Seanad Éireann debate -
Tuesday, 28 Apr 2009

Vol. 195 No. 2

National Drugs Strategy.

Senator Jerry Buttimer

I thank the Chair for allowing me to raise this issue. I thank the Minister of State for coming in to deal with the issue of drug rehabilitation facilities outside Dublin. It must be acknowledged that we do not have enough beds for rehabilitation, particularly in Cork which has no detox beds. A report carried out by Dr. Mai Mannix highlights the fact that we should have 24 beds for the region, 12 of which should be in the city. There has been a lack of funding for drug rehabilitation over the years, particularly outside Dublin. As the Minister of State knows, rural Ireland has seen an increase in drug use and waiting lists have increased dramatically. According to the Irish Examiner, people in the midlands are waiting for extraordinary periods. Some 90 people are waiting in Athlone whereas 205 are attending its clinic, an increase of 53 from the end of 2007. The increase in the number seeking and availing of services has two implications, namely, putting a strain on drug treatment centres and pressure on the local and regional drugs task forces.

It is clear that the national drugs strategy has done good work, but the Government has failed to deliver a credible and competent rehabilitation service. Drug use has spiralled out of control in many regions. In some cases, the numbers seeking treatment for cocaine abuse have increased over a seven-year period. The drug prevention projects must, alongside rehabilitation, be the cornerstone of any strategy. The regions require treatment and rehabilitation centres, as outlined in articles 48 and 74 of the national drugs strategy. The mid-term review included it in the fifth pillar.

It is extraordinary that Cork has no detoxification beds. The rehabilitation centres are not enough. Drugs are a problem, but the lack of support is becoming a greater one, given the budgetary situation. If we are serious about a prevention and rehabilitation service, funding in these economically stringent times must be provided. We need growth rather than a cutback in the number of places and beds provided.

Rehabilitation involves a multiplicity of disciplines, be they statutory, voluntary or community organisations. People need support, resources must be strategically used and more beds are required at all levels. There are too few dedicated residential services to assist in the recovery and detoxification programmes. In the Minister of State's reply, will he refer to the southern region in this regard? As of last summer, nine counties had no dedicated residential services. This number is extraordinary, given this period of unparalleled drug usage, especially cocaine.

I thank those who work in the voluntary and State agencies and the local drugs task forces. I have concerns about the Health Service Executive, HSE, being the conduit for everything. Perhaps the Minister of State will make some comments in this regard. We have not lived up to our commitments in the national drugs strategy in terms of rehabilitation and detox. We need joined-up thinking.

During the past year, the Irish Examiner published a series of articles. The Minister of State saw the article yesterday that is specific to the matter of drug prevention facilities and so on. Drugs have infiltrated society. Stories such as those printed yesterday and in recent weeks highlight a failure of bureaucracy to channel money and to provide resources to people locally. I compliment the Irish Examiner in this regard.

This debate is not on Dublin specifically, rather on the regions which are suffering an increase in polydrug use. I hope to see a proper rehabilitation and detoxification programme in the new national drugs strategy. I also hope budgets will not be cut. The fifth pillar is pivotal. We need action, not words or empty promises, although I accept the Minister of State's bona fides.

The number of people seeking treatment in all corners of Ireland has increased. Slashed budgets and a lack of commitment will not help. While we live in a world of recessions and cutbacks, drug rehabilitation should not be affected. I hope the Minister of State's reply will be positive. I thank the Cathaoirleach for allowing me to raise the issue on the Adjournment.

Minister of State at the Department of Justice, Equality and Law Reform (Deputy John Curran)

Significant changes have occurred in the pattern of drug use since the 2001-08 national drugs strategy was developed. In particular, the number of drugs involved has increased and polydrug use occurs to a greater extent. It is now accepted that problem drug use has spread throughout most of the country, presenting a broader challenge of bringing rehabilitation facilities.

The 2001-08 strategy focused on heroin which was a major problem in the Dublin area. The use of heroin has ameliorated to an extent in Dublin, with the overall number stabilising and the rate of new entrants to treatment dropping significantly by approximately 20% between 2001-02 and 2006-07. However, heroin use has become more widely dispersed throughout the country and is still a significant problem. It remains to be seen whether current economic problems might affect the numbers involved. The use of cocaine has grown, albeit from a small base, especially among younger adults. While it is a countrywide problem, it is most prevalent in Dublin, the east and the south.

The Government is responding to the drug problem and, in this context, a new national strategy is being developed for the 2009 to 2012 period. The steering group set up to develop proposals and make recommendations on a new strategy has made significant progress and I expect to receive its final report shortly. The new strategy will continue to focus on treatment and rehabilitation.

On 31 March, a Government decision was taken to include alcohol in a national substance misuse strategy. The development of a strategy encompassing both drugs and alcohol presents many challenges and will take a considerable period to finalise, especially given the nature and complexities of dealing with illicit drugs together with alcohol, a legal substance. In view of this, the national drugs strategy, for which I will seek Government approval before the end of May, will reflect as far as possible the combined approach that is now Government policy. However, when approved, it will be published as an interim strategy pending the drafting and finalising of a national substance misuse strategy.

The mid-term review of the national drugs strategy in 2005 identified rehabilitation as an area requiring development and it became the fifth pillar of the strategy. In this context, the report of the working group on drugs rehabilitation was published in 2007. The recommendations cover issues such as inter-agency working, medical support, employment, education, housing, child care and family support. The implementation of the recommendations is included in the programme for Government.

The Health Service Executive, HSE, has the lead role and has recruited a senior rehabilitation co-ordinator to progress matters. A national drug rehabilitation implementation committee commenced work last November. The setting up of this committee was a key recommendation of the rehabilitation report, representing an important step towards developing the continuum of care approach recommended for clients, as well as the inter-agency working required. I have requested the national drug rehabilitation implementation committee to undertake a review of the available rehabilitation facilities. I have asked it to identify the types of rehabilitation services being offered and the potential these services offer for the future.

In 2006, the HSE appointed an expert working group to provide an analysis and overview of known current residential treatment services and advise on the future residential requirements of those affected by drug and alcohol use. The report of this working group will feed into the work of the national drug rehabilitation implementation committee and its planning for the future.

In terms of providing facilities outside of Dublin, when we determine from the review the mix of services provided, the relative focus on drugs, alcohol and other addictions and the number of community-based and resiential-based services, we will consider what flexibilities and improvements can be achieved to provide services that best meet the needs of the client. Obviously, all this will be done against the backdrop of resources available in the current economic climate.

Considerable resources are targeted at problem substance use in Ireland and the challenge over the coming years, given the current financial constraints facing the country, will be to maximise the overall effectiveness of that funding. In the context of the new national drugs strategy, the reorganisation of the HSE and the continued partnership of the community and voluntary sectors, I am confident we can improve on the already extensive network of services.

Overall, I believe that future development of services must be based on having in place a system that guarantees a continuum of care for people presenting for treatment and rehabilitation. I am determined to foster the development of integrated service provision and enhanced interagency working between the statutory, voluntary and community services to ensure successful outcomes are achieved for those endeavouring to rehabilitate from drug use.

Having travelled the country and met many people who have gone through different forms of rehabilitation, I wish to make two observations. First, I recognise that some people do not seek residential rehabilitation and there is an argument for it to be community based. It is important to examine this issue and determine the effectiveness of both. Much of the time people place considerable emphasis on residential rehabilitation, which is the topic raised by the Senator. While it serves a purpose and is fine up to a point, my second point is the subsequent follow-on, and is of equal importance, to allow those who come out to be part of a support group.

I have been Minister of State with responsibility for the drugs strategy for almost a year and there is no better way to learn than by travelling the country. In that regard, I have visited many rehabilitation facilities run by the HSE, as well as community and voluntary sector facilities, such as Sr. Consilio's Cluain Mhuire centres. For example, I have visited its centres in Athy, County Kildare, Bruree, County Limerick and in Galway. I also have visited a group of residential rehabilitation centres, including Hope House, County Mayo, Aiseirí in counties Tipperary and Wexford, Tabor Lodge, Cork, the Aisling centre, County Kilkenny, and the Rutland Centre, Dublin.

I visited Cork twice in the past six months, most recently last March, when I launched the new HSE treatment centre, Arbour House, in St. Finbarr's Hospital, as well as visiting Renewal, a residential rehabilitation centre for women, and the Anchor Treatment Centre, Mallow, which is a day rehabilitation centre. On my previous visit to Cork last November, I visited Tabor Lodge, Fellowship House, which is a residential centre for men, and Cara Lodge, an adolescent male residential rehabilitation centre. I specifically wished to mention those facilities because I had the opportunity to visit them. Sometimes, when one speaks, it is disingenuous to those who work in such facilities to indicate there are no services. I met the people involved in those facilities, all of whom are working in different ways in the community and voluntary sectors to provide a huge range of services and I acknowledge the great contribution such people are making to tackling this issue.

Senator Jerry Buttimer

While I thank the Minister of State for his reply, the people he mentioned would state they are struggling to cope with demand and that they require more resources. The Minister of State stated he had requested the national drug rehabilitation implementation committee to carry out a review. When does he hope to have this review published and implemented?

Deputy John Curran

I have not been given a date for it yet. Incidentally, that review pertains to all rehabilitation, community, voluntary and statutory.