the closing date for receipt of submission is 7 August. We hope to liaise with the Joint Committee on Health and Children and engage in further joint consultation and discussion when submissions have been received. We look forward to our engagement this morning and further engagement with the Minister of State, Deputy Aodhán Ó Riordáin, on the policy in this area.

Co-Chairman Deputy Jerry Buttimer

The purpose of this morning's session is to hear evidence on the impact of so-called legal high drug stimulants on communities. The committees are meeting jointly for the first time in accordance with Dáil Standing Order 84 and Seanad Standing Order 72. I again thank the Joint Committee on Justice, Defence and Equality for facilitating this important and historic meeting.

Deputy Caomhghín Ó Caoláin who invited the representative of the Cavan-Monaghan drug awareness project to come is, unfortunately, tied up in the Dáil asking questions of the Minister for Health. He sends his apologies, but he will be here as soon as he can.

Should those watching and listening to the proceedings at home wish to make representations to us on the issue, they can do so through our e-mail address which is available on the Oireachtas website.

I wish to advise witnesses that by virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of their evidence to the committee. However, if they are directed by the Chairman to cease giving evidence on a particular matter and they continue to so do, they are entitled thereafter only to 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 are asked to respect the parliamentary practice to the effect that, where possible, they should not criticise or make charges against any person or an 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 they should not comment on, criticise or make charges against a person outside the Houses or any official by name or in such a way as to make him or her identifiable.

Apologies have been received from Senator Imelda Henry and Deputies Eamonn Maloney and Ciara Conway. The Co-Chairman, Deputy Stanton has also received an apology from a member.

Co-Chairman Deputy David Stanton

Yes, from Deputy Gabrielle McFadden.

Co-Chairman Deputy Jerry Buttimer

I invite Mr. Kelly to make his opening remarks. Before he does so, I remind members and the witnesses to ensure their mobile phones are turned off.

Mr. Packie Kelly

I thank the members of the committee for this opportunity to present the findings of the report we have carried out in Monaghan. I would also like to thank my colleague, Mr. Tim Murphy, for coming along today. As the Chairman stated, Teach na Daoine Family Resource Centre is one the national programme of family resource centres which is currently funded by Tusla, the Child and Family Agency. We had this report in mind as during recent years we were contacted by numerous people seeking support who were facing drug addiction issues and a range of difficulties accompanying those, both psychiatric and other illnesses. We were not sure what was happening within the community in the early days. Unfortunately, today we are mindful that in a very small community of only 170 houses we have lost two of our young people, young P.J. McQuaid and Michael Power, in a 12-month period as a direct result of the synthetic cannabinoids. We are very mindful of their families in Monaghan town.

After those events, a number of public meetings were held at which a huge outcry and frustration was voiced in the community of Monaghan town about how we would tackle this issue and try to solve the problem. As a result of that, the Teach na Daoine Family Resource Centre decided to embark upon a short piece of research, the outcome of which is this report, to gather evidence on the extent of the problem not only within the area of Teach na Daoine but the wider area of Monaghan. We were getting anecdotal evidence that this was the number one drug of choice within the county of Monaghan, that it was becoming a serious problem and more people were surfacing with a range of needs. Thankfully, we got some support from Tusla, the Child and Family Agency, and the HSE and we also got expertise from Cavan Monaghan Drug Awareness Project and we put together this report. Unfortunately, it makes very stark reading. This is a very difficult problem. It is compounded by a number of issues that are affecting our community. They range from the services that users and their families will need and difficulties around the legislation on this area. We are facing a difficult problem. It seems to be escalating. Those are the difficulties we face.

I am not going to read the brief that has been provided to members but the report touches on the key issues, namely, awareness of harm and consumption of these products. They are know locally as "herbal", which is a terrible name because any herbal products carry the connotation that they must be good for us but, unfortunately, that is very much not the case with these products. They have many negative consequences for users and also for the community because they cannot understand the uncertainty surrounding the legality or illegality of these products.

We want to give the members as much information as possible. We have brought along information cards that have been given to families and I will circulate them to members. Probably the most important item we have is the wrappers these drugs come in and I would also like to circulate those to the members. They will note that they way they are packaged and marketed shows that they are clearly targeted at the very young market. Our survey has highlighted that children as young as 13 years of age are using these products and the oldest user, of whom we are aware, is in their early 40s. Unfortunately, these products are freely available.

With regard to the marketing of these products, they are called "Joker", "Juicy Fruit", "Clockwork Orange Loaded" and we found a new packet on the market only yesterday that is called "Volume 2". From a chemical composition, we suggest they contain all the same things, namely, synthetic cannabinoids. The newest version we found on the street yesterday has the exact same kind of compound. It is causing a wide range of difficulties for children and their families. The scale of the problem is escalating as we find that a range of people are accessing our family resource centre every day seeking support.

From the service point of view, the growth of this problem has compounded matters as it is impacting on a number of areas. People are behaving in an extremely psychotic way and they may not have a mental health diagnosis. It is quite difficult from a service point of view to work out the treatment to provide. One of the recommendations in our report is to create a separate path where a detoxification unit could be accessed by high-end users of these products. Unfortunately, in Monaghan town and county, these products are the number one drug of choice. Their availability is quite unbelievable. The report refers to the issue of drug tourism. One can go across the Border to the North and buy these products in a joke shop. They are sold as incense products. If one has an address in the North, one can order these products in large quantities, 100 bags at a time, on the Internet and bring them across the Border where their legal status is somewhat grey. The issue is further compounded with Monaghan's proximity to the Border and these products being openly available in the North.

Our community has faced a number of difficulties. They are outlined in the report, which is an attempt to seek the support that is required. There are key recommendations in the report. It is a short piece of evidence. We are very thankful that nine users were very honest and truthful in telling their particular stories. It seems clear that high-end users are afraid of coming off these products because one of the deaths was related to a young person struggling to come off them. One seems to go to a very dark place in trying to do that and, unfortunately for that young fellow, it ended in suicide. Many people who are on these products and wish to come off them are terrified about trying to do that on their own. The expert advice suggests that one should not do this on one's own as it is very dangerous to do so. That is a very small snapshot of where our community is at in dealing with this issue. We will field any questions members may have.

Co-Chairman Deputy Jerry Buttimer

Does Mr. Tim Murphy wish to make any remarks to the meeting?

Mr. Tim Murphy

I would mention the issue of the legislation.

I understand that even perfect legislation will not necessarily solve the drug issue. As was pointed out, investment in treatment services is what will produce change.

As far as I understand, the difficulty with the legislation and the reason it does not appear to be working is because the laboratories are having difficulty demonstrating that these substances are psychoactive. My perception is that they are only able to compare new psychoactive substances against lists of controlled drugs. It is difficult for a laboratory to say with any degree of confidence whether a new substance is psychoactive in effect. The only way we can determine if something is psychoactive is through observable effects. A key recommendation I would make today would be for other evidence to be taken into account when classifying and cataloguing new psychoactive substances, for example, evidence from accident and emergency admissions, psychiatrist and pharmacologists.

Co-Chairman Deputy Jerry Buttimer

I should have also mentioned there were apologies from Deputy Kelleher, who is in the Dáil Chamber. I welcome Deputy Ó Caoláin to the meeting. I mentioned earlier that he was in the Chamber but that he had made a request for the committee to discuss the Cavan-Monaghan project. Perhaps, in the absence of the Fianna Fáil spokesperson, Deputy Ó Caoláin would like to contribute now.

Deputy Caoimhghín Ó Caoláin

I apologise to both our guests here this morning for not being here to hear their full contribution. However, I read my copy of it in advance of this meeting. The clash between the timing of this committee's sessions and parliamentary questions to Ministers has irked us for a long time.

This is not an abstract issue, but is about people. Once again, speaking on behalf of my entire home community, I extend sympathy to Sharon McQuaid and her family on the tragic death of her son, P.J., and to Michael Power and the Power family on the sad passing of his son, Michael junior. This is the reality of the presence and ever-growing threat represented by so-called legal highs. Our community has been severely hit, not only with the tragic loss of two young lives but by the fact that many other lives have been significantly impaired and seriously affected. This was demonstrated in a recent television interview and has been graphically outlined in the report commissioned by Teach na Daoine. I understand copies of that report will be circulated to members before the conclusion of today's session. I commend Teach na Daoine on its initiative and its support for not only the immediate community it serves but the wider community in Monaghan whose interests it has always sought to represent.

It is vital that members not just of the Joint Committee on Health and Children but also of the Joint Committee on Justice, Defence and Equality inform themselves on this issue and collectively impact on Government consciousness in regard to the threat presented by legal highs. We will have an opportunity to hear and question the newly appointed Minister of State with responsibility in this area, Deputy Aodhán Ó Ríordáin, shortly. I wish him every success in his new role and responsibilities. We would urge that one of the first things he should do is inform himself in regard to any deficiency in the legislation to ensure there can be no question or doubt on the part of the Garda or the wider community as to the effectiveness and efficiency of existing legislation. We also urge that he takes the required steps to amend legislation as required to properly combat this substance threat.

The Criminal Justice (Psychoactive Substances) Act 2010, which saw the demise of the head shops, clearly has loopholes that allow for modified and re-modified substance manufacture and marketing. The efforts in evidence in my community are geared towards a particular profile of young people and the opening statement from Packie Kelly indicates the profile of the users. That profile is a particular cohort of people in every one of our communities who are clearly at risk. This is not only a County Monaghan or a Cavan-Monaghan issue. It is an issue of concern throughout this State and island.

I have a few questions in regard to mental health services, for young people in particular. I understand there is some difficulty in this regard and that the mental health services will not deal directly with a young person presenting with substance abuse, either its side effects or active use of legal highs. Their position is that this abuse in some way disguises what might be underlying mental health issues. It is important we give some attention to the point made in the presentation about compounding difficulties in securing treatment for young people. This issue must be examined in tandem with an evaluation of the legislation's fitness for purpose. Will Mr. Kelly and Mr. Murphy explain the situation in regard to the relationship with local gardaí? What do they feel are the difficulties in regard to the Garda facing up to and presenting a serious challenge to the proliferation of these products? Will they expand on the difficulties there are in securing access to and support from local mental health services?

Deputy Dan Neville

I welcome Mr. Kelly and Mr. Murphy. I find this extremely interesting, because I was unaware of this development. When the witnesses say this drug is freely available, what do they mean. Is it is in shops or where do people get it?

Co-Chairman Deputy Jerry Buttimer

We will get back to the witnesses for a response when questions are completed.

Deputy Dan Neville

Where do people get this substance? We know the sale of illegal drugs is underground, yet they are freely available. However, the impression given in regard to these drugs is that they are perfectly normal and without side effects. This is obviously not the case. Has research been done in other countries into these products? Our witnesses are based near the Border, but what are the implications in regard to controlling the sale of these drugs in this regard, particularly if the Minister responsible needs to make an urgent response in this area?

I believe Cavan-Monaghan has one of the best mental health services in the country, especially in community mental health services, and it is often held up to other parts of the country as an example of how to improve. I recognise that no system is perfect, but I acknowledge the excellent community health service in Cavan-Monaghan.

This is one of the products. How many products are there? I will leave it at that.

Senator Jillian van Turnhout

I join other members in thanking Mr. Packie Kelly and Mr. Tim Murphy for their presentation and in thanking Deputy Ó Caoláin for suggesting they appear before the joint committee. On reading this report, this is a new area for all members but as members of the Joint Committees on Health and Children and Justice, Defence and Equality, it is important that this issue be examined and grasped and that members give consideration to what they can do. On listening to the presentation, I have a specific question. Mr. Kelly mentioned the term "young people", which can have a wide meaning in certain ways. I seek greater understanding of the profile of the type of young people concerned. Is it socio-economic or what is the age profile? I ask to enable me to understand, because it is a new area. On examining the materials and packaging the witnesses circulated to members, some of it certainly is aimed not even at teenagers, but at very young people. As for the report produced for Teach na Daoine by Dr. Marie Claire Van Hout and Evelyn Hearne, I opened one page on which there was a quote from a participant in one of the case studies stating:

There’s also child protection issues, very young children and their parents are taking this stuff, they’re exposed to this stuff, and they’re walking around picking it up off the street. Sometimes parents and children are fighting over it. Fighting over who needs it the most.

As one of the children then even went on to ask, "How do you expect me to report my mommy and daddy?", there also is an intergenerational aspect. I wish to try to understand better, in order that I do not leave the meeting misinformed. In the specific recommendations made, I note Mr. Kelly called for increasing local sports partnership activities. What of the youth work organisations' activities in the area and the funding thereof because drastic cuts have been made to those areas and perhaps this is an area that should be examined? Mr. Kelly mentioned clinical awareness. What engagement does Teach na Daoine have with the formal health services? Obviously, it is positive that it is getting funding from Tusla, the Child and Family Agency. What engagement does Teach na Daoine have on a clinical level? On the interagency side, is there an issue with regard to dual diagnosis, that is, looking at the mental health issues? While I have not seen it yet, I am merely trying to wade through this report, which was handed to members as the meeting began. Consequently, I would be interested in being apprised regarding the mental health issues and the correlations.

Co-Chairman Deputy Jerry Buttimer

I thank the Senator and will hand over to Mr. Kelly to respond.

Mr. Packie Kelly

I thank the Co-Chairman and we will do our best to field all those questions.

Co-Chairman Deputy Jerry Buttimer

As other members also have indicated, I will come back then after Mr. Kelly has responded.

Mr. Packie Kelly

First, I wish to deal with the issue of the Garda, which was raised by Deputy Ó Caoláin. Certainly, in talking to local members of the Garda, they are as frustrated by this issue as is the community. As there appears to be a degree of greyness around the current legislation as to whether they are able to charge people, I believe they are quite frustrated with it. As for the Garda's level of knowledge with regard to availability, this also is within our report, the availability of this substance is that it is easily purchased in the North, where it currently is legal. The BBC programme in which we participated recently highlighted issues whereby the United Kingdom is trying to bring forward legislation that would effect a total ban on this and they were examining existing Irish legislation to ascertain whether that current ban is effective. It certainly showed up anomalies within the current Irish legislative system that allows stuff like this to be legal as such.

In respect of the mental health issue, we certainly have had experiences of young people presenting themselves, either to accident and emergency units or to the mental health service, in a highly psychotic state. The difficulty is that it is not until those young people come off the drugs and are clean, for want of a better word, that the mental health services then can diagnose and confirm the person in question has a mental health difficulty which the service can treat. Consequently, it really is a chicken-and-egg position as such for the mental health services. I hope I have answered the Deputy's question with regards to availability. What one can do is to purchase this substance on the Internet if one has an address in the North and, as stated earlier, one can purchase 100 or 200 bags. Then, if one is a dealer, one gets one's runners or one transports it oneself across the Border-----

Deputy Dan Neville

Is it in shops?

Mr. Packie Kelly

It is in joke shops, other incense shops and health shops in the North. It is sold openly at a local market that is just across the Border in County Monaghan. The going rate one pays for it is €7 and one sells it on the street at either €10 or €15.

Co-Chairman Deputy Jerry Buttimer

It is €7 for this package?

Mr. Packie Kelly

Yes. That is the purchase price, while the street price ranges anywhere from €15 to €20. I think I have touched on the point regarding the legal stuff.

To respond to the Senator's point, our age profile is in the range between 14 and 43 or 44 year olds. The socio-economic profile is such that most of the users have a range of socio-economic difficulties such as no formal qualifications, an unemployment history and addictions to other issues. In respect of the youth work, which is an important point the Senator also raised, the only people within the area who are carrying out any youth work are attached to the family resource centre because of the cutbacks to other youth organisations. Within Teach na Daoine's area, it is the only organisation which is doing this. There is the Garda youth diversion project but again, as members will be aware, one may already have committed an offence or have been on the verge of committing an offence before one gets access to that. Perhaps, if it is all right with the Co-Chairmen, to fill up some of the gaps, I will ask Mr. Tim Murphy to respond to some of the questions asked.

Mr. Tim Murphy

As far as the Garda is concerned, I believe that samples have been seized and sent away in earnest. My information, after a couple of queries, going back to November 2014 is that the results coming back from the laboratories stated it was not a controlled drug, which I believe may be answering a different question from the one being asked. Again, one can see how, despite the Garda taking a problem seriously, it is unable to bring a successful prosecution. I think Mr. Kelly outlines the age profile well. Predominantly, we are seeing young males between the ages of 18 to 25, all presenting with serious mental health-type symptoms such as paranoia, suicidal ideation or depression. The difficulty for us as a support service is they often are so affected that they are unable to engage with counselling in any meaningful way and what they probably actually require in many cases is inpatient treatment and for the symptoms to be managed symptomatically by mental health services in an acute setting before they would be able to engage with addiction support services in a structured way.

As for the range of substances extant, I believe a Home Office report was issued in 2013, which I think has been well summarised by an organisation called Drugwatch, which published an article in 2014. Its findings were that there were more than 80 different synthetic cannabinoids available on the European market at that time and that there was potential to make hundreds more by relatively easy manipulation of the production process.

In respect of the mental health services response, the difficulties go back to the A Vision for Change document, which clearly stated that stand-alone addiction problems should be outside the mental health services. In my opinion, the presenting symptoms are so serious - as Mr. Kelly noted, in many cases we are dealing with psychosis and serious suicidal ideation - that there must be at least a short-term response, probably in an inpatient setting. Without going into detail, in one case with which we are dealing, we have someone who has been referred to our service. The person ended up being admitted to acute psychiatric services on an inpatient basis, only to be released within a few days when the symptoms had abated somewhat. However, because the person does not appear to be past that critical withdrawal period, and these substances are highly unusual in that there appears to be a withdrawal syndrome, the person turns to alternatives very quickly and is constantly bouncing back into the accident and emergency units, the general practitioner and those kinds of services. We have also had recent uncorroborated reports, although I have seen availability of the Internet, that the products may be becoming available in vaporiser form for e-cigarettes.

That would be another particularly worrying development if it becomes widespread.

Senator Colm Burke

I thank the witnesses for their presentation and the work they are doing in a very difficult area. Their work is of help to a lot of people.

Have we any idea of the percentage of young people availing of this drug, although I presume we are talking about any age from 14 or 15 up? I presume it is an illegal high. Is it spreading by word of mouth within communities or are people actively promoting it and making money out of it?

On education, I note Mr. Kelly's presentation stated that three of the user participants were educated to junior certificate level, two only to primary school level, and one to leaving certificate level. In view of the fact that some people did not go beyond primary school, how can a message be gotten across to that group? I have worked in projects in Cork and have found that many people drop out of school because there is no parental support. What is the best way of trying to get the message across of the dangers of using these substances? Is there anything new that can be done to move people away from using these drugs? I know it requires a collective approach.

Deputy Sandra McLellan

I thank the witnesses for their presentations and commend the work they do. It was stated that when someone presents to the mental health services with symptoms, he or she is not dealt with directly if he or she is using legal highs. When this happens, where are those people sent? Is any comparison available with how people are treated in the Six Counties?

Deputy Finian McGrath

I welcome the group. One of the recommendations is to review cross-Border policing approaches in order to address drug tourism. Based on the evidence, is that a two-way flow? Are the drugs coming from the South or from the North?

Deputy Catherine Byrne

I thank Mr. Kelly and Mr. Murphy for their presentations. This is one of the best ideas I have seen in a long time. The whole issue of herbal drugs is something I would be familiar with in my own constituency. I am glad to hear that the HSE and Tusla have helped to produce a document. I have not had a chance to read much of it at this stage, but the information card is very important.

I remember that when the drugs problem was at its height in the inner city, a small group of parents came together to organise groups and information sessions highlighting the drugs issue to young people. The problem is right across the country, in every corner of every town and outside the towns. Herbal highs are very attractive to young people, in particular, and they are marketed very well.

We have just gone through a whole rigmarole with cigarette packaging and we are going through the process of introducing minimum pricing of alcohol. Looking at the price of this drug on the street, €20 would buy 20 bottles of beer rather than one package of the drug. Where are young people getting the money? Has crime increased in the area? Have there been more break-ins and burglaries? Anywhere we see people hitting hard on drug, we will get the bounce-back in criminal activity. Unfortunately the users themselves often turn to criminal activity to fund their own personal use, which is very sad.

I did not read the community-based study because I did not have time. The one thing that struck me from what I read was the line from one of the participants that "[t]here's only one way of getting off herbal and that's taking yourself out of this life." For me that is very stark.

What has been done to educate parents on this? As parents, we live in a bubble and think our children are far beyond doing anything wrong. On the ground in communities, there are opportunities to bring parents in through schools, local groups or the family resource centres.

What happens to the people the witnesses have met on the street and in the resource centre, who have given their sad and poignant stories? What do we do with people like that? What channel can they be put into? Is there a detox programme for them and, if not, why not? Our job here is to listen to the witnesses and to try to find some solutions to help their work.

Senator Ivana Bacik

I am a member of the Joint Committee on Justice, Defence and Equality and "herbal highs" is the more correct term in the sense that these are not legal highs in this jurisdiction. Is that right? The report said there is a lack of clarity regarding the substances' legal status. I wanted to clarify that. Did the witnesses mean that people who are taking them are not necessarily clear as to whether or not they are legal in the Republic? Different laws apply in the North, where the substances are obtained. To describe them as legal highs here is, I think, incorrect in legal terms, is it not? The legislation banning psychoactive substances would presumably apply to at least some of these products but there is a question mark over others. Are the witnesses advocating any particular change to criminal justice law in this jurisdiction?

Mr. Packie Kelly

We will try to field as many questions as we can. I thank the members for their questions.

On the issue of availability, the substances can be purchased on the Internet and there are numerous dealers. We have knowledge of about eight dealers within Monaghan town from whom people can freely buy the drugs. When members get time to peruse the report, they will read about the way herbal is advertised. People come into the area in their cars playing very loud music. One participant said it is like the ice cream van. Everyone knows the dealer has arrived.

The age profile of users is 50:50. There are children as young as 14 and some people in their early 40s. While our small study covers Monaghan town, I was glad to hear Deputy Byrne saying the problem is everywhere. It certainly touches every aspect of life in County Monaghan. This is not just a Teach na Daoine or Mullaghmatt Cortolvin issue. Herbal highs are widely available in Monaghan town and in the small villages throughout the county.

The issue of accident and emergency services and what happens to young people was raised. To be fair to everyone, no one knows how to deal with the symptoms of this issue.

What the experts would say is: "We do not know what is in this stuff, so we do not know how to treat someone." The real difficulty for us in the family resource centre with limited resources - although by no stretch of the imagination would I wish to dramatise this - is that on a daily basis we are afraid that once the person who has come in and sought some resource from us, or just some chill-out time, leaves the centre, they may not be back. There is certainly talk within the community of who is going to die next. That is the level of substance use that exists. People are afraid that another person within the community may die as a result. It is a very difficult issue for a family resource centre or even for an addiction service such as that in Cavan-Monaghan to deal with this issue, as there are many layers to it and it is compounded with many difficult problems, not to mind access to the services or the legality of the issue. We have asked the experts about this because, like the committee today, we are learning in regard to this issue. We asked them what is the equivalent of this problem, and they said it was the equivalent of crystal meth. Given the international experience in this regard, that really hits hard. They say that users who use crystal meth only use crystal meth. In Monaghan, users who use this do not use any other substance. Current users of this would previously have been abusers of alcohol, but they have stopped. I said that in the report. They say, "Forget about alcohol; alcohol does not count any more. This is the stuff." This is the stuff that puts them in a place where they unfortunately want to go.

Mr. Tim Murphy

One of the questions was about where the service users go after they present to mental health services. The answer is to the other community services, such as ourselves, the Cavan-Monaghan drug awareness project, and Teach na Daoine. The issue is that they are not properly equipped to deal with the problem. They present with symptoms so serious that often they require inpatient treatment. Because we cannot get them past that critical withdrawal period that I described earlier, they are discharged quite quickly after being admitted to acute services, and they return to using the drug just as quickly. Clearly, trying to provide a counselling and support service to a person who is in an awful mental state is not the correct approach. In terms of prevention and education initiatives, the leaflet we produced was made because that is what we are currently resourced to produce. As to what education needs to be provided, it needs to be a solid evidence-based approach, possibly delivered through social, personal and health education in schools. I think that is the only way it can be done in a structured and widespread manner.

We have certainly conducted educational initiatives through talking to parents and young people whom we know to be at risk, and certain groups within Youthreach organisations and such places. Again, there are not sufficient resources to cover all the schools and all the areas where there are identified problems.

As a follow-on to a point made by Mr. Packie Kelly about the seriousness of the presenting symptoms, I do not want to be alarmist, but, as the committee has probably deduced, I am originally from just outside Liverpool, where I worked in addiction services, where we had a significant crack problem, and the comparisons in terms of the way people are presenting are quite stark. We run a methadone clinic - opiate substitution - in Cavan. We have a small number of habitual heroin users who have presented to our service, saying they are in a mess. That really focuses the attention. Without doubt, synthetic cannabinoids are a very serious substance. In terms of legality, this is probably a question for legal experts and the Garda rather than me, but there appears to be a general lack of understanding about its legal status. I think users are under the impression that it is perfectly legal because they have been told so by the Garda Síochána or they have been told there is no way the Garda Síochána can pursue a successful prosecution. The people who use these substances know that, and that is why it is an even more attractive alternative to, say, cannabis - because they know it does not carry any penalties under law.

As well as investing in treatments and support services, I believe we need to review the policy document A Vision for Change with a view to establishing dual diagnosis, because there appears to be great emphasis on primary and secondary diagnosis - that is, there is a primary addiction issue which is causing one's secondary mental health symptoms, which are therefore not within the remit of addiction services. However, the whole principle behind dual diagnosis, and what the research would support, is that the two issues are so inextricably linked that one cannot tell which issue came first, and both needed to be treated in tandem by multidisciplinary organisations or support teams.

Co-Chairman Deputy David Stanton

I thank the representatives for the presentation. It is very timely, and the work they are doing is very important given that we are dealing with life-and-death issues. Along with Deputy McGrath and two other colleagues, I recently visited Portugal, which is on the real front line. While we were there we engaged with the European Monitoring Centre for Drugs and Drug Addiction. I will read into record what one of them said to us:

New psychoactive substance (NPS or 'new drugs', often sold as 'legal highs') were detected in the EU last year at the rate of around two per week. A total of 101 new substances were reported ... in 2014 (up from 81 substances in 2013), continuing an upward trend in substances notified in a single year. This brings the total number of substances being monitored by the agency to over 450, with more than half of that figure being identified in the last three years alone.

What they told us is that there are labs in third countries where highly qualified people - people with PhDs - are manufacturing these substances and churning them out. The issue we have here, from a justice point of view, is the arrival on the market in Europe, Ireland or wherever of something that is not on our list. They have changed some chemical in it and it is a different substance. It is so difficult, as Deputy Finian McGrath would agree, to keep track of that. The other thing that is playing an increasing role is the Internet. The idea of somebody dealing in the back corner is old hat. There is the deep web, the dark web, and hidden transactions using Bitcoin. It is hugely complicated and a major challenge for policing across Europe and in Ireland, as well as for our health services. It is not simple. It is a multi-million-euro business, billions in fact. These are powerful and wealthy organisations - multinational drug cartels - dealing with this stuff. The growth of online virtual drug markets poses a major challenge to law enforcement and drug control policies, as stated in the report.

Existing regulatory bodies need to be adapted to perform in a global and virtual context. What the representatives are presenting to us today is a microcosm of a larger national and European issue that is growing. I do not think we are equipped to deal with it. Our thinking is back in the 20th century, whereas these guys have moved on to the 21st century. We have got to get away from the idea of somebody dealing and handling stuff. It has gone beyond that at this stage. We were told in Portugal that they are putting this substance in the post. It is so small that it is easily hidden, and it is impossible to detect because the volume of post is so huge.

One suggestion I would like to make - Deputy Finian McGrath and others discussed it earlier - is the idea of a standing parliamentary committee to deal with this issue alone. That is something I will be calling for.

Deputies Finian McGrath, Catherine Byrne and others have brought to our attention the major gangland crime issues that feed on this also. It is a major issue for us from a criminal justice point of view. The presentation referred, as have Deputies Ó Caoláin, McLellan and others, to health, education, youth leisure, boredom and increased sports partnership, which is another issue. Justice is in there, and one can go across the whole range of Government Departments. All committees here are extraordinarily busy, but I suggest that there should be a standing parliamentary committee focusing on this alone. I would be interested in the reactions of colleagues and the witnesses to the suggestion. The standing committee would work with the Minister of State with responsibility for drugs, who, thankfully, is now in position and is very active. This is extraordinarily serious stuff. The witnesses are right that this new substance is highly addictive and very dangerous, and we do not know what chemicals are in there. Those chemicals are changing constantly. The issue has to be dealt with on a multi-agency level. There is no simple answer and it is not just a matter of putting more gardaí out there. Those involved are bypassing that. Borders do not matter here. In many instances, they are just posting the stuff through. It is changing so quickly. We must change our thinking as well to bring it into the 21st century. We have the resources in mental health prevention, etc., but we must focus on this on a constant basis and work with our European partners, as they are also facing the same issue.

Deputy Caoimhghín Ó Caoláin

I refer to Senator Bacik's question and her view that surely these are not legal highs in Ireland. It is certain that they should not be. As I said in my opening remarks, I have met with gardaí in my local community to discuss the tragedies that have occurred, the community response and the need to have effective redress. I can report to the joint committees in session here today that one of the most senior gardaí, whom I respect personally, has told me the Garda does not have the legal resourcing to deal with this. It is not only about manpower; the legislation does not do the business. It links a little bit with what Mr. Tim Murphy was saying. These are synthetic cannabinoids. Mr. Murphy made the point that tests came back and the substance did not fit with any of those listed in the legislation. The Criminal Justice (Psychoactive Substances) Act 2010 listed more than 200 so-called legal highs and we have been adding to that year-on-year in the period since. The trick these people use is not to reuse or rehash; it is to mimic. It is a mimicking process, as the Co-Chairman, Deputy David Stanton, has said. They are finding a way to replicate and reproduce the psychoactive experience of the known drug - cannabis or another illegal drug. There are chemists who are investing all of their knowledge and time in this mimicking process.

We must get away from the notion that once we identify something, we can add it to the list. One is always playing catch-up. We have to leapfrog to be ahead of them. We must put the hand up and stop them in their tracks, which requires strong and tough legislation in the first instance and all of the other resourcing that must come also. We need to have the strongest possible legislation and there must be some way to say that any and all of these, no matter what the substance, are illegal unless they are actually provided for and listed as legal. We should work on the basis that they are illegal until they are, for whatever qualifying and acceptable purpose, brought on to a legal list of substances for human use as drugs, medications etc. I am in favour of simply going ahead of them and doing it most effectively. There is no other answer.

When Mr. Packie Kelly and Mr. Tim Murphy respond to Senator van Turnhout and talk about supports, alternative opportunities and different activities within relatively deprived or unprovided-for communities, this is where the risk presents. We must look at that and provide for and reintroduce the necessary supports in order to provide for that community response. That is also imperative.

Deputy Catherine Byrne

There is a great deal here. The more one listens, the more one learns, they say. I was very interested in what Mr. Tim Murphy said about education, particularly through schools and SPHE. I am a firm believer that if you get people at a very young age, instil in them some sense of who they are, where they have come from and a sense of worth and build their confidence, one can prevent many of them from doing things they know very well to be harmful to them and their families. When my children were in school, I was very aware of local people and community gardaí being able to respond and come in to talk to children about drugs. Sometimes, however, I thought it was not graphic enough. I think back to the television advertisement about a young girl losing her ability to walk because a guy in a car veered off the road and jammed her up against a wall. Those are very poignant images for young people. My own children hated that ad. They saw the reality of what could happen with this guy completely out of control and bouncing into a wall. I wonder if the issue is whether we can instil in young people through education in school the image of what can happen to them, how this could affect their lives. It is the fact that we do not even know what is in some of these things and how it could affect them, not only now but into the future as regards their bodies and everything else.

Alcohol is the stepping stone into any kind of addiction. It starts off with young people having a few cans and then getting into something else. For some people, unfortunately, the train left the station on this a long time ago. It is very difficult for those people, but we should focus now on those people who are still in school, whether through youth work, music or sports. We should focus on improving their self-image and allow them opportunities. Deputy Ó Caoláin talked about community provision, but I am not talking only about the provision of services; I am talking about the provision of education in school around sport, music, theatre and all of those things that give children a different image of what they want to do with themselves.

Deputy Mary Mitchell O'Connor

I read the submission from the witnesses. I am someone who protested outside a head shop in Dun Laoghaire until it had to close down due to the level of bad publicity we brought to it. I am also very aware that a beautiful young girl died recently in my constituency, while a number of others were rushed to hospital, after taking something like this outside a nightclub in Dublin city centre.

I hear about education and I am a former school principal, but I believe the parents need to be educated. Everyone talks about the children. There is overload in school and we are telling them what not to do. Often, we are bringing in strangers to tell them about things and provide programmes.

When I was raising my own boys I felt it was my responsibility to warn them against taking drugs. In my view, when it is done in school and when a parent hands over that responsibility to a school, sometimes parents sit back and think the kids will have the information. However, I think that parents need to be targeted. I am sure they are not aware that these drugs are available which look like chewing gum. It is necessary to empower parents, to give them the power to parent their children properly and to know who they are with and what they are doing.

Co-Chairman Deputy Jerry Buttimer

There is a vote in the Dáil.

Deputy Mary Mitchell O'Connor

I have concluded and I thank the witnesses.

Deputy Dan Neville

Previously in the health committee I was chairman of a sub-committee on suicide which presented two extensive reports. I suggest the co-chairmen might consider whether a joint sub-committee with its own chairman could examine this area.

Co-Chairman Deputy David Stanton

We have been discussing that and it might be worth doing.

Co-Chairman Deputy Jerry Buttimer

I thank Packie Kelly and Tim Murphy for their presence and their presentation this morning and for the work they do. We will discuss our next actions as two committees together.

Sitting suspended at 10.50 a.m. and resumed at 12.10 p.m.