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Seanad Éireann debate -
Friday, 14 Dec 2001

Vol. 168 No. 25

Drug Treatment Services.

I wish to raise a serious issue. It relates to a young man who has been addicted to heroin for a number of years, who is endeavouring to get onto a detoxification and methadone treatment programme and has put his name down with the Mews Clinic.

The young man's name has been on the list since July, when he moved into the area. He is residing there permanently now. He was originally told that six months residence in the area was sufficient for acceptance on the programme but that has been increased to 12 months. The waiting list for the Mews Clinic in January this year was six but there are now 18 people on the list. The waiting list in the Eastern Regional Health Authority area was 390 in January and it has now increased to 529. We seem to be going backwards.

The Minister of State, Deputy Eoin Ryan, trumpeted the new national drugs programme which was to be delivered on a local and regional basis. It was to be decentralised in terms of delivery. The purpose of establishing local clinics was that each area would take care of its local population of drug addicts. That policy does not appear to be working. When I contact the Department of Health and Children, I am told there are no waiting lists but I have now received the official figures which indicate that not only are there waiting lists, but that they are growing – they have trebled in the case of my local clinic – in the space of 12 months.

This case involves a young man waiting to detox. He has made the decision and is committed to it. A heroin addict cannot wait forever because they go back to drugs very quickly. This young man has reduced his intake, although he is still an illegal consumer of heroin. He is now trying to get on a programme which will assist him to get off heroin. He is trying to get a job and build a stable life with a companion. However, when he presents himself at the clinic, he is told that the waiting list has trebled and that the length of time he must be living in the locality has doubled from six to 12 months.

We are supposed to be getting to grips with the biggest drug problem, heroin, in the country and particularly in Dublin where the problem is mainly concentrated. I do not know what is happening. I thought the resources, personnel and programmes had been put in place. I am a member of the local drugs task force where I raise the issue of the lengthening queues at every meeting. All I hear is the Minister clapping himself on the back for his wonderful strategy. He claims treatment is now provided on a community basis and that the community is participating in its implementation. However, although that is useful in terms of capital expenditure on the provision of youth facilities, it is not doing anything at the coal face, where people who are anxious to kick the habit and to leave the illegal activity in which they are engaged are prevented from doing so. I would have expected the Department to be desperately inviting people to participate on a programme and to be overjoyed to encounter somebody who is prepared to commit themselves to it, rather than closing the door and shunning them. He is told to return in another six months but at that time he might be told there will be a further six month wait.

It is disappointing that the situation appears to have deteriorated despite all the tragedies that have happened. Yesterday, I was in Buckingham Street for the switching on of the Christmas lights for the people in the area who have died from drug abuse. Nearly 200 young people from that little locality, many of whom I knew to be fine young people, got into the drugs habit and died extremely young as a result. We still have not learned the lesson that we must provide a decent treatment service for them.

I hope the Minister of State's reply will allow me to assure this young man that he will be received into a detoxification and maintenance programme and that it will provide hope for the hundreds more people who are waiting to get onto such programmes.

I thank Senator Costello for raising this matter and giving me the opportunity to explain the position in relation to drug treatment services.

The provision of drug treatment is the statutory responsibility of the health boards but the person the Senator refers to has been on the waiting list for methadone maintenance treatment since 1 August this year. He is currently eighth on the list and it is expected that the first three on this waiting list will be offered treatment places shortly. Normal procedures for acceptance onto a treatment programme at a clinic are that the individual requesting treatment must reside in the catchment area of the treatment clinic for at least one year. I understand that in this case the person concerned has not yet produced evidence that he has lived in the area for this period of time, despite requests to provide this information.

The overall objective of the Government's strategy in relation to drug misuse is to reduce significantly the harm caused to individuals and society by the misuse of drugs through a concerted focus on supply reduction, prevention, treatment and research. With regard to treatment, the objective is to provide a range of options to encourage and enable drug misusers to avail of treatment with the aim of reducing dependency and improving overall health and social well-being, with the ultimate aim of leading a drug free lifestyle.

The national drugs strategy, 2001 to 2008, published in May 2001 by the Taoiseach, is the result of a comprehensive review initiated by my colleague, the Minister of State with responsibility for the strategy, Deputy Eoin Ryan. The strategy has been developed around the four pillars of supply, prevention, treatment, including rehabilitation and risk reduction, and research. This approach incorporates, more or less, the full range of activities which are the hallmarks of modern drug strategies in other jurisdictions.

The strategy provides that there should be 6,000 people on methadone treatment by the end of 2001. At the end of November there were 5,888 people receiving methadone nationally. Of this number, 5,435 were receiving treatment in the Eastern Regional Health Authority area. This shows an increase since the beginning of the year when there was a total of 5,084 people in treatment nationally, with 4,961 of those in the eastern region.

In September 2001 there were 529 people waiting for treatment. This figure represents a decrease on the previous month when the list was at 561. Figures for the Mews Clinic also show a decrease, with ten people awaiting treatment in September compared with 16 in August. Another target of the national drugs strategy is that drug misusers have immediate access to professional assessment and counselling, followed by commencement of treatment as deemed appropriate not later than one month after assessment. Ideally, we would wish to see a situation where there was no waiting lists, but our ability to expand services are constrained.

The methadone protocol was introduced in October 1998. Since that time 169 general prac titioners and 241 pharmacists have joined the scheme. The participation of these professionals is crucial to the successful operation of the scheme. However, the number of new general practitioners and pharmacists coming into the scheme is very low. That makes it difficult to transfer stable patients from clinics to general practice, thus freeing up spaces in the clinics. Health board officials are working with the Irish College of General Practitioners to explore ways of encouraging GPs to become more involved in methadone treatment. The difficulties which the Eastern Regional Health Authority and the health boards experience in gaining acceptance for the provision of local drug services are well known and, in some instances, are severely limiting the capacity to respond to actual need in these areas.

Health boards will continue to work to develop effective responses to the problem and, through regular monitoring of the overall implementation of the strategy, I am confident that the actions undertaken will have a positive impact on the health and well-being of all the population, but particularly on those misusing drugs.

I take this opportunity to wish everyone, including Senators and staff, season's greetings.

I do likewise.

The Seanad adjourned at 6.05 p.m. until 2.30 p.m. on Tuesday, 18 December 2001.

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