I thank the Senator for raising this issue. Much of the concern expressed about waiting times for access to addiction services in the Cork area in recent times has been in respect of the waiting times for opiate users to access methadone treatment. Currently, 106 opiate users in the Cork area are awaiting this service, a decrease of almost one third on the 150 opiate users who were on the waiting list in January. The average waiting time in Cork city is ten months. While recognising that this situation needs to be improved, we should also acknowledge that there has been a substantial increase in the numbers receiving treatment. There were 94 patients with addresses in Cork on the central treatment list for methadone at the end of March this year, which represents a 40% increase over the number at the end of 2008.
The HSE is working to reduce the waiting time in Cork. Before turning to that situation, I would like to set the national context. The HSE provides treatment and rehabilitation services for those misusing opiates and other drugs through a combination of direct provision by HSE staff or voluntary agencies that it funds to provide services on its behalf. There is also a wide range of partnerships with community-based groups and agencies. Individuals presenting for treatment for opiate related issues are provided with a full and comprehensive assessment, not only in terms of medical, but also psychosocial needs. The assessment process can take up to three weeks. Some people may be prioritised for clinical reasons, for example, pregnant women. The range of interventions includes assessment, stabilisation, harm reduction measures, care planning, methadone maintenance, counselling and detoxification either in specialist clinics, residential settings or community settings.
A total of 36 beds are available for medical and community detoxification. While all of them are situated in the greater Dublin area, they are available to appropriate clients nationwide, with the exception of the 13 beds in Cuan Dara in Cherry Orchard Hospital, which only takes clients from Dublin, Kildare and Wicklow.
The funding committed to addiction services has increased year-on-year over the lifetime of the National Drug Strategy 2001-2008. In 2008, €101.87 million was spent by the HSE on specific addiction services provided directly by the HSE and those that it funded. This represents an increase of €45.9 million from the 2001 levels of funding. In addition, it should be noted that HSE mainstream services, such as accident and emergency services, acute hospitals and mental health services, address the treatment needs of alcohol and other substance misusers who avail of them. The cost of these services is not included in the figures that I have already cited.
The number of people receiving treatment continues to rise and addiction services continue to develop, with an additional 3,686 methadone treatment places created from 2001 to 2008. In addition, needle exchange services have been developed in 13 local drug task force areas and five regional drug task force areas covering the areas most affected by opiate misuse. Training needs have also been addressed. The establishment of the national addiction training programme in partnership with Waterford Institute of Technology and the community and voluntary sectors has resulted in the upskilling of 1,645 front line staff. This training has enabled the HSE addiction service to respond to the changing trends in prevalence, for example, polydrug use, cocaine use and the misuse of alcohol, as well as maintaining a focus on opiate abuse.
The HSE, as the lead agency, has commenced the implementation of the report of the working group on drugs rehabilitation, which was published in May 2007, by establishing the national drug rehabilitation implementation committee and employing a national senior rehabilitation co-ordinator. This committee is developing a rehabilitation framework for all addiction services, as recommended in the report, and is building on co-ordination arrangements that are already in place.
With regard to the situation in Cork, regional drug co-ordinators in the HSE southern area are working with the national GP co-ordinator to increase the number of level 1 and level 2 GPs in the methadone treatment service. An additional GP has been providing services in Arbour House in Cork since January 2009, which has enabled an increased number of sessions to be provided for clients.
To address the issue of waiting times further, the HSE, with the assistance of minor capital grants provided by the Department of Community, Rural and Gaeltacht Affairs, is developing additional methadone clinics in a number of locations, including two locations in the Cork area, namely, one in the local drug task force area and one in the regional drug task force area. It is expected that these additional clinics in Cork will be operational in late 2009 or early 2010.
Services for opiate users comprise just one element of the much wider range of drug services provided under the umbrella of the national drug strategy by the statutory, voluntary and community sectors. The Department of Community, Rural and Gaeltacht Affairs is providing €1.76 million for the Cork local drugs task force in 2009. In addition, the southern regional drugs task force is supported by funding of approximately €800,000 for County Cork.
The HSE acknowledges that there are challenges with respect to waiting times for treatment in certain parts of the country where drug usage has increased significantly in recent years. It points out that while there are approximately 600 clients on waiting lists, more than 10,000 clients received methadone treatment in 2008. Overall, the Minister for Health and Children considers that progress is being made in this area nationally and in the context of services being provided and developed in the Cork area.
