Dáil Éireann díospóireacht -
Wednesday, 28 Jun 2000

Vol. 522 No. 3

Written Answers. - Drug Treatment Services.

Alan Shatter

Ceist:

123 Mr. Shatter asked the Minister for Health and Children the number of patients under methadone treatment in each of the past five years; the numbers who have ceased such treatment and have remained drug free; and the number who, either during the treatment or subsequent to it, have continued to use illegal drugs. [18404/00]

Minister for Health and Children (Mr. Martin):

The number of patients under methadone treatment in each of the past five years is as follows:

Year	December 1996	December 1997	December 1998	December 1999	End of May, 2000
No. of patientson methadone	1,861	2,859	3,610	4,332	4,638

Information on the number of people who cease methadone treatment or who remain drug free is not readily available as it involves following a cohort of people for a period of time and is done by means of periodic survey. The review of the Eastern Health Board's drug services, which was carried out in 1999, referred to such a study in the National Drug Treatment Outcome Review Survey in the UK. This study looked at a one year follow-up of 478 clients on methadone. Of this number, after a one year period 22% abstained from using other illicit opioids as opposed to 5% who abstained at the initial stage of treatment. Some 64% abstained from using stimulants, compared with 47%, and 5% were sharing injecting equipment compared with 13% at the beginning of treatment.

For many opiate users the main goal is to stabilise their chaotic drug taking habit, so that they can aim at rehabilitation, with the ultimate goal of becoming drug free. The evaluator noted that the effectiveness of maintenance treatment appears strongest in reducing drug-related criminal behaviour. On use of other drugs, once again from the Eastern Health Board's review of services in 1999, a study conducted in five addiction clinics over a four month period showed that 30% of clients tested positive for using other opiates while on methadone treatment, 65% had used benzodiazepines and a further 14% had used tricyclics. Health board clinics have a range of sanctions in place when a client tests positive for other drugs when that person is on methadone. These sanctions range from a reduction in the dose of methadone being prescribed to removal altogether from treatment. It is generally acknowledged that treatment is more likely to achieve success where methadone programmes are part of a wider treatment regime which includes counselling, after care and rehabilitation. For this reason rehabilitation has been given high priority in the Eastern Regional Health Authority's Service Plan for 2000, which recognises that further expansion of rehabilitation services must take place to assist people to break the cycle of addiction and return to a relatively normal lifestyle. Three rehabilitation co-ordinators are being appointed to link statutory, voluntary and community groups in developing rehabilitation initiatives. The Eastern Regional Health Authority is in the process of developing a drugs and AIDS information system, which will be in place by the end of the year. This database system will improve clinical management of drug misuse and AIDS, and will also allow for routine surveillance of treatment patterns and outcomes.