Ceist:
188 Dr. Upton asked the Minister for Health and Children the number of beds available in the Eastern Health Board area for the detoxification of drug addicts; and the waiting list for this service. [5860/00]
Written Answers. - Drug Treatment Services.
Ceist:
189 Dr. Upton asked the Minister for Health and Children his views on detoxification rather than methadone maintenance as a means of dealing with drug addiction; and if he will make a statement on the matter. [5861/00]
Ceist:
190 Dr. Upton asked the Minister for Health and Children the sum of money spent for each year on managing drug addiction in Dublin; and if he will provide a breakdown for each category of expenditure. [5862/00]
I propose to take Questions Nos. 188 to 190, inclusive, together.
The provision of drug treatment services including detoxification facilities for drug misusers in the Dublin area is a matter for the Eastern Health Board in the first instance.
I understand from the board that there is currently a 17 bed in-patient detoxification unit at Cuan Dara in Cherry Orchard Hospital. There is also a ten bed detoxification unit at Beaumont Hospital. This compares favourably with international standards and guidelines for such facilities which indicate an average of between 0.5 and 1.5 beds per 100,000 of population. In addition the Eastern Health Board provides resources for a post detoxification unit operated by the Merchants Quay Project in High Park, Drumcondra. It also provides funding for a post detoxification rehabilitation unit at Cuan Mhuire in Athy.
The board is continuing to expand its drugs services including the number of detoxification beds available to drug misusers and will shortly open a 20 bed downstream detoxification unit in St. Mary's Hospital, Phoenix Park and a 12 bed in-patient stabilisation unit is also being developed at Cherry Orchard Hospital.
There is currently a waiting list for entering into the detoxification unit of between eight and twelve weeks. This may vary depending on circumstances. During this period of time all individuals who are awaiting a bed in the residential detoxification unit are linked in with an addiction counsellor at community level for ongoing support. Many of these clients are also linked to a methadone treatment programme at local level prior to entry into the unit.
The board is confident that when the extra facilities open throughput will increase and as a result waiting times for entry into a detoxification programme will shorten.
Irish Government policy on drug misuse is that a wide range of treatment options should be provided, including methadone treatment, detoxification and other programmes aimed at those addicted to drugs, especially people who are addicted to heroin. The ultimate aim of treatment programmes is to return those addicted to drugs to a drug free lifestyle. Methadone maintenance is internationally recognised as a valid and successful part of an integrated response to the drug problem. It has also been shown that it is possible to reduce the antisocial behaviour of intravenous drug users by taking them into treatment on methadone maintenance programmes.
A recent report reviewing the services of the Eastern Health Board stated that methadone maintenance is one of the most widely evaluated treatments for opioid dependence worldwide. Internationally, there is a well established research and a clinical evidence-base for substi tution treatment with methadone. On average, methadone maintenance is associated with lower rates of heroin consumption, reduced levels of crime and improved social functioning. A lower risk of premature mortality amongst maintained patients has been reported and substitution programmes have also contributed to the prevention of the spread of HIV infection. The report also found that a number of satellite clinics informally reported rates of 40% plus of those on methadone returning to work. Although it is acknowledged that this may partly be due to the current work climate which exists in Dublin, it also states that this high percentage is very striking as evidence of successful social habilitation or rehabilitation.
Every patient on presentation to the drug treatment services is given the option of a drug-free route by detoxification, either as an in-patient or as an out-patient. In addition the initial assessment carried out on an individual recommends the most appropriate treatment option for that particular client.
Detoxification and methadone maintenance are well recognised treatment options for an individual with a history of drug misuse. It should, however, be pointed out that success rates for detoxification either as an in-patient or as an out-patient are generally less than 20%. Support needs to be given to those who complete withdrawal in order to prevent relapse and it is often difficult for a client to maintain abstinence from drugs. The board also has in place a range of counselling and support services which will support drug misusers in their efforts to deal with their addiction.
With regard to funding for the drug treatment services the following is a breakdown by pay and non-pay categories for the Eastern Health Board since 1997:
|
Year |
Pay |
Non-Pay |
Expenditure |
|
£m |
£m |
£m |
|
|
1997 |
4.4 |
11.7 |
16.2 |
|
1998 |
7.4 |
9.0 |
16.4 |
|
1999* |
9.2 |
9.7 |
18.9 |
*These figures are provisional
In its 2000 service plan the board has indicated that it will spend an additional £5 million on its drugs services.
In addition the Drug Treatment Centre in Pearse Street received funding of £1.363 million in 1997, £1.646 million in 1998, £1.646 million in 1999 and has been allocated £1.651 million for 2000. It is not possible to break down these expenditures by the type of service.