(Limerick East): The provision of treatment and rehabilitation services for drug misusers is a matter for health boards in the first instance.
Drug misuse in this country takes two forms, the misuse of so-called "soft" drugs such as cannabis and ecstasy, which is prevalent throughout the country, and the misuse of heroin, which is confined mainly to certain parts of Dublin. The most recent report of the Health Research Board on treated drug misuse in the greater Dublin Area noted that in 1994, 2,702 persons received treatment for drug misuse in that year. The 1995 report, which will be published before the end of the year will have details of treatment from all over the country.
The Government decided in February of this year to implement a range of measures aimed at reducing the demand for drugs. These measures include strengthening existing school-based substance abuse programmes in conjunction with the Department of Education; boosting locally-based initiatives on education and prevention, in conjunction with education personnel, the Garda and other agencies; running national and locally-based drug awareness campaigns aimed at young people and their parents; and targeting specific education programmes at high risk areas such as the inner city.
They also recommend improving the service provision for drug misusers, particularly in Dublin city, where the problem is most acute. This is being done by extending locally-based drug treatment facilities in Dublin; giving general practitioners a wider role in the provision of treatment to stabilised drug misusers; co-ordination of detoxification facilities and improving rehabilitation. Since the Government decisions, all health boards have established regional co-ordinating committees to monitor the problem in their area and to make recommendations on the appropriate response.
Treatment for cannabis or ecstasy misuse generally takes the form of counselling and support while, for those misusing heroin, treatment involves a number of other therapies including drug substitution therapy, i.e. methadone.
A register of drug addicts receiving methadone treatment is maintained in the Eastern Health Board area. The total number of persons on this register at present is 1,552. There are in excess of 500 persons awaiting treatment for drug misuse in the Dublin area at present. The Eastern Health Board hopes to have cleared this waiting list by the end of the year. The nature of the problem is such, however, that as services develop more people come for treatment. It is not possible at this stage to put a definite figure on the number of heroin addicts in the city. The Eastern Health Board has concentrated on putting in place a comprehensive range of services as provided for in the decisions. These include the extension of locally based drug treatment facilities in Dublin, in consultation with local communities. Supports for community-based initiatives have been put in place in areas such as Kilbarrack, Clondalkin, Killinarden, Fettercairn and Ballyfermot; general practitioners will play a wider role in the ongoing maintenance on methadone of persons who have been stabilised in the treatment centres. Over 50 general practitioners are now involved; rehabilitation and support services have been further developed; special attention is being given to the problems of persons who smoke heroin. Detoxification programmes for young heroin smokers have been established in a number of centres; there has been an external evaluation of the adequacy and effectiveness of services in the Eastern Health Board area; the nuisance which drug misusers can cause in the vicinity of treatment centres and other locations is being alleviated by arrangements agreed between the Eastern Health Board and the Garda; the co-ordination of detoxification facilities has been improved. In addition, the number of detoxification beds has been increased and a downstream facility is in planning; a total of 1,552 people are now in receipt of methadone maintenance; crisis intervention programmes are being put in place in each of the health board's treatment centres; a mobile methadone service has been introduced; a treatment service has commenced in Ballymun; education officers are being recruited to work with "at risk" young people; an information database is being set up; and the board's management has been restructured. The Eastern Health Board is confident that the implementation of the measures outlined above will result in the provision of services for about 2,500 drug misusers by the end of this year. This will be a significant contribution to addressing the drug misuse problem.
The total amount of money allocated annually to health boards for HIV/AIDS and drug treatment and prevention services has increased steadily since 1992. For example, the allocation to health boards for these programmes in 1995 was approximately £13 million. This figure will increase by £4 million in 1996. It is not possible to put a specific figure on the allocation for drug treatment services by each health board because such services would range over a number of programmes, including psychiatric care and acute hospital care.
I assure the Deputy that services will continue to be developed and expanded to meet the threat posed by this scourge to society.
