Seanad Éireann debate -
Thursday, 16 May 1996

Vol. 147 No. 7

Drug Misuse: Statements.

Minister for Health (Mr. Noonan

, Limerick East): As well as distributing my speech, I have asked my officials to distribute a copy of the press release which contains the Government decisions of 21 February on reducing the demand for drugs and a copy of the Eastern Health Board's plan, which was a response to these decisions.

I am pleased to have the opportunity to address the House on the important issue of drug misuse. I intend to outline the steps being taken by the Department of Health to tackle this serious problem which particularly affects young people and which is the concern of parents and politicians alike in every town and village in Ireland today.

There are no hard data available on the exact number of drug misusers in Ireland. Estimates of the number vary from 3,000 to 7,000. The Health Research Board report of 1994 gave a figure of 2,702 people who were treated in the greater Dublin area. It must be emphasised that this is the number of people receiving treatment and that the number of people misusing drugs is greatly in excess of this figure. Future Health Research Board reports will give statistics on treated drug misuse on a countrywide basis as opposed to the greater Dublin area. The board has already taken steps to access other treatment sources countrywide in order to compile this data.

It is recognised generally that there is a deficiency with regard to gathering of data on drug misusers. The recent Government decisions recognised this deficiency and each health board will now be requested to undertake research on the extent of the problem in its area, the location of the problem areas and the types of drugs being misused. This information will give a more precise indication as to the extent of the problem and will allow health boards to plan their drug strategies accordingly.

In the absence of hard data, other evidence from Garda seizures and health service personnel and anecdotal sources indicate that Ecstasy and cannabis use are widespread. In the greater Dublin area, these problems are compounded by a serious heroin problem.

The Government recognises that the problem of drug misuse is a complex and difficult one to which there are no easy or instant solutions. The strategy to prevent drug misuse, which was published in 1991, employs a multi-disciplinary approach, requiring action in the areas of supply reduction, demand reduction and increased access to treatment and rehabilitation programmes, together with a comprehensive co-ordinated structure geared towards their effective implementation. The Department of Health, in co-operation with other Departments and State agencies, has been implementing this strategy.

Despite this strategy, it was clear to me that more dramatic and forceful action was needed to meet the growing menace of drug abuse and, in particular, the sinister heroin epidemic in the Dublin area. Accordingly, I went to Government with a package of proposals and, on 20 February 1996, the Government approved a series of new demand reduction measures to prevent drug misuse. The objectives of the proposals are based on two key elements: reducing the number of people turning to drug misuse in the first instance through information, education and prevention programmes and providing a range of treatment options for those addicted to drugs, the ultimate objective of which must be a return to a drug free lifestyle, although this may not be a realistic goal in every instance, in the short term at least.

The features of the Government decisions are as follows. No steps should be taken to legalise or decriminalise the use of so-called soft drugs such as cannabis and there should be further development of education and prevention programmes in conjunction with the Department of Education and other relevant agencies. This will include the development of a multi-media awareness and prevention campaign, a programme aimed specifically at deprived areas and the other educational programmes outlined in the Department of Education's action plan.

Specific measures include a total of £500,000 will be spent on awareness campaigns, including a major public media campaign which will be launched this year; each health board will launch information and awareness campaigns aimed at young people and their parents, which will focus on the dangers of drug misuse, with particular emphasis on the misuse of Ecstasy; health boards should in future play a more active role in local initiatives on education and prevention; my Department's Health Promotion Unit, in conjunction with the Department of Education and other relevant agencies and groups, will design a specific education and health promotion package for use in the inner city areas of Dublin and which could be adapted for use in other high risk areas.

A task force under the aegis of the interdepartment policy committee on local development will examine the root social factors which give rise to drug misuse in the Dublin inner city area and recommend how best local community groups can be harnessed to prevent misuse and how partnership arrangements with parents on prevention strategies should be structured.

New management and evaluation procedures should be put in place for the services of the Eastern Health Board area. These procedures should be ongoing and be directed to examine best international practice for application in Ireland. Specific measures include a programme manager is to be appointed with specific responsibility for the drugs misuse programme — this post has already been advertised; a system of external evaluation is to be established for the services in the Eastern Health Board area and all services will be funded and co-ordinated by the Eastern Health Board once the new management arrangements are put in place.

Treatment programmes should continue to be developed and have as their objective in the short term control of the drug misuser's addiction within the context of the long-term aim of a return of the drug misuser to a drug free lifestyle. Methadone maintenance programmes should continue as a valid and successful element in treatment services and the role of general practitioners in providing this service is to be strengthened. Specific measures include the ultimate aim of demand reduction measures must be that those misusing drugs and particularly hard drugs will, after appropriate counselling, treatment and rehabilitation, lead a drug free lifestyle. Methadone maintenance programmes are a valid and successful part of an integrated response to the problem of heroin abuse and such programmes should continue to be developed; drug treatment centres are to put in place appropriate measures to ensure that the leakage of methadone on to the illicit market is eliminated; the Eastern Health Board is to engage in widespread consultation with community groups in the establishment of community drug treatment facilities and negotiations with local communities should be handled with the utmost sensitivity; the emergency response service in Dublin is to be extended to a 24 hour service and each health board is to establish a contact service which will provide information, advice and assistance on drugs to the public. While heroin misuse is confined largely to Dublin, all boards are to have in place an emergency response if an addict or addicts should come to stay in the areas or be stranded there.

The Eastern Health Board regional co-ordinating committee is to make proposals on the provision of appropriate services for persons who smoke heroin. Adequate detoxification programmes are to be developed and health boards are to be responsible for the development of appropriate counselling, treatment and rehabilitation programmes, including those provided by voluntary bodies and therapeutic communities, to lead a drug free lifestyle. Local co-ordination committees representing all local interests should be established at health board level to develop and monitor education and prevention measures and service provision and the demand reduction subcommittee of the National Co-ordinating Committee on Drug Abuse should be comprised largely of representatives from these local committees.

Specific measures include each health board is to establish local co-ordination committees to involve all bodies in the fight against drugs; each health board is to formally involve local voluntary and community groups on their co-ordinating committees which gives them a direct input on the decision making process and the national subcommittee on demand reduction is to be composed largely of representatives from the eight regional committees under the chairmanship of an assistant secretary from the Department of Health.

A new unit is to be established to ensure that all businesses involved with controlled drugs comply fully with the terms of the Misuse of Drugs Acts, 1977 and 1984, and the UN Convention on Narcotic Drugs and Psychotropic Substances.

Liaison arrangements between the health services and the prison services should be put in place to ensure that co-ordinated treatment regimes for prisoners are in place. It is further agreed that the national co-ordinating committee be given specific responsibility to achieve maximum co-ordination.

There should be a greater emphasis on providing basic information on the extent and type of drug misuse and more research should be undertaken as to best approaches to demand reduction services.

Specific measures include that each health board is to put in place a system of monitoring on an ongoing basis so they will be fully informed of the level of abuse in their areas and of any new trends which may be emerging. This country is to partake with a number of other European countries under the aegis of the Council of Europe as part of a working group to look at approaches to treatment in various member states. Other measures include that all health boards are to be mindful of the security risk to personnel and property in the drugs misuse service. The Eastern Health Board is to discuss with the Garda the discreet local arrangements to be put in place to alleviate the nuisance caused by addicts congregating at treatment centres.

I now turn to the Eastern Health Board development plan for services in the Dublin area. This arises from the Government decision which requested all health boards to produce such plans. However, because of the scourge of heroin in the Eastern Health Board area, it is appropriate that we spend more time on its plan rather than on the others.

An evaluation of existing services in the Eastern Health Board, which was carried out by Dr. Michael Farrell of the National Addiction Centre and Institute of Psychiatry, University of London, and Mr. Ernst Buning of the Bureau of International Affairs in Amsterdam, noted that by international standards, there was a good level of drug treatment service provision in the Eastern Health Board.

Based on the recommendations of this evaluation and on the proposals in the Government's decisions, the board has developed a comprehensive plan for the development of its services during 1996. The plan includes ten specific proposals as follows: (1) increasing access to methadone maintenance treatment, increasing the number of patients on treatment from 1,400 to 2,500 through additional prescribing by GPs, the establishment of additional drug treatment centres and extension of services in existing centres and the introduction of a mobile service providing methadone; (2) the introduction of a seven day dispensing service in community drug treatment centres; (3) providing a rapid response to young problem drug users, including heroin smokers, through early intervention, particularly in the inner city areas; (4) increasing the number of rehabilitation places from 60 to 250 per annum; (5) increasing the number of detoxification beds in Cherry Orchard Hospital from ten to 15; (6) extending outpatient detoxification through both community drug centres and local GPs; (7) establishing a regional education and prevention unit to deliver awareness, education and prevention; (8) providing parenting programmes for drug using parents in the north and south inner city; (9) establishing an information database and (10) establishing a regional telephone helpline.

It is expected that if this plan is implemented in full, significant progress can be made in reaching the vast majority of drug misusers who are at present in need of treatment services. I have asked my officials to circulate the complete plan to Members. The plan is moving in the right direction. We are still discussing some details of it so if Senators wish to make comments on the plan, these can still be taken on board before we finalise it.

In my view the most significant aspect of this plan is the involvement of general practitioners in the provision of methadone to misusers. Up to now, GPs have been slow to get involved in this service and I can understand their fears in this respect. They may be afraid of the effect on their practices of having heroin addicts among their clients; they may even be afraid of violence.

A pilot scheme initiated in March this year aims at implementing all the elements of the Protocol for the prescribing of methadone. These include the provision of a treatment card to all drug misusers and the registering of all patients being treated on a central treatment list. A facilitator will also liaise with GPs, pharmacists and community drug treatment centres. It is hoped that with the success of this scheme, which is being independently evaluated, a number of other GPs will be happy to become involved in the prescribing of methadone. In my address to GPs at the Irish College of General Practitioners' conference last Friday I asked for their assistance in addressing this serious problem and I was encouraged by their response. Indeed, a further meeting held this week between my officials and representatives of the college to pursue this issue further was very constructive and I am confident of a successful outcome.

The expansion of health services alone, however, will not remove the problem of drug misuse from our society. In common with our European counterparts, Ireland's hard drug — heroin — problem can be linked with several socio-economic factors. For example, of those who received treatment in 1994, 84 per cent were unemployed while 60 per cent had left school with the minimum education.

Drug misuse in these circumstances needs a far reaching, multi-agency approach, which tackles not just the results of misuse, crime and ill-health, but also the root causes of the problem, which are linked with a multiplicity of socio-economic factors. In areas such as the north and south inner city, local communities have come together in a positive way to assist statutory and voluntary agencies working in the drug misuse area. With this support, local GPs are becoming involved in treatment, and preventive initiatives are being undertaken among parents who are drug misusers. Rehabilitation programmes such as the Saol and Saoirse programmes provide drug misusers who have become stabilised with the skills necessary to integrate back into society.

In the fight against drugs we should concentrate our efforts on prevention beforehand rather than rehabilitation afterwards. Outside of the Dublin area, where the main drugs of misuse are ecstasy and cannabis, education continues to be the first line of defence. The second level school based programme, which was jointly launched by my Department in conjunction with the Department of Education, is now in place in over 50 per cent of schools, with teachers being provided with training to deliver the programme effectively. A similar programme for primary schools will be introduced next autumn.

My Department's health promotion unit and the Department of Education continue to support the youth health programme being co-ordinated by the National Youth Council of Ireland which is at present drawing up guidelines for youth leaders on how to deal with drug misuse. The HPU also supports parenting programmes and the efforts of a number of voluntary groups involved in education and prevention. It also relaunched "Drugs Questions — Local Answers" last year. This programme can provide local communities with a useful approach to addressing local drug problems. A national media awareness campaign, supported by a wide range of printed materials, will provide adequate information on drugs to parents, youth leaders and young people themselves.

So, as you can see, my Department is actively engaged in a multifaceted approach to tackling the drug problem. We cannot do it on our own, but need the support of community leaders, politicians, educators and parents. The Government decisions have clearly marked the way towards progress. My colleagues in other Departments, particularly the Departments of Justice and Education, have also pivotal roles to play in this process. I am confident, however, that we may see the fruits of our labour soon, with a reduction in the toll and misery caused by drug misuse.

Mrs. McGennis

I welcome the Minister to the House. He spoke of his announcement of a comprehensive range of measures to reduce the demand for drugs, and I accept there are some concrete proposals in it. Clearly, if the Minister's proposals were comprehensive and had any chance of working, this announcement would be welcomed by every Member of the House. It would be welcomed if the Minister mentioned just once in his proposals how he will fund the increased services necessary to combat this crisis. However, the Minister's announcement contains none of these things and I think he may have mistaken "comprehensive" for "long". He announced a long list of measures with no real indication of how, when or by whom they can be implemented. In fact, he indicated that the Eastern Health Board will implement these provisions.

Two nights ago an alleged drug dealer was beaten to death not far from this House. The worrying backdrop to this death is that many ordinary decent people in the communities in which we all live will not condemn the killing. Drugs are killing our children, communities and, ultimately, society. They wreak havoc on all our lives. I condemn unequivocally this killing. However, it is a further sign of the reduced respect for life which the scourge of drugs has caused.

The problem goes far beyond the direct damage inflicted on those addicted. Drugs are directly responsible for the vast amount of violent crime in Ireland today. This is particularly true in Dublin, where muggings, assaults, handbag snatches, theft from cars and aggravated burglary are almost an hourly occurrence, with virtually every person you meet having been affected in some way. Yet the Minister and the Government seem so unaware of the crisis unfolding around them that he comes here today with a series of bland platitudes and aspirations. Worse than that, he has the nerve to propose yet another task force to carry out another special study.

We know about the problem, its causes and most of us know what needs to be done. I can tell the Minister here and now of the most important step he can take to combat drugs. Anybody with a grain of sense can tell him. The engine driving the drugs trade is vast amounts of money. If the Minister and his Cabinet colleagues make drug dealing unprofitable, it will not occur. Attack the assets of major dealers unless their source is justifible, demand explanations to the Revenue of unaccounted wealth and investigate closely the assets of suspected dealers. This problem requires a committed and aggressive approach but the Minister and his Cabinet colleagues seem unwilling to make such an approach.

The drugs issue cannot be separated from the overall law and order record of the Government, which is truly appalling. The stop-go on prisons, the failure to legislate, particularly on the key issue of bail, and the arrogant refusal to consider Opposition legislation on law and order issues is not the record of a Government which has the commitment required to tackle the drugs problem of Ireland today.

The Minister is right to state that local, voluntary and community groups have a crucial role to play. I believe that the alleviation of the horror of drugs for users and their families is an issue best dealt with at community level. Despite the Minister's very public announcement, I see no sign that he has set about consulting people at a community level on how he will involve them in his plans. His record in this area is far from impressive, and I would refer specifically to previous Eastern Health Board decisions.

The Minister made some interesting points, but I want to deal with the Eastern Health Board's proposals on co-ordinated, directed, focused campaigns on addiction treatment. In my constituency, as the Minister will be aware as he referred to it in his speech, the Eastern Health Board came to inform, not consult, the communities that it proposed to open a methadone distribution clinic, a needle exchange facility and counselling service, not for addicts in the greater Blanchardstown area but for addicts in community care area six, that is, Finglas, Cabra and Blanchardstown, in a small caretaker's house which had subsequently been used as a school for autistic children. When the Eastern Health Board was asked about the level of abuse in Dublin 15, it had to admit it could not quantify it. While I recognise there is a need to provide methadone treatment facilities, needle exchange facilities and counselling service, there is no need for the staff of the health boards to decide to proceed half-cocked to offer a service to the communities just because they have a building when they have no idea about the need for such a service. I think the health board has put that proposal on a back burner for six months and I await its long-term outcome.

The Minister should proceed to implement his proposals. They will do some good and I would acknowledge that many of the Minister's proposals would coincide with the policies of most parties in this House, but he needs to make sufficient funds available to ensure they can be implemented properly. Certainly, from the kind of representations which I am getting at constituency level, the general health services are underfunded to an extent which they have not been for a number of years, so I want the Minister to indicate exactly what finance will be made available for the package of proposals he is recommending.

More importantly, the Minister must return to Cabinet and convince his colleagues in the Departments of Justice, Education and Finance that much more needs to be done. In his conclusion, the Minister stated that we need a comprehensive multi-agency approach. All strategies to combat drug abuse have made the same point, that unless we can involve the Departments of Education, Justice and Health there was no way of making an impact on the problem, which is growing daily. However, once again, we see one arm of Government heading off at a pace alone. It looks like the Minister is appealing to his Cabinet colleagues to at least join him in the fight against drugs, but there is no co-ordinated approach.

I know for a fact, from knocking on constituents' doors two nights ago, that people know of unemployed people living in housing estates who are drawing the dole but seem to have huge wealth. There seems to be no attempt by any of the Government agencies to find out how people are able to live in expensive houses, own cars and still draw the dole. There was a famous case, and a number of other instances, where such people also had local authority dwellings. There is no co-ordinated approach, and unless there is such an approach, we are really doing nothing.

The Minister's proposals appear to address those who have a problem. I commend and welcome that, but that is only one aspect of the matter. All the health board strategies and policies which have been agreed focus on reducing demand, and then supply, which would be the Department of Justice side of the matter if that was happening, but it is not. The way to reduce demand is through education. I do not see the Minister for Education's involvement in this area as being particularly enlightening or huge. I know that the voluntary bodies, such as the Lions Club, are paying for an educational package for some of the post-primary schools in my constituency. The Government and the Department of Education are failing miserably if charitable groups must fund educational packages.

The Garda say they do not have sufficient powers in relation to the sale of drugs in that a person must be found in possession of drugs. It does not matter that neighbours and members of the community regularly telephone the Garda to inform them of unusual comings and goings in houses. The power to get warrants is very restricted. I know of instances where gardaí staked out communities to try to swoop on known drug dealers only to discover that their equipment, including walkie-talkies, was dead. Yesterday the newspapers said that gardaí did not have the necessary forms in Garda stations and that they had to drive to another station to get forms and charge sheets.

The situation in relation to drugs is appalling. The Minister acknowledges that Dublin and the other cities are suffering dreadfully as a result of the drug scourge. Yet the Government has not set up special drug units in every district. When we ask the Minister for Education to provide remedial teachers, she says that is the primary school teacher's job in the first instance. We need a specialised force in every district to deal with drugs, but the Minister for Justice is not moving in that direction. While I recognise gardaí are empowered and obliged to deal with the problem of drug sales and drug pushing, they are not fully equipped to do so.

I welcome the involvement of GPs. This proposal has the support of GPs in the community and it will make a significant difference to the lives of addicts seeking to come off drugs. The sister of the person beaten to death two days ago said that he tried to come off drugs for one year but that the pushers pushed freebies into his letterbox. The Minister's proposals are not as aggressive as drug pushers pushing freebies into letterboxes. We must match that type of cunning.

This document tries to address those using drugs. Because it does not have a multi-agency approach and is there no overall Government strategy to deal with this problem, only a specific area of this is being dealt with.

I was intrigued when the Minister said that by international standards it was discovered that there was a good level of drug treatment service provision in the Eastern Health Board area. That flies in the face of reality and his speech. If that was the case he would not have put forward these measures and he would not have to deal with queues of drug addicts looking for methadone or physeptone. If the Minister wants this strategy for the treatment of users to work, he must ensure that it is comprehensive. We should not open a treatment centre in one community area and six months later open another down the road. That strategy was opposed by communities, including my own, which I supported. The health board's proposal in my area was to attract drug users from the adjoining communities. Unless treatment centres are opened at the same time, this support strategy for those trying to come off drugs will not work.

I recognise the Minister faces difficulties in that there is not total Cabinet support for any concerted approach to combating drugs. There has not been a reduction in drug use in the community. Drugs are cheaper and more widely available in schools and in the community. The Minister's proposals have some merit but have little chance of survival if they are not matched by a Government commitment to do something in the other areas, because nothing is being done in the education and justice areas. He will be left handing out methadone, while the queue will get longer because there is no reduction in demand and supply is not being curbed. I wish the Minister and the health boards well in what they are attempting to do, but this scourge will continue unless his Cabinet colleagues join in the fight against the drugs.

Mr. Doyle

I thank the Minister for coming here to deal with this problem again. Drug misuse is a complex problem and requires various responses at different levels. There is no single or simple solution and there is a need to regularly review and modify responses to problems to achieve an efficient and cost effective service.

The services of the Eastern Health Board, of which I am a member, for drug misuse have undergone rapid expansion in the past three years and they continue to expand under the high level of executive and board support for the development of these services. These services could not have expanded over the past three or four years unless they had got the necessary finances, which Senator McGennis mentioned, from the Department of Health. Some £3.5 million has been made available this year and £4.5 million will be made available in a full year. The Department of Health has provided finances to enable the health board to carry out its programme. I am pleased to have the opportunity to review the service programme of the Eastern Health Board, which the Minister attached to his speech. As Members will note, ten specific proposals have been detailed in the plan. Each proposal has four subheadings — target date, outcome, output and estimated cost.

I would like to deal with the methadone service. There are currently 1,400 people on methadone treatment in the Eastern Health Board area, which is no mean achievement. It is proposed to increase this number to 2,500 by the end of 1996. Waiting lists are a problem in relation to methadone treatment and it is important that we reduce them. They are a cause of concern for individuals, communities and organisations for various reasons. Drugs users awaiting admission are at greater risk of contracting HIV by injecting drugs. They may also cause disturbances because of their drug use and barter. There is also the possibility of the consumption of non-supervised methadone. People hanging around clinics often make demands on those using its services to sell their methadone. It is important that we reduce waiting lists so that only a small number will need to attend clinics.

As a result of these problems, people and organisations perceive the drug service as failing in its task and interpret it as a sign of an inadequate governmental response to the drug problem, which is not the case. The Eastern Health Board intends to tackle the waiting list by extending the hours of two clinics and recruiting additional counsellors and outreach workers to provide support to general practitioners and the introduction of special arrangements to deal with crisis cases. As the Minister said, an important aspect is getting GPs involved in methadone treatment programmes. The Department of Health, in conjunction with drugs specialists and some leading practitioners, has drawn up a Protocol for the management of drug users in primary care.

The Eastern Health Board has transferred 100 individuals as part of the strategy to move stabilised addicts from specialist services to primary care. However, this is contingent on the willingness of GPs to participate in such a programme. A number of practioners are prepared to develop this programme and it is planned that a minimum of a further 200 drug users will enter general practice treatment this year. However, this will only involve addicts who have been stabilised in the special care centre.

It is also proposed as an interim measure to introduce a methadone programme using a mobile bus. A bus has already been converted for this purpose and is available for immediate use. It will serve various neighbourhoods and it is possible it will be able to deal with a maximum of 40 clients per location. In view of the opposition of the public to treatment centres in their areas, it has been suggested that one of the sites for the bus should be Dr. Steeven's Hospital, the headquarters of the Eastern Health Board. I proposed this at a health board meeting and it was agreed.

Detoxification plays an important role in enabling drug users to achieve a drugs free lifestyle. The health board has ten detoxification beds at Cherry Orchard and it is proposed to extend this to 15 beds. It is also proposed to provide outpatient detoxification through community drug centres. This will be done by enabling practitioners to provide detoxification with community support.

The rapid growth in the scale of the coverage and complexity of the drugs service in the Eastern Health Board in recent years and the proposed further growth has given rise to the urgent need to strengthen the management structures relating to the services. At present the health board has three programme managers for special hospital care, general hospital care and community care. It is now proposed to appoint a fourth programme manager. In addition, it is proposed that all the initial services, including those for alcohol addiction, should ultimately be amalgamated under the fourth manager, who will also be responsible for the services for adults who are homeless and disadvantaged.

The appointment of a fourth programme manager has received Government approval. Advertisements have been placed in newspapers and I am sure an appointment will be made in the near future. I stress to the Minister the urgency of this appointment. The entire programme outlined in the Eastern Health Board's ten proposals hinges on the appointment of a manager to carry it out. The Government has also approved the appointment of two consultant psychiatrists in addition to the consultant psychiatrist already appointed by the drug treatment centre at Trinity Court. This will allow the board to subdivide its region into three catchment areas and facilitate a move which will further improve the co-ordination of services. Liaison with prison services will also be strengthened with the appointment of the two new consultant psychiatrists.

Regarding treatment in prisons, the international consultants who reviewed the Eastern Health Board programme were of the opinion that the appointment of a consultant with specific prison sessions is a major resource investment in enhancing links between prison and community services. However, they were also of the opinion that there is no infrastructure to support this level of input. It was their considered view that some community drug workers must be used in the prison services so as to construct a prison drug team with good links with the three sectors of the community services.

They were also of the view that the most popular form of drug treatment is drug free therapeutic communities and the possibility of developing such facilities should be explored further. The Minister for Justice has established a drug free unit in Mountjoy and the Coolmine therapeutic community appears to be the best service to develop such an approach.

I make these points because I am somewhat shocked by a headline in today's Irish Times, “Substitute for heroin is itself a killer, says Harbison”. The report states:

The drug methadone, used by hundreds of addicts as a heroin substitute, is itself a potential killer and is certainly not a safe opiate, the State Pathologist warned yesterday at an inquest into the death of a Mountjoy prisoner.

Dr. Harbison said methadone was regarded as safe for heroin abusers because it could be taken orally. It was intended to banish the use of contaminated needles.

However, he said it was not in itself a safe drug because it had been associated with death by overdose. According to the Irish Times report, the jury heard the prisoner in question had taken a mixture of heroin, methadone, cannabis and tablets during his 39 hours of compassionate leave from prison, which ended the previous evening.

Methadone taken in such situations would be a potential killer, but I understand methadone taken under proper medical supervision can assist people to get off heroin. The consultants employed by the Eastern Health Board to review its programme said methadone maintenance is the most evaluated form of treatment in the management of heroin addiction. There is clear and consistent international evidence that this form of treatment achieves significant reductions in heroin use and crime and a lower risk of premature deaths, including those from overdoses.

The consistent finding is that a daily dose of 50 milligrams of methadone is associated with lower rates of heroin use. Methadone maintenance has been found to be effective in reducing the spread of HIV through intravenous drug misuse, while receipt of counselling and length of time in methadone treatment are both factors associated with favourable outcomes. I regret that Dr. Harbison is reported in today's Irish Times as having made those comments, because methadone plays an important part in helping people to get off heroin.

The two experts appointed by the Eastern Health Board to evaluate its programme stated:

The need for locally based services is a key aspect of the Eastern Health Board strategy. It is important that professionals, politicians, key policy makers and the broader community understand the public importance of such services and their overall value to the community. Community consultation needs to take place with a clear understanding that the needs of particularly needy and vulnerable individuals will be addressed and are not subject to community veto on the development of such services.

I hope politicians will listen to the views of the consultants and the Minister will not have to bestow on others the honour he gave to a Senator on the last occasion he addressed the House, president of the NIMBY syndrome. This is the problem faced by society; everybody wants something done about drug treatment, but they do not want it done in their back yard. Unless the community assists and co-operates with the health board, this problem will not be overcome.

Senator McGennis mentioned areas which do not come under the Minister's jurisdiction but rather relate to the Departments of Justice and Education. These areas are important in relation to drug treatment. During yesterday's Order of Business, when the despicable murder of a gentleman in the centre of Dublin was mentioned, Senator O'Toole called for the introduction of a preventative drugs programme in schools. The stay safe programme has been successful in our schools and a preventative programme should be introduced at primary level to educate young people about drugs. What children are taught at a young age remains with them for the rest of their lives. If they are informed of the problems drugs could cause it is possible they could stay drug free later in life. The Minister for Education should introduce such a service in schools.

As a member of a health board I have been happy with the progress it has made. The public have occasionally shown opposition to clinics being opened. However, if we are to serve the community, it is vital that we have a substantial number of clinics. We cannot provide the methadone treatment to stabilise people using heroin unless we have these clinics. As the consultants have said, it is up to every politician and every person in public life to support the efforts of the health boards and the Minister for Health in overcoming this problem.

Dr. Henry

The Minister's statement was very interesting. The House has discussed the drugs problem before and it remains a topic of great concern. There have been improvements in the availability of treatment of those addicted to illegal drugs. However, there are still waiting lists for people to get treatment. When a person is on illegal drugs one of the most important decisions they can make is to come off drugs. It is preferable that they undertake a detoxification programme and lead a drug free lifestyle. Therefore, it is depressing to find that once a person has made this decision there is a waiting list for treatment.

I am glad that the Cherry Orchard facility has been opened at last and will be expanded. A serious effort will have to be made to extend the number of beds available for detoxification if we want to deal with the city's heroin addicts. Occasions when addicts want to come off drugs may be missed if there are not enough beds, and addicts may continue to use drugs for several years, contract associated diseases and the opportunity to rescue their lives may be lost.

Methadone programmes are worthwhile and I welcome the increase in the number of treatment units. In a sense methadone programmes are of more benefit to the community than the drug addicts. Methadone itself is an addictive drug and there are dangers associated with it. The advantage for society is that the heroin addicts who decide to go on a methadone programme do not become involved in crime because their habit is supported. They are free from the risk of infection with HIV or Hepatitis B because they do not use syringes. The addicts using heroin have to steal a large amount of money or goods and setting up methadone programmes prevents this crime.

It is a good idea to involve GPs in methadone treatment programmes and I realise the Minister is disappointed at the level of take up of the idea. Following the Minister's speech to the Irish College of General Practitioners in Waterford last week, GPs are looking at their involvement in the programmes and may make a greater response. The Minister should ask the Medical Council to look again at its ethical guidelines on doctors becoming involved in the treatment of drug addicts. We have been warned not to become involved in treating drug addicts unless we have the skills. Drug addicts are very manipulative and it may be too easy for them to control the programme rather than the doctor controlling what is happening with the patient.

The ethical guidelines say that one should not become involved in treating patients who are not within a doctor's practice. The vast majority of heroin addicts are in the inner city area of Dublin and it is the GPs in those areas who would have to take on enormous numbers of addicts if they were to deal with them from a GP base. The Minister might talk to the Medical Council to reexamine the guideline to see if it could be altered.

We have talked about the resistance of communities to the setting up of methadone treatment units. However, there can also be considerable resistance if a GP sets up a programme to treat addicts. The Minister referred to getting more community involvement and it is essential that greater community education is undertaken. It is hard for a GP to have members of the community urge them not to become involved in programmes when they would like to do their share to deal with the problem.

Security is another problem for GPs. Drug addicts can become violent if they have problems with their addiction and there may be a problem with other addicts congregating in an area where they know that treatment is being given in the hope they may be able to get methadone. However, most methadone is now given in a liquid form. Visiting the drug treatment units can be a very depressing experience. People queue at a hatch where they are given their 40 or 50 milligrammes of methadone which they drink. The places are joyless and depressing and the people who go there can be in a bad state. It makes one realise that we must prevent people falling into such a pitiful condition.

Doctors who take on drug addicts do not have to deal only with the drug addiction but with the complex medical and social problems. The man who was beaten to death recently was dying of AIDS. In dealing with patients on methadone programmes doctors will also have to deal with medical and social problems that can be very time consuming. I get cross when people say that doctors do not want to treat drug addicts in their practices because it will ruin their private practice. I assure the House that is not a concern. Most doctors who work in communities where there is a great deal of drug addiction have limited private practices. However, the rest of a GP's patients may object because a great deal of time and effort has to go into treating addicts.

The Minister was disappointed with the small number of GPs who offered to take part in the pilot study and who insisted they would only treat people who were stabilised on methadone. That is to say, people who had already gone to a drug treatment unit, had been put on a specific dosage and who might then be transferred to a GP. Realising the seriousness of the problem, the College of General Practitioners is prepared to take on people who have just decided they will come off illegal drugs and go on methadone. It has set up training programmes and has a Protocol of its own for GPs. If this takes place it will be an important advance because we are making slow progress with the clinics as it is.

Senator Doyle stated that 1,400 people are involved in these programmes, but that is an optimistic estimate. The actual number may be somewhat less than that, but we must make a major effort in this regard. It is important to remember that there is no guarantee that people on methadone programmes will be cured. Methadone is not a cure, it is another drug of addiction.

Doctors alone will not be able to deal with this programme. Community support is essential and any statutory backup that is required should be put in place. I welcome the fact that there will be a new programme manager. This is at the top of the pyramid, however. It is important that GPs working at ground level with drug addicts have access to key liaison workers who are essential for the success of such programmes. These people could be social workers, community psychiatric nurses or members of voluntary groups and would provide an important liaison between doctors, pharmacists, acute hospitals, the Garda Síochána — some of those in the programmes may have been involved with the police — and the prisons.

It is very important that there be proper liaison between the prisons and the community in general. There has been a serious deficit in this regard in the past because prisoners who may have been off drugs while in prison become involved in drug abuse almost immediately after being released. It is essential to encourage better liaison with the prisons.

I welcome the establishment of the drug-free centre at Mountjoy Prison and the appointment of Dr. Fiona Bradley to work in that programme. This centre will remove people from the pressure of their peers and efforts can then be made to have them detoxified and encouraged to embrace a drug-free lifestyle. It may be the best opportunity they have to stop taking drugs. Therefore, it is important that an additional advantage be taken while they are in prison. Current programmes are very short. Three weeks for a detoxification programme is quite short and much more must be done in this regard.

Another very important area in which liaison workers are required is that of communicating with pharmacists who become involved in these programmes. Pharmacists in Dublin city have been extraordinarily co-operative about becoming involved in the programmes. They take on the risk of their pharmacy being disrupted during the day or burgled at night. I praise the efforts they have made. Liaison with pharmacists is essential because some drug addicts are very manipulative people and may be attending up to four GPs to obtain as much methadone as possible and they may also be attending different pharmacies. It is essential that support is provided to those who have agreed to work within the programmes.

The security of premises has been an important obstacle for GPs becoming involved. Some GPs have had to erect bars on surgery windows and doors. It is not a very welcoming sight for patients to see steel shutters or steel bars preventing entry to a doctor's surgery. Members are aware that some GPs involved in working with addicts have been attacked. It might be possible that GPs who have agreed to work with addicts could work in health board clinics. Senator McGennis made the point that such clinics would have to be established at the same time because communities resist strongly when their areas are targeted for clinics. The reasons for this are a mystery because the situation will improve if the numbers of addicts in an area can be controlled.

I live near the Baggot St. clinic, which caused turmoil in the past. There were almost 180 addicts attending the clinic at one point and the authorities estimate that the problem becomes serious when the number rises above 100. With the establishment of clinics at Trinity Court, Amiens St., etc., people could attend in their own districts, which improved the situation. The possibility of GPs working in health board clinics should also be considered.

The seriousness of the problem of soft drugs — cannabis and Ecstasy — must not be underestimated. On previous occasions I have spoken about the dangers of abusing Ecstasy from a medical point of view. There have been many deaths in Dublin from such abuse. This drug is widely available and is not considered to be harmful. It is an extremely dangerous drug and is probably the only one which is being manufactured in this country. We must take care not to consider the heroin programmes in isolation.

The key to this entire problem is preventing people becoming involved with drugs, even prescribed drugs. Doctors have become increasingly careful about prescribing drugs which become addictive because such prescription also gave rise to serious problems within the city. I am glad that the programmes will begin in primary schools because it is often too late by the time people reach secondary school. I hope that there will not be any resistance as there was in the case of the "Stay Safe" programme. Parents must face the fact that there is a great deal of drug addiction in all walks of life. Heroin abuse in confined to the inner city but a problem with drug abuse also exists in the suburbs. Prevention is much better than cure and I believe that doctors will become involved in the programmes.

We have always believed that by diverting children into other activities such as sport, etc., we could prevent their becoming involved in drug addiction. However, I have visited many schools and I was informed by one young person who is involved in international canoeing that soft drugs were often available at parties following international events. This is an extraordinarily depressing revelation.

In conclusion, Senator McGennis was very kind about the amount of money involved in this problem. She also referred to unemployed people in certain housing estates who appear to have access to much money. We must consider the amount of money involved in the heroin "industry" alone. If there are 7,000 drug addicts in the country and each spends £500 per week on heroin alone — which remains expensive even though the cost has fallen — this would amount to £175 million per year. I do not know what is the cost of heroin abroad but it must be expensive to transport and those making deliveries must rake-off a share of the profits. However, there must be many people in Ireland who are making millions of pounds from the sale of heroin. A recent conference of accountants was addressed by a Mr. Mitchell from England who stated that until the situation relating to money laundering — I am not merely referring to people claiming unemployment who can afford to purchase a house worth £70,000 — was addressed in this country, the problem of drug addiction would not improve.

This is an important, multifaceted problem. The Minister for Health's efforts are very worthwhile but it is essential that the problem be addressed by the Minister for Education, through our schools, and the Minister for Justice.

Mr. Maloney

This issue is the most important to be debated in this House in recent times. The drugs problem is the greatest issue which Irish society faces. However, it is not treated as such despite the fact that it is an issue of life and death for many people. The problem is that for many people drug abuse is containable, but it is containable only in a geographic sense. It can be confined to major urban centres such as Dublin and even then to smaller sections of that city.

I visited New York in 1993 when the drugs issue was being discussed at the UN by Parliamentarians for Global Action. A man called Jerry Brown referred to the American problem and it came across that countries throughout the world do not seem to have a uniform way to deal with the massive problem of drug addiction and abuse. He also said there were about 5.5 million registered drug users in the United States. During his speech this morning, the Minister mentioned that a number of thousands of people are addicted in this country. We should contact our American friends to ascertain whether they have a system whereby they register addicts and keep an eye on them. We do not seem to be able to do that. He maintained that over a period of about five years they brought the figure of registered drug users from 5.5 million down to 1.75 million. He was not able to tell us how they did it.

Eamon Doherty, the chairman of Cospóir, spoke after him and delivered an excellent paper on how the Irish deal with the drugs problem. The representatives from 15 countries present asked for a copy of Eamon Doherty's paper. I asked him why they were interested in his paper and he said that we seem to have a common sense approach. Drugs mask many issues in our society. It is unquestionably linked to poverty and social disadvantage. Any long-term solution to the problem that does not tackle social exclusion, particularly its concentration in regional blackspots, is a nonsense. Successive Governments have failed to recognise this factor and have not done enough to address social exclusion.

For too many people the drug problem exists only because it leads to crime. Far too seldom is concern expressed for addicts themselves and the communities in the grip of ruthless drug barons. If any indication of the lack of the community's concern for the problem is needed, it is found in the reaction of many to the news that a treatment centre is to be established in their area.

There are two drug problems — soft drugs, such as cocaine and Ecstasy, and heroin addiction. The second is responsible for the scenario we have already outlined and huge social problems, but fortunately for those living in rural areas, it is confined largely to the Dublin metropolitan area. Even as a Member from Donegal I can recognise the size of the problem. I see it particularly in the priority and urgency with which my Dublin colleagues talk about the problem and their frustration at what they perceive to be a lack of progress on it.

During the Troubles in the North over the past 25 years one would have found that the importation of drugs into a county like Donegal was perceived to be very small. One of the reasons was that the security on the Border meant very little got across. Since the ceasefire, or even since the breakdown of the ceasefire, there has been a marked increase in the amount of drugs, especially Ecstasy, coming across the Border because security is not as tight. Sometimes one gains and sometimes one loses.

Ecstasy is known to us all. It has penetrated almost every rural town and village. Its definition as a soft drug is a complete misnomer. As cases in this country, and perhaps more particularly in Britain, have indicated, it too can be a killer. Last February at the launch of the Government's anti-drugs programme the Minister for Health announced that a media campaign on the danger of drugs would be launched. To be honest I have yet to see it. I hope the Minister can confirm that it is at an advanced stage of preparation. He outlined part of it in his speech and I welcome some of the measures mentioned. Such a campaign is essential to inform young people that Ecstasy is not a leisure drug.

There is another danger with Ecstasy. Throughout Dublin Ecstasy is used as a gateway drug to heroin. It is sold in party packs comprising two Ecstasy tabs and a heroin joint. While it has not been difficult to confine intravenous heroin use to a major city, it is not so easy to prevent the use of heroin through smoking from spreading throughout the country. This is one thing of which we must be fearful in rural areas. While I acknowledge that in its recent package the Government has recognised that heroin smoking is a problem, I have yet to hear any proposal as to how the problem is to be tackled. The Minister mentioned it this morning but there do not seem to be any moves to see how the problem will be tackled.

Despite large investment in treatment clinics in the Eastern Health Board area there are still considerable waiting lists for treatment for those injecting heroin. There is no service available for those who smoke heroin; this is an unacceptable state of affairs. I agree with the Government's proposition that the treatment available for heroin users should aim at bringing users to a state where they can appreciate a drug free lifestyle. I have no time for those who argue for the legalisation of drugs. This can only serve to legitimate certain kinds of drug abuse but there is no guarantee that we can confine that abuse to so-called soft drugs. I believe it would be a retrograde step.

I support the Government's suggestion that every effort should be made to prevent the introduction of teenagers to the drug culture in any form. Consequently, I welcome the measures announced by the Minister for Education in this regard. One would have to guard against the fact that children are not always amenable to listening to their superiors or to people in authority.

I worked with youth clubs in my home town. We knew everything that was happening. Very few of the young people we worked with or who played football and other sports got out of line because we were in touch and had our finger on the pulse at all times. Whenever someone in authority goes to a school to speak about drugs, young people look up and see somebody from the establishment. The message does not seem to get home. Young people will respond more quickly to a message coming from people who are involved in sports, whether footballers, hurlers or whatever, than to a message coming from somebody in authority. This should be complemented by other support services.

Youth workers are often the only adults who deal with teenagers on a one to one basis. They can play an important role in diverting teenagers' activities elsewhere and in so doing earn the respect necessary to operate effectively an anti-drugs education programme. It is acknowledged that parents also play an important role in helping sons and daughters come off drug dependence. However, too often parents who find themselves in this situation do not know to whom they can turn when a problem arises. Community drug teams operate in certain areas of Dublin and I would favour their expansion to rural areas.

It is difficult to escape the conclusion that the current allocation of facilities for heroin treatment is geared excessively towards methadone maintenance. Methadone maintenance is effective in stabilising many addicts but its effectiveness as a means of bringing people into a drug free environment is less clear. It can only be successful if backed by other services. I have heard reports that drugs are freely available inside these clinics.

Although it is regrettable, it is hardly surprising that people in local communities are wary of these clinics. The same problem may arise in relation to GPs who come on board with the Government's proposals. The Government has expressed support for locally sponsored drug centres or community developed responses. This would be a profitable avenue to pursue as would more support, financial or otherwise, for the voluntary agencies involved. Some of these agencies, like the Coolmine clinic, pursue approaches other than methadone maintenance and claim that these are no more costly and are as effective. They too should be examined.

I would like to say more on this issue. Thankfully, we have been confined to measures aimed at reducing demand. If we were to consider supply reduction as well we could debate for a week. This is a question of priorities. We have a problem and we need to address it in a fundamental fashion. A piecemeal approach would be futile. I welcome the measures adopted by the Minister. He has gone further than any of his predecessors but, in my view, the time for playing catch is over.

Mr. Lydon

There are just a few things I would like to say and I hope they are not recorded in the same way as remarks I made the last time we spoke on health with the Minister when I was accused of saying that he was economical with the truth after spending a speech praising him. Today I will state clearly that I congratulate the Minister on the measures he has taken.

The drug problem is horrendous. For 25 years or more I have been working with adolescents and their families. A number of years ago I would come across this problem occasionally but now, nearly every problem faced by a young person — whether they are not doing well in the leaving certificate, they are being promiscuous or they are stealing cars — has a drug basis. It is unbelievable. They use drugs as a natural or normal way of getting high. Senator Henry spoke about the dangers of Ecstasy. A young man came to me the other day and told me that of course he used E but: "I always know from whom I buy it". That was it; as long as he knew the supplier he believed he was safe. I tried to explain the drug to him. I am continually surprised that so many teenagers do not have accurate information on drugs. That is why I welcome some of the measures outlined today.

Education has an important role and more resources could be put into that area. It involves not just the Department of Health; the Departments of Education and Justice must also row in. A figure of £500,000 is to be spent on awareness campaigns. It is good that a figure has been included but I believe it should be nearer £500 million. If a bank went bust we would somehow find the money to bail it out. We could find millions for Irish Steel and Aer Lingus but those problems are nothing compared to the drug problem. Entire areas of our cities and towns are populated by people who are suffering daily, committing crime and dying slowly from drug abuse. The £500,000 should be millions of pounds. No Government or political party has tackled the problem with enough determination. I realise that a Minister at the Cabinet table must fight for what he or she can get and I am not detracting from what the Minister has done in this instance. However, the figure must be higher.

I dealt with another young man who had a problem with drugs. Both his parents smoked throughout the interview and the father was recovering from a hangover. Yet they wondered why their child was on drugs. As long as we continue to advertise alcohol on television and laud it as something nice, people will naturally take to drugs. Most of the children I see mix alcohol with drugs, such as Ecstasy, heroin or acid. They will take anything.

A young lady I saw recently is spending £200 per day in the Dún Laoghaoire area. She said she would do anything except kill somebody for that money. She had done practically anything, including prostitution and stealing. The young people in that area have a system. They usually steal from ladies who carry their cheque book and cheque card together in their handbags. They use the cheque books by forging the signatures in the bank on the first day, in pubs and shops on the second day and they throw them away on the third day. It costs them £100 to buy the package and a group specialises in it. The child had reached that stage. She did not know one person in her environment who was not using drugs. I am often gobsmacked by what I hear. I showed her that there was another world outside that environment. I do not know how she is doing now but perhaps she will make it. The problem is the drugs are so addictive.

Children mix drugs and use lethal combinations. That is why the education process is so important. I use the word "education" in the broad sense. The awareness programme will be operated through each health board so that children might begin to understand. Most people who use alcohol know that if they drink too much they will rot their brains or suffer liver damage. People who smoke know that they will eventually die of cancer. However, many of the young people who use drugs do not understand that it is not safe to use them. Many people will say that hash and marijuana are relatively harmless and it is true they do not develop a physical dependency, but they develop a psychological dependency and tend to accumulate in the brain. I cannot praise the awareness campaign enough but I would like to see more of it.

It is ironic that drugs is one of the major worldwide industries, with arms and tourism; the fourth major industry is pornography which tells us something about how we are developing. I do not know how we will eradicate the drugs problem. The Department of Justice probably has a major role but so does anything that educates people about drugs. If we prevent even a few people going on drugs it will help in the struggle against the problem.

Increased involvement for general practitioners in drug treatment is proposed. I am not sure that is a good move. The Minister said he is committed to it and that he has received a positive response. I know one doctor on the northside who dispenses methadone. He is now frightened because the patients call when he is not there or when the surgery is locked up. He has been threatened a couple of times and he is very frightened. There should be designated clinics in particular areas to carry out such treatment. It would be better not to involve general practitioners in this type of programme. They have enough to do and other patients in some of the surgeries involved have been threatened.

There has been much talk recently about decriminalising the use of soft drugs. There is no such thing as soft drugs. They do not inevitably lead to hard drugs and many young people are aware of that but prolonged use of such drugs encourage a laissez faire attitude to life and reduce motivation. I am glad the Minister is not opting for that route. It has not been successful in other countries and has not reduced the drug problem; in fact, the problem has increased.

I congratulate the Minister on his work to date. I do not disagree with the measures he has outlined, with the exception of his proposal regarding general practitioners. I would like to see more money being spent. The drugs problem is so strong that we must adjust our mindset and realise that we must do something about it. The three Ministers who have responsibility should get together and insist that the Government put money into dealing with the problem. If Irish Steel or Aer Lingus need money it is made available immediately. We may have no money but the Government, regardless of which party is in power, is always able to produce it. I have never been a Minister so I do not know where the money comes from but I know that it is there.

If we put £500 million or £600 million into tackling the drugs problem we could eradicate it. It can be done. Senator Henry calculated that £170 million is spent on this; we cannot combat that with £500,000. This is big business and the profits are huge. People kill for it with impunity and they beat up people. It is a violent business. I know another young man who was involved in it and he is now frightened because he was threatened. He has to keep producing and dealing even though the police know about it. The money, even for a small dealer, is so large and can produce such large profits almost instantly that people take chances. The fines and penalties must therefore be large, as must the help.

Mr. Sherlock

I wish to share my time with Senator Hayes.

Acting Chairman (Ms Kelly)

Is that agreed? Agreed.

Mr. Sherlock

I welcome the measures put in place by the Minister, Deputy Noonan. The urgency of the drugs crisis became even more apparent this week when a suspected drugs dealer was murdered. Unless measures such as those proposed by the Minister are not only implemented but expanded, we might see more people taking the law into their own hands.

Up to now we have tended to view drug addiction and the crimes associated with it as urban rather than rural problems. In recent months we have heard of a drugs epidemic in our cities which, according to experts, is reaching levels last seen in the 1980s. However, we have heard relatively little about the drug crisis facing Ireland's towns and villages. The heart is being torn out of rural communities by unemployment, emigration and the slow winding down of essential services such as Garda stations and post offices. A fairly large town in my area, Doneraile, is awaiting the deployment of gardaí for almost six months. That is not good enough. If it is an internal problem, the gardaí should sort it out. Young people in these communities are vulnerable to the quick fix promise of drugs and are increasingly targeted by pushers and dealers, many of whom operate openly.

Garda drug teams in Dublin, Cork and other areas have succeeded in stemming the drugs trade in our cities, but there is a danger that they will be pushed into surrounding towns and villages. In latter years some progress has been made in terms of drugs seizures as a result of co-ordination between the Garda and the Navy, which is important. We must ensure that gardaí in rural communities are given the expert backup they need to tackle the problem and that their numbers are increased or at least maintained.

We must ensure that drug abusers in rural communities have full access to drug treatment services such as methadone maintenance programmes. I urge the Government to build on recent progress in this area and to establish community drug teams in those rural areas where drug problems have been identified. We need to catch drug addicts at the beginning rather than at the end of the drug abuse cycle. We need to ensure that the first contact drug addicts have with the State is through the social and medical services and not through the justice system.

We must address the issues surrounding the supply of drugs and we must tackle the demand for drugs. That is the crux of the issue being debated today. There are still long queues of addicts waiting for treatment which would not only save their lives but would reduce the suffering of thousands of victims of drug abusers. If these were ordinary patients suffering from some form of organic disease, there would be a national outcry. Instead, we turn a blind eye until we are confronted with the effects of drug abuse in the form of crime and anti-social behaviour.

Drugs, like any other product, are subject to the laws of the market. I am advised that Ecstasy tablets are currently available in Cork for a few pounds and that the prices continue to drop due to what can only be termed a glut on the market. These tablets, like heroin, are ideal contraband — small, easily transported and, despite the drop in prices, sold at enormous profits. Many young people do not regard Ecstasy tablets as real drugs until they suffer the side effects. This is the view of young people with whom these matters are discussed. There is a clear need for a frank, no holds barred education and information programme along the lines of the successful Manchester initiative.

Unless we address the issue of supply and demand, we will not stem the drugs crisis and the crime wave will continue unabated. The link between drugs and crime is incontrovertible. It is estimated that approximately 80 per cent of all petty crime in urban areas is committed by drug abusers. At our recent annual delegate conference, Democratic Left debated a wide range of topics associated with drugs, crime and justice administration. The intensity of that debate reflected the widespread public concern at increasing levels of petty crime and violent offences against the person. Contrary to popular belief, Democratic Left is not soft on crime. My party believes that every crime must carry an appropriate punishment which must be fully implemented while safeguarding the rights of the innocent.

It is vital that persons convicted of a crime serve the sentence handed down by the court. It is unacceptable that persons should be released on an ad hoc basis after serving just a few months of their sentences. This is one of the issues which must be addressed as a matter of urgency. Temporary release was originally intended as a compassionate measure and to help rehabilitate prisoners into the community. However, in the 36 years since temporary release was introduced, it has become little more than a convenient instrument used by the Department of Justice to relieve the pressure on prison places. There is now an urgent need to review the operation of the temporary release system not simply for drug related offences but also in connection with other serious offences.

We must stop viewing prisons as instruments of containment and start viewing them as instruments of rehabilitation. This requires a co-ordinated policy of sentence management for each prisoner to ensure that the pattern of offending and reoffending is broken. We must also ensure that all prisoners have access to a comprehensive, individually tailored programme of drug treatment and rehabilitation, which they can continue after they are released.

Mr. Hayes

I thank Senator Sherlock for agreeing to share his time with me. I congratulate the Minister for Health, Deputy Noonan, on his statement this morning.

Some figures were bandied about during this debate. Substantial additional resources will be given to this area over the next two years — in excess of £3.5 million will be provided this year and £4.5 million next year. It sometimes galls me when the Opposition attacks increases in public expenditure and then calls for additional resources in these areas. They are either for additional resources in this area — in which case they should support the Government and the work it is doing in preparing the Book of Estimates and stop playing politics with the issue — or they are not.

Why are so many young people caught up in the drugs spiral? The Minister issued a statement in February that he will set up a task force to address this issue. There are many underlying reasons, including the fact that many of our young people live in ghettos and because of the lack of educational facilities and opportunities, they are sucked into a drugs culture. That is the case in many parts of my constituency. Senator Lydon is correct when he says that in certain parts of the city it is usual for young people to get caught up in the drugs scene. We must recognise that fact and ascertain why it is happening. Certain areas of the city need more funding and services.

Ecstasy tablets came to public attention approximately 18 months ago when people living on the hill of Howth suddenly realised their children were being caught up in the drugs scene. Yet many areas of this city have been dealing with the drugs crisis for years. That is the nub of the problem we face. Poor conditions can lead to drug abuse. This is a nationwide issue and should be dealt with as such. There has been a good response by the Government. The interdepartmental committee formed by the Departments of Health, Education and Justice was dormant for a considerable period. It is now working again and I congratulate the Ministers involved for taking the initiative to re-establish it.

We have an opportunity during our six months Presidency of the EU to highlight this issue as a European wide one. I suspect that much of the information we have in terms of recent seizures comes from the good intelligence which has been built up by police forces throughout the EU. This needs to be streamlined because we can only get at the surface of the problem when we take drugs out of circulation and we need the support of our EU colleagues in doing so.

I wish to put on record my support for the residents of west Tallaght in their efforts to get rid of drug pushers from their community. They have engaged in a peaceful protest for the last month or so. This is in great contrast to the summary execution which took place on the streets of Dublin a few days ago. The residents, by peacefully protesting against the pushers, have shown the level of community action which can bring about results, once effort is channelled and directed in a certain way. I congratulate them because they have shown what communities can do when they stand up to pushers.

Senator McGennis spoke about the Eastern Health Board and this should be an issue for the Minister. Many residents of large sections of this city are frustrated by the fact that where pushers or large scale drug abusers are thrown out of local authority houses, they frequently receive rent subsidies from the health board and end up not too far from the communities they left. This is an issue of co-ordination. The Eastern Health Board, the Department of Health, the Garda Síochána and the local authorities need to concentrate their minds on this issue because it causes havoc in many parts of the city. Pushers are bringing supplies of drugs into drug free areas and are causing havoc there.

I support the work being done in local communities. In my area a volunteer put together a community anti-drugs newsletter, in conjuction with the area's local newspapers. There has been a focus in the area on bringing the attention of parents to the problems of drug abuse because many of them are not fully aware of them. As Senator Henry said, drug abusers are manipulative and children want to experiment at a young age. We need to inform parents that the community level is the best one at which to deal with the issue. This initiative in Tallaght is having much more impact in the area than any nationwide campaign costing £500,000 could have. I would like to see part of this money directed towards initiatives which are already in place and are working.

Those who suggest that legalising soft drugs is part of the answer to the problem come from the vested interests of the pushers themselves. We need to scotch the nation that we would should accept the legalisation of these supposedly soft drugs. It is pushers themselves who are spinning this line, which is finding its way into many of our newspapers. This is not an issue. People who read about this suggestion may not be aware of the problems of drug abuse and they need to familiarise themselves with the dangers drugs cause in my community.

Professor Lee

I cannot speak with the impressive local authority with which the party spokespersons have addressed this issue. They are able to draw on their knowledge of what is happening in their areas. I echo Senator Henry's call that we should not regard this as predominantly a hard drugs, inner city Dublin issue. It is a national issue. In Cork the Ecstasy problem is a recurring threat to civilised young life and we should not become soft on so-called soft drugs. I echo entirely what Senator Hayes has said in this regard.

I am saddened at the way we have approached the issue. The heading of the Minister's speech refers to the Department of Health's response to the problem. The problem, as we have said time and again, transcends Departments. From the point of view of coping with problems, we chop them up so that they fit in with departmental structures. This is no reflection on people in Departments; but I find it staggering that we still approach debates from a specifically departmental perspective on issues which cannot be resolved by individual departmental measures, however worthy they are. The measures proposed by the Minister seem eminently worthy, but to have the most fruitful debate possible we should have representatives from all the Departments involved, however that would be logistically organised. Debates in this and the other Chamber would be far more fruitful if we could have representatives transcending a departmental basis on problems which are not departmental problems as such. We can only get a partial perspective here, however insighted it may be.

When the Minister of State, Deputy Currie, was here earlier I thought it was because he might have joint responsibility for programmes by the Departments of Education and Health on drug abuse. I am informed that while he is responsible for child abuse programmes, he or anybody else does not have specific responsibility for drug abuse programmes across Departments. I may be wrong but this is the information I have been given. If this is the case, it is high time there was a Minister or Minister of State with specific responsibility for leading the Government's campaign against drugs misuse. If there is somebody with specific responsibility, I would be glad to hear it; but I would like to see more reference to it in documents. If there is not, given the centrality of this problem in Irish life, which is one of the saddest issues with which we must cope, it is high time there is a Minister with specific responsibility who would be required to provide specific accountability to the Oireachtas on the progress of these admirable measures and others which may be decided on.

One of the problems which emerges and at which I am taken aback is how little we seem to know specifically about the scale of the problem. Different figures have been quoted and we have been warned that they are probably underestimates. I am grateful that the task force which has been appointed is not a high level but a poor ordinary one because there might be a chance that it will find something out. A task force has been established now, even though we have been talking about drugs year after year.

Senator Henry, who has a knowledge far exceeding mine or that of most of us on an issue like this, doubts the figure of 1,400 given by the Minister. I do not know if her doubt is valid. She used a figure of 7,000 heroin addicts to make calculations about the total cost. However, the figure of 7,000 in the Minister's speech refers to drug misusers, not just heroin misusers. I do not know which is correct; maybe none of us knows. It is staggering that at this stage we seem to have so little concrete data on the scale of the problem.

The Minister for Health finished by saying he is confident that the proposed measures will lead to a significant reduction in the scale of the problem. If we do not know the scale of the problem, it will be extremely difficult to report back in a year's time on how successful the measures have been. One would be hopeful, but I do not think we are in a position to use the word "confident" on the basis of the evidence contained in documents like this. It is important to get basic data as quickly as possible.

We have to some extent discussed the root causes. I turn to socio-economic factors mentioned by the Minister. He said that in 1994, 84 per cent of heroin addicts who had received treatment were unemployed and 60 per cent had left school with a minimum education. I agree with Senator Hayes. The Tallaght experience and the intense concentration of heroin addicts in a limited number of areas show that a focused specific programme is more important than a blanket national media programme. In so far as a choice is to be made between them because of limited resources, I would try to focus an information programme on the areas and categories most at risk. They are not confined to Dublin but there will be a disproportionate number in Dublin.

I am a little sceptical about the hopes being placed on education and the education system. I am in favour of introducing as much information at primary level for pupils as possible but I am sceptical about the overall consequences. The culture of the school has only a very small chance of conquering the culture of the outside world from which these children come. If that culture is so deeply rooted in deprived areas, we are treating symptoms rather than substance. Until we can reduce the level of deprivation in these ghetto communities, we will have only limited success with a drug information programme in schools, much as I support it.

I look at the Departments involved and I see no reference to any economic Department even though, in so far as policy can influence these matters, it will have to be the policy of economic Departments which influences levels of deprivation. How much integrated thinking is there in Government about how one tackles these problems? No economic Department should be allowed propose policies which have any potential impact on these areas without having them drug proofed. We have gender proofing and a variety of other types of proofing, which are very valuable. We must ask about the knockon implications for drug abuse in identified areas. Economic programmes focused on these areas should also be required to take cognisance of their possible implications.

Co-ordinating one Department can be a major problem but co-ordinating a number of Departments challenges our ability to conduct policy. This afternoon we will discuss a report from a committee of departmental Secretaries on reforming the Civil Service. When one reads their report one finds that a central question is how to achieve co-ordination between Departments. I can think of few programmes which require that co-ordination more than drug abuse. Until we get it, however admirable the individual proposals, we will not be successful in reducing demand for drugs.

Reducing demand is crucial. There are drug pushers and we know about the horrible event last night. Demand can to some extent be created, but until demand is significantly reduced supply will be found for it. I support all the measures which try to get hold of drug pushers but as long as there is demand, a supply will find its way in. If one reduces supply, the only thing that happens is the price rises. If the price rises, it makes addicts even more desperate and more reckless in the criminal measures they often take to find the money with which to get drugs. Reducing demand must be central. I applaud the emphasis on demand reduction measures in the title to the Minister's speech, even if it is a departmental rather than total response.

My final point echoes Senator Hayes's comments. Why do young people take drugs to the extent to which they are taking them? That comes back partly to the precise environment in which they find themselves. It also comes back to the wider value system in society. We are fostering what I will loosely call, without being clinical about it, a no fault value system. It is a value system which says that anything goes and it is coming at us every day from most information sources and the media. The schools can only counter the problem with a modest effort. As long as those value systems are coming at us and appear to be embraced by the bulk of opinion forming establishment, all the specific programmes in the world which are attempting to cope with demand for drugs will have only limited success.

It is like sticking a finger in a dyke. If the waves are coming, one can do a bit here and there; but, irrespective of good intentions or the intelligence with which programmes are formulated, they are fighting an uphill battle. Tá siad ag snámh in aghaidh an easa an t-am go léir. We have to look at more than specific measures. We must also examine the impression Government and indeed the rest of us are giving about the type of society we want and about its basic value system.

Ms Honan

I welcome the Minister and the opportunity to discuss the drugs issue, which is most important. Any of us who are parents or who have any contact with young people are aware of the increasing use of drugs in our communities and the dangers posed by the drug threat to the health, safety and future prospects of all our children.

The Minister for Health outlined the steps being taken by Government to tackle this serious problem. It is a complex and difficult one to which there are no instant solutions. However, we must address ourselves to these problems with a greater sense of urgency. I was quite shocked to see the estimates of the number of drug misusers varying from 3,000 to 7,000. Having discussed the issue with the gardaí in my own constituency, I believe there are anything between 700 and 800 people abusing drugs in the Laoighis-Offaly area. It is no different from any other area of the country and a figure of 3,000 to 7,000 seems to underestimate the problem. This could be why the greater sense of urgency needed to address the problem is not apparent.

Recently, 300 gardaí were moved to the Border counties because of the BSE crisis. When are we going to see a similar announcement of a like number being allocated specifically to deal with the problems of drug abuse in our communities? We do not have any official drug squads in any of the divisions in the country. I know that some official drug squads were set up in the cities recently. However, unless we are to face problems in country areas which we have already seen in the cities, it is vital that we appoint official drug squads to deal with the issues now.

Those who present themselves for treatment for drug addiction should not be put on a waiting list. Continuing to allow bail to drug addicts, without offering them treatment, when they have no visible means of supporting their habit is quite reckless. I accept there is a need for a multi-disciplinary approach to tackle the drug problem and that it is not all within the responsibility of the Department of Health.

Deputy Currie is the Minister of State with responsibility for children. Drugs affect our children and we need a Minister with special responsibility in this area because it is the greatest scourge and threat which faces society. There is a belief in rural areas that drugs are seen by the authorities and the powers that be as a city problem. We all would acknowledge that not a village or town remains unaffected by drugs.

As long as we pay lip service to the drug problem it will escalate and reach a crisis point, when we will feel helpless. Individual gardaí are doing a tremendous job with the limited facilities available. Burying our heads in the sand and pretending the problem is not as great as it is will lead us in future years to look back and ask how we ignored the seriousness of the problem.

In my area of Laoighis-Offaly the main drug being used is cannabis, followed by Ecstasy, LSD and speed. Thankfully, we do not have a heroin problem yet, but with the increasing use of Ecstasy over the past 18 months it will not be too long before it will be freely available. In the past six months in Edenderry over £30,000 worth of Ecstasy tablets were seized by the Garda. That gives us an indication of the seriousness of the situation.

We should also be aware that very young people take drugs. While the main problem is with teenagers and people in their early 20s, the Garda will say that people from 14 to 50 years of age are misusing drugs. The situation in my area is different to that in Dublin. Although people may believe drugs are not freely available in rural areas, on Tuesdays and Thursdays in Laoighis-Offaly when people collect their dole, large groups pool their money and send a person to Dublin on the train to purchase drugs to distribute among them. On Fridays third level students return from Dublin, Cork, Galway, Carlow and Athlone, some of whom bring back hash and Ecstasy. Many people in rural areas working in the larger cities bring back supplies of hash, Ecstasy and LSD. As a result, there is a regular supply of drugs in every town and village, particularly at weekends. Much cannabis dealing is taking place.

Our greatest concern is the increase in the use of Ecstasy. Some people believe that Ecstasy is only available at raves. Many young people in towns where discos are held at weekends take Ecstasy. This is very frightening because many do not know what is contained in Ecstasy, which is extremely dangerous. Over the past 12 months a number of young people have died as a result of taking Ecstasy tablets, which are not only available in the cities but in discos, bars and any place in which young people congregate.

We must stress the importance of contacting gardaí and of using their expertise in this area to talk to young people. In many areas gardaí have gone into schools to talk to children and to parents groups about drugs. As parents we must be conscious of the example we give to young people. The greatest abuse of any drug in this country is alcohol. Statistics show that 72 per cent of all adults drink. We cannot except our children to look at us drinking and smoking and then turn around and tell them that they cannot take cannabis or Ecstasy.

We must also be aware of the high level of prescribed drugs taken in every home. If young people see their parents taking prescribed drugs, it is easy for them to drift into the use of illegal substances. As others Senators said, there is no such thing as a soft drug. Alcohol, cigarettes and cannabis can cause considerable harm to young people and may involve them in a drug culture which will lead them to harder drugs.

Underage drinking is a huge problem. The Garda will say that the use of false ID cards by young people is widespread. There has been a huge increase in underage drinking in recent years, which should be of concern to us all. We must ask why young people become involved in drugs. Many believe that if they do not take Ecstasy, they are not cool. They see their peers smoking hash in the same way as cigarettes. Lack of self-confidence and self-esteem cause young people to turn to drugs. It is important that parents are aware of the dangers and communicate and support young people when required. Parents have a duty to educate themselves as to the availability of drugs, to know where drugs are available in their areas and to co-operate with the Garda and the schools in trying to rid their communities of drugs.

The Government responded to the BSE crisis by increasing the number of gardaí at the Border. If we are committed, we can react quickly. The drug problem is the greatest scourge facing society and it is a huge threat to young people. A difficulty many parents have is that if their children become involved in drugs they feel it is difficult to reach them and that they are beyond redemption, which is difficult for parents to accept. We must acknowledge the extent of the problem; it is only then we will be able to tackle it.

The Garda in Tullamore have told me that after discos at weekend the town is like Grafton Street on Christmas Eve. People move into the area from County Tipperary and County Westmeath and drugs are freely available. We must face up to this issue. I welcome the measures announced. I accept there are specific problems in the Dublin area, particularly in relation to heroin, and that the Department faces difficulties in terms of involving larger numbers of GPs in methadone treatment and the setting up of residential centres for the treatment of drug addicts. If we manage to get across to people the extent of the problem and the fact that it not only affects children of a particular class in society, they might accept measures necessary to rid ourselves of this curse.

Mr. Kelleher

I place on the record my condemnation and abhorrence of the recent summary execution of a person for alleged drug dealing offences. It is a sad indictment on Government and society that such an appalling tragedy can occur. I welcome any announcement by a Department, Minister or Government which tries to address the problems associated with the misuse of drugs. However, Ministers and Governments have had a haphazard approach to the issue of drug abuse.

The Garda will admit that it has lost the battle as regards drug dealing and the distribution of drugs. It does not have enough resources and cannot convict drug dealers because of the inadequacies of the law. Drug dealers out on bail can continue to profit while awaiting conviction. These issues must be addressed.

There is a huge Ecstasy problem. It is sad that we did not respond to the misuse of drugs in society until it touched middle class people. For many years, there was a huge heroin problem in the Dublin inner city area and we had a haphazard approach to dealing with that problem. It is only now when teenagers from all sections of society go out on a Saturday night and pop two Ecstasy tablets that we realise we have a drug problem in society. However, all is not lost because if a coherent and definite approach is taken by the Government and a liaison group involving the Departments of Justice, Health and Education is established, a strategy could be adopted at some stage to address this issue.

Fifteen years ago young people drove their cars home after a dance, having had up to 11 whiskeys and perhaps a couple pints. This was acceptable, but young people today do not think drinking and driving is acceptable. Their views have been cultivated through education and advertising. A coherent educational advertising campaign would get the message across to the vast majority of young people that taking drugs is dangerous and antisocial.

An educational programme should be established which covers every school in the country. This should also involve community gardaí, who are most effective but who do not have sufficient resources. They attend meetings at night and discuss issues with parents and teenagers, but not enough resources have been directed towards education in terms of combating the drugs problem.

We must face the fact that there is a huge heroin problem in inner city Dublin. The statistics show that 2,700 people are receiving treatment. From speaking to people who have been on heroin and went on to methadone treatment programmes, addicts only approach such programmes when they become ill, weak and unable to sustain their addiction through illegal activities, such as stealing and shoplifting. The problem is that heroin addicts are not being reached in time. They ask for treatment and are told there is a waiting list. If one is addicted to heroin, which is one of the most addictive substances available, it is pointless being told one is on a waiting list. One needs immediate treatment. The methadone treatment programmes must be vastly extended to ensure heroin addicts know they are available when they require them. Addicts want to get off heroin.

At this stage we have at least acknowledge there is a drugs epidemic throughout the country, particularly of the designer drug, Ecstasy. There is a heroin crisis in Dublin's inner city areas. Sadly, this acknowledgement has come late and resources must be put into the education, health and justice areas to combat the importation and distribution of drugs and cultivate the thinking of young people so the next generation realise that taking drugs is dangerous and antisocial. I mentioned the example of a good advertising campaign about drink driving.

My sister returned from Sydney a couple of weeks ago and she told me a girl died there as a result of taking Ecstasy. It was the first time she had taken it and the Australian Government immediately latched onto this point and ran a huge advertising campaign involving the girl's parents, friends and school she attended. This had a major impact on young people's views on what was considered a designer drug. The Minister and his Department should take this example on board.

Mr. Enright

This matter is immensely important and I concur with many of Senator Kelleher's points. It is vital to get the dangers of drug abuse across to young people. The Department of the Environment ran a successful campaign over several years in relation to drink driving. This had a significant effect on preventing people driving after drinking; but, regrettably, young people still abuse alcohol to a large extent. Similarly, a campaign against cigarettes is ongoing but many young people are still smoking. Nevertheless, campaigns make a difference.

The drugs problem is no longer confined to Dublin, Cork and other large cities. It now affects every town and village. I discussed with the Garda Síochána the methods used by drug pushers to bring in drugs and it is amazing how devious they can be. We need to reach the drug barons, but this is difficult because the Revenue Commissioners are reluctant to pursue many of these people due to the physical intimidation of staff members and their families. Social welfare officers, who had occasion to call on these people to investigate their means, and their families have also been physically threatened and intimidated.

This is the scenario and it is serious. The Garda has extensive powers with regard to stopping, searching, arresting and holding people. It also has powers to search houses, etc., but people are able to escape convictions. If a person was charged in a country town, such as Portlaoise or Tullamore, it would be difficult to secure a conviction against known drug pushers from a jury. The situation is bordering on a crisis at present. It involves paramilitaries and millionaires who have no regard for the life or limb. We may have to declare an emergency and, although I am reluctant to say it, it may be necessary to consider establishing non jury courts to hear cases against drug barons. I wish the Minister well in his difficult task and thank him for his efforts to date.

Minister of State at the Department of Health (Mr. O'Shea)

I thank Senators Kelleher and Enright for providing time for me to reply to the debate. I thank Members for their valuable contributions to the debate and I endorse everything that has been said by my colleagues about the Government's intention to tackle the drug problem head on. The fact that the Taoiseach's office is co-ordinating the establishment of the task force, under the aegis of the interdepartmental policy committee on local development, is also an indication of the Government's resolve to do all it can to address the issue.

The task force will concern itself not with treating the fallout of drug misuse, which affects a number of areas — for example, health related problems and crime — but with tackling the root social factors which give rise to drug misuse in the Dublin inner city areas. It will also examine how best local community groups can be harnessed to prevent misuse and how partnership arrangements with parents and other groups should be structured. The only way forward in the fight against drugs is an integrated approach which involves statutory, voluntary and community groups working together for the benefit of local communities.

Senators McGennis, Lee and Kelleher mentioned the need for co-ordination. Following a Government decision in july last year on measures to control the supply of drugs, the national co-ordinating committee on drug misuse was reconstituted. The committee's terms of reference are as follows: to advice the Minister for Health and Justice, and other Ministers as appropriate, on issues relating to drug misuse, including best practice in Europe; to monitor trends in drug misuse; to co-ordinate demand and supply reduction measures on drug misuse; to monitor the effectiveness of actions taken to combat drug misuse, and to make recommendations to the Ministers for Health and Justice, and other Ministers as appropriate.

Membership of the committee is drawn from the Departments of Health, Education, Justice, the Marine, Defence, Foreign Affairs, the Environment and Enterprise and Employment and the Revenue Commissioners with representation also from health boards, the Garda national drugs unit and the health research board. I have the honour of chairing the committee and as chairman I have a particular interest in ensuring the efforts of all agencies involved in the fight against drugs are co-ordinated to maximum effect.

At its meetings to date the committee has reviewed current policy in relation to preventing drug misuse. It has established two subcommittees, one responsible for demand reduction and the other for supply reduction. It was apparent at the first meeting that there was an urgent need for all of the agencies involved in tackling drug misuse to engage in ongoing communication and to collaborate on the formulation of all policy and in developing initiatives.

The measures announced last February by the Minister for Health help to define the agenda for both the national committee and the subcommittees. One of the Government's decisions was that each health board should establish a committee to co-ordinate activities at a regional level. The regional structure will provide a forum for co-operation in which all major issues can be addressed. The Eastern Health Board has established such a committee already which is fulfilling a valuable role in recommending how proposals to tackle drug misuse should be developed. Representatives from each of the regional committees will sit on the demand reduction subcommittee ensuring there is a flow of information from national level to regional and local levels and vice versa.

Addressing drug misuse involves action at many levels. While dealing with those who are misusing drugs must be a priority for the health services, in order to reduce the number of young people who are turning to drugs as a means of coping with life one of the most effective tools we have is education and prevention. My colleague, the Minister for Education, is working on the development of a substance abuse prevention programme for primary schools which will commence in the autumn.

As part of my brief at the Department of Health I have responsibility for health promotion and I am particularly pleased that in implementing these proposals major emphasis will be placed on education and prevention measures. The promotion of healthy lifestyles among our young people will be a core theme. Self-respect is important in this regard and it is the best way to demonstrate to them that drugs need not impinge on their lives.

Others will have a vital role to play in this approach. I cannot emphasise enough the part which parents have to play. Parents are, after all, the essential role models for their children and it is to them that children look for guidance and support. They are also more likely to notice the tell tale signs, such as changes of behaviour, which can be an indication of experimenting with drugs. In the Eastern Health Board's service plan, parenting programmes will be initiated among drug using parents in order to equip them with basic parenting skills to help them play a more positive role in rearing their families in a difficult environment. Other health boards and agencies have developed parenting programme models for use with parents whose children may be experimenting with or misusing drugs. These models aim to equip parents with skills to deal with communicating with their children and also to deal with conflict resolution.

The Department of Health will move forward with implementing the Government's drug misuse strategy as a matter of urgency. With improved co-ordination and a commitment to work together to find solutions to the dreadful problems which drug misuse causes in society, I am confident the services we provide at preventive, treatment and rehabilitative levels will be greatly improved.

While health services alone are only one element in a much bigger strategy, my Department and all the agencies which come under its remit will work relentlessly to address this major issue. We have consulted with a number of our British and European counterparts in examining how these countries address drug misuse. From these consultations I am encouraged and confident that the Government decisions have set us on the right track and that the actions implemented as a result of these decisions should result in an improvement in management of the drug misuse problem, particularly in the Eastern Health Board area, where the problem is most acute.

Sitting suspended at 1.5 p.m. and resumed at 2 p.m.