Thank you, a Cheann Comhairle, for allowing me to raise this important topic. I support the methadone maintenance programme. However, as operated at present it is exacerbating the hard drug abuse problem in Dublin. An expert group established by the Minister for Health in a document published in March 1993, recommended various measures to control the supply and distribution of methadone. That group drew attention to the potential for the abuse of methadone and pointed to the thriving black market for methadone on the streets. It made a number of recommendations designed to ring-fence the supply and distribution of methadone. Among those recommendations was the establishment of a central register of methadone users and the issuing of treatment cards containing, among other information, a photograph of the user. It almost defies belief that two and a half years later neither of those fundamental recommendations have been implemented. The previous Government must share responsibility for that — I say that to prevent a re-run of what we heard a moment ago.
No realistic steps have been taken to control the supply and distribution of this substance. Admittedly, a voluntary register is maintained in Trinity Court. However, it has been represented to me that it is totally inadequate and falls far short of what the expert group had in mind; in terms of control and supply, it is virtually worthless. Treatment cards for patients have not been introduced despite the fact that in a letter written to the general practitioners in the Eastern Health Board area on 20 September 1994 Dr. Niall Tierney, Chief Medical Officer of the Department of Health, said that arrangements for their implementation were being finalised.
The net result of this bureaucratic inertia is that the thriving black market in methadone, which the expert group warned about in March 1993, has grown substantially. Some addicts are selling methadone and using the money to purchase hard drugs. It is not uncommon to see a number of individuals at various locations in Dublin sharing a bottle of methadone. That is hardly surprising in view of the fact that, apart from Trinity Court which is open seven days a week, the other satellite clinics open only five days a week and close early. It means that people are being handed a week's supply of methadone, a recipe for disaster.
In addition, there does not seem to be any control over the distribution of methadone by general practitioners who are dispensing it to all and sundry without properly checking the people they supply. Addicts are attending several doctors accumulating a stock of methadone and selling their surplus supply to purchase heroin. That intolerable position must be brought under control without delay. The Government should urgently move to implement the recommendations of the methadone Protocol published by the Department's expert group in 1993. It should also establish a system of court clinics for the worst cases which would be referred to ordinary satellite clinics as the next step and, ultimately, to a GP.
The Government should also implement a proposal made by a number of people, including myself, to establish mobile clinics with a proper back-up service. Such clinics would enable the system to reach those whose addiction behaviour is most chaotic and who reside in an area where a satellite clinic service may not be available at present. It would also take a great deal of pressure off the present system. Experience elsewhere has shown that the availability of mobile services can complement the service available at satellite clinics and assist in the development of such clinics. The Government must move immediately on all those fronts to control the supply and distribution of methadone or the methadone maintenance programme will continue to do more harm than good.
