Prison Service

Dáil Éireann Debate, Thursday - 25 November 2021

Thursday, 25 November 2021

Questions (306, 307, 308)

Patrick Costello

Question:

306. Deputy Patrick Costello asked the Minister for Justice the details of all drug and alcohol treatment services available to prisoners in each prison in 2021, in tabular form; and if she will make a statement on the matter. [58144/21]

Patrick Costello

Question:

307. Deputy Patrick Costello asked the Minister for Justice the way drug and alcohol treatment services were provided in each prison in 2021, for example, in-person, by video or by telephone; and if she will make a statement on the matter. [58145/21]

Patrick Costello

Question:

308. Deputy Patrick Costello asked the Minister for Justice the number of persons who availed of each drug and alcohol service provided in each prison in 2020 and to date in 2021; the range of the shortest and longest of waiting list times for accessing each service; and if she will make a statement on the matter. [58146/21]

Written answers

Minister for Justice

I propose to take Questions Nos. 306 to 308, inclusive, together.

The information requested by the Deputy is currently being compiled and I will write to him directly when it is available.

The following deferred reply was received under Standing Order 51

I refer to your Parliamentary Questions No. 306, 307 and 308 of 25 November 2021 requesting:

… “the details of all drug and alcohol treatment services available to prisoners in each prison in 2021, in tabular form; and if she will make a statement on the matter,

….the way drug and alcohol treatment services were provided in each prison in 2021, for example in-person, by video or by telephone; and if she will make a statement on the matter, and

…the number of persons who availed of each drug and alcohol service provided in each prison in 2020 and to date in 2021; the range of the shortest and longest of waiting list times for accessing each service; and if she will make a statement on the matter”.

You will recall that at the time the information sought was requested from the Irish Prison Service and I undertook to forward the information to you as soon as it was to hand.

I recognise just how devastating alcohol and substance misuse can be on individuals, families and communities across our country and I want emphasise that tackling this issue remains a priority for me as Minister for Justice and for this Government. We are firmly committed to addressing this issue through our responsibilities and targeted actions under the National Drugs Strategy, ‘Reducing Harm, and Supporting Recovery: a health-led response to drug and alcohol use in Ireland 2017-2025’. This strategy represents a whole-of-government response to the problem of drug and alcohol use in Ireland. It highlights the importance of addressing substance misuse through a health lens and not solely via a justice response.

The ongoing and close collaboration with our partners in the HSE, and other relevant Government Departments is, and will continue to be, critical to ensuring the State provides effective and integrated interventions, that are person-centric and focused on helping people to rebuild their lives. This will in turn reduce crime and make our communities safer for all. This is particularly relevant when we consider the well-documented relationship between substance misuse and offending behaviour and that a history of substance misuse is clearly identified as a strong predictor for reoffending.

However the healthcare and rehabilitative needs of vulnerable, sometimes seriously ill, people who interact with the criminal justice system are complex. This is acknowledged in the Programme for Government commitment to establish a high-level cross-departmental/cross-agency taskforce to consider the mental health and addiction challenges of those imprisoned, and primary care support on release. Considerable progress has been made on meeting this commitment. Last April, the Minister for Health and I established a High Level Taskforce to consider the mental health and addiction challenges of persons interacting with the criminal justice system. The Taskforce has already met on six occasions and has established three expert subgroups on diversion, prison and Central Mental Hospital capacity and community throughcare. The Taskforce is aiming to provide a high level implementation plan for its recommendations early in 2022.

Prisoners are more likely to have a challenging lifestyle that predisposes to substance misuse. This includes those with a dual diagnosis of addiction and mental health issues. Broadly it is estimated that in the region of 70% of prisoners have drug addiction problems (a figure consistent with international research).

Everyone committed to prison is subject to a comprehensive medical assessment by the Prison Healthcare Team. This information is used to develop an individual healthcare plan for the prisoner while in custody and a treatment plan is agreed for those who wish to address addiction issues.

An alcohol treatment service is provided if clinically required and it is the policy of the Prison Service that, if clinically indicated, where a person committed to prison gives a history of opiate use and tests positive for opioids, they are offered a medically assisted, symptomatic detoxification. Patients can also, as part of the substance misuse assessment process, discuss other treatment options with healthcare staff, which may include stabilisation on methadone maintenance for persons who wish to continue on maintenance while in prison and when they return to the community on release.

The Prison Service provides a health care service for prisoners with addictions on a structured, safe and professional basis in line with international best practice and continues to seek to construct a range of programmes, support services and through-care options for prisoners demonstrating a commitment to addressing substance misuse.

Drug rehabilitation programmes for prisoners involve a significant multidimensional input by a diverse range of general and specialist services provided both by the Prison Service and visiting statutory and non-statutory organisations. The following are the drug and alcohol treatment service available to prisoners in closed prisons;

- Drug and Alcohol Treatment Service

- Drug Detoxification

- Drug Stabilisation

- Drug Maintenance

- Alcoholics Anonymous

- Merchants Quay Ireland – Substance Misuse Counselling

In line with the National Drug Strategy, the Prison Service has an agreed protocol with the HSE for the seamless transition of prisoners engaging in drug treatment while in custody to community drug treatment settings. The Prison Service use suboxone, subutex and methadone as treatments for opioid drug dependency. Both suboxone and subutex are used to treat patients with a specific medical need for whom methadone is not tolerated, contraindicated or not suitable.

It is however, important to note that while the Prison Service endeavours to provide a comprehensive range of drug and alcohol treatment services in closed prisons, the same type of programmes are not offered in open prisons. This is because a condition of transfer to an open prison is that the prisoner is drug free. However, counselling sessions provided by Merchants Quay Ireland (MQI) are available in open prisons as is Narcotics Anonymous which is prisoner lead and community linked.

The Prison Service has worked tirelessly to prevent the entry of COVID into our prisons. As well as working in tandem with National Government Guidelines, bespoke arrangements had to be put in place to respond to the unique challenges posed for the prison environment. Throughout the pandemic every attempt has been made to maintain as many services as possible for the whole prison population. These include services such as healthcare, psychology, psychiatry as well as drug and alcohol treatment services. At the outset, the Prison Service identified the need to rapidly introduce a range of technological responses to provide prisoners and the in-reach services with viable and practical alternatives. This has included developing a blended model for consultations to include telephony, video calls as well as direct one to one consultations where possible.

In addition the Service have trialed the use of iPads and video link to allow prisoners to engage with services. These services are available across the entire prison estate and have greatly assisted in maintaining the provision of drug and alcohol treatment services to vulnerable prisoners. Other innovations included the development of a prisoner TV channel and the installation of in-cell telephones to allow prisoners who were isolating to have contact with a counsellor.

A major part of responding to the needs of prisoners during our first period of National Lockdown was supporting and assisting prisoners with the inevitable lack of supply of illicit drugs in the prison system. Medical, nursing and counselling staff adapted their usual routes of access and intervention with prisoners, using the resources noted above, to ensure continuity of service.

Symptomatic detoxification programmes were supported alongside the requirement for counselling services to assist and ensure prisoners were able to cope with the new challenges in their life.

Unfortunately, the substance misuse counselling service provide by MQI, suffered serious disruption due to measures taken to prevent the spread of Covid in the prison system. As a result of restrictions introduced to manage Covid, MQI were unable to provide any group work since February 2020 and there has only been a resumption of these services since September 2021. While this was unavoidable it is regretted, as group work allows MQI to see more individuals and increases the total of prisoners accessing services each year. Prisoners are seen as soon as is possible if the requirement to speak with an addiction counsellor is deemed urgent.

Notwithstanding the ongoing pandemic, the Prison Service continues to seek to construct a range of programmes, support services and through-care options for prisoners demonstrating a commitment to addressing their substance misuse. All prisoners engaged in drug treatment have the support of healthcare staff and in reach services as required.

I include the details requested on the number of prisoners in receipt of Opioid Substitute Treatment across the prison estate in 2020 and to date in 2021 in Table 1 and 2 below. In addition, I also provide the number of prisoners who availed of the addiction counselling service in 2020 and to date in 2021, as well as the longest waiting times to access these service in Table 3 .

I trust this information is of assistance.

Table 1

Subutex/ Suboxone	2020	2021
Subutex/ Suboxone	2020	2021
Castlerea	0	0
Cloverhill	4	5
Cork	3	6
Dochas	3	1
Limerick	1	3
Midlands	0	0
Mountjoy	4	6
Portlaoise	0	1
Wheatfield	1	0

Table 2

		2020		2021
Methadone	Detox	Maintenance	Detox	Maintenance
Castlerea	4	62	1	52
Cloverhill	282	354	211	281
Cork	79	148	52	138
Dochas	4	189	5	166
Limerick	65	132	36	111
Midlands	48	180	24	149
Mountjoy	73	414	68	378
Portlaoise	0	33	0	48
Wheatfield	20	241	18	191

Table 3 - Addiction counselling services

Prison	2020	2021	Longest Waiting Time
Prison	2020	2021	Longest Waiting Time
Cloverhill	193	153	9 Months
Wheatfield	349	240	10 Months
Castlerea	216	118	14 Months
Shelton Abbey	150	118	4 weeks
Cork	128	107	13 Months
Midlands	140	117	7 months
Limerick	159	155	2 Months
Portlaoise	554	47	29 Months
Mountjoy Prison	362	278	10 months
Dochas Centre	118	102	8 weeks
Louhan House	78	84	9 Months

Question No. 307 answered with Question No. 306.

Question No. 308 answered with Question No. 306.