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Seanad Éireann debate -
Wednesday, 29 Sep 2010

Vol. 204 No. 6

Drug Treatment Programme

I welcome the Minister of State to the House. I raise this important issue because I understand that only an ad hoc service is provided for methadone users and those suffering from addiction in the midlands. One doctor must be assigned for the exclusive care of the increasing number of drug addicts in the midlands.

I understand we live in challenging times, with serious rises in unemployment and poverty levels, which means that people are becoming desperate. Almost 500,000 people are vulnerable and down on their luck, having lost their jobs, whose bills piling up and relationships are breaking down, and who are under serious pressure to pay their mortgages. They find themselves with no alternatives and that is why some are turning to drugs. Many of them have serious mental health issues due to the stress and strain of coping with the recession. The Government is to blame for mismanaging the economy. People end up taking their own lives, and I know some of them.

Tony Geoghegan of the Merchants Quay project said at last week's launch of its 2009 annual review that the steep rise in unemployment and poverty levels did not bode well for drug-taking patterns in the months and years ahead. He referred to what happened in the 1980s and said that the rising tide of desperation is in danger of sinking many boats. There has been a 17% increase in demand for the Merchants Quay homeless service so far this year, with 9,422 people in 11 counties using the service. This desperation is clearly evident in the Longford-Westmeath region, with 205 people availing of heroin addiction services in the Athlone area alone.

I compliment general practitioners in the Athlone and Moate areas who work with clients, treat them with dignity and respect and try to help them and their long suffering families out of a miserable existence. While I acknowledge the HSE support in the midlands, I fail to understand why a dedicated doctor is not heading up the service in an organised fashion. I understand the service in the Longford-Westmeath area is operated by a number of GPs on a sessional basis and that clients must be bussed — in this day and age — to their appointments from Longford and Mullingar and, I know, from Laois and Offaly. I query the cost of providing this ad hoc service and I would like to use the privilege of the Seanad to request from the Minister of State the actual cost of providing this service so far this year. I do not believe an adequate service is being provided for these unfortunate people.

Tony Geoghegan from the Merchants Quay project stated that the use of heroin in the regions has increased fourfold in recent years, which is much greater than the increase in Dublin. I would be interested to hear the Minister of State's reply.

I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. The management and delivery of health and personal social services, including methadone services, are the responsibility of the Health Service Executive under the Health Act 2004. I thank the Senator for raising this matter as it provides me with an opportunity to outline the current actions being taken by the HSE to expand the availability of and access to drug treatment services.

Under the interim national drugs strategy for 2009 to 2016, the HSE is implementing part of action 34 by providing methadone clinics in target areas where waiting lists have emerged. One of these target areas is the midlands. The HSE provides methadone as an opiate replacement treatment to support those who are addressing their heroin misuse problems. Methadone is a controlled drug that is regulated under the Misuse of Drugs (Supervision of Prescription and Supply of Methadone) Regulations 1998. Only GPs trained as level 1 or level 2 for methadone prescribing are permitted to participate. The HSE, through the Irish College of General Practitioners, facilitates GPs in training to level 1. This training is carried out primarily on-line and within a set timeframe. Level 1 GPs can provide methadone in a community-based setting to stabilised patients who do not require methadone clinic services. The HSE encourages all GPs to take part in this training.

Level 2 GPs are trained by the ICGP to offer a full range of treatment services to opiate-dependent patients, including full assessment, initiation of treatment when appropriate, and stabilisation. The HSE has 70 methadone clinics and has trained a cohort of level 2 GPs to operate in these clinics. These include methadone clinics in Athlone and Portlaoise. Alongside these clinics, the Irish Prison Service provides methadone services at Midlands Prison. During 2010 the HSE trained a further group of level 2 GPs to add to the existing cohort so that new clinics could be provided. The HSE plans to provide two of these new clinics in the midlands.

There are an estimated 14,500 opiate users in Ireland. At the end of August 2010, according to the latest figures available, 9,217 clients were receiving methadone maintenance services. Of these, 5,510 clients had their methadone dispensed by pharmacists in the community rather than in specialist addiction clinics. The corresponding number of GPs providing a methadone maintenance treatment service was 281 while the number of pharmacies involved was 489. The HSE is committed to continuing the development of these services in 2010 and 2011.

The question I asked was very clear. I asked specifically about the prospect of a dedicated doctor running this service, not a doctor who is also running a busy GP practice. This is an outrage. The situation was brought to my attention by health care professionals in the midlands area. I do not wish to annoy the Minister of State or cause her any grief. I understand we are in financially constrained times. That is the reason I specifically asked about the cost of the ad hoc service. A dedicated person looking after the service, for which the professions are crying out, would provide a better organised service, through which people would be looked after better. I ask the Minister of State to get back to me with the relevant figures.

I will ask for the details of the cost of the service to be provided.

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