Dáil Éireann díospóireacht -
Wednesday, 28 Jun 2000

Vol. 522 No. 3

Written Answers. - Drug Treatment Services.

Alan Shatter

Ceist:

16 Mr. Shatter asked the Minister for Health and Children the number of methadone related deaths in Dublin in each of the years 1997, 1998 and 1999; and the way in which he regards methadone maintenance as being effective in stabilising drug-addicted people. [18413/00]

Minister for Health and Children (Mr. Martin):

Information on drug related deaths is collected by the Central Statistics Office for the general mortality register in accordance with guidelines developed by the World Health Organisation using International Classification of Diseases Code 9 which includes deaths due to drug dependence and poisoning by opiates and other narcotics.

Figures provided by the CSO, applying the ICD 9 definition, show that in 1997 there were 55 deaths, in 1998 there were 99 deaths and in 1999 there were 80 deaths in this category. These figures however, should be regarded as provisional at this stage, particularly the 1999 figure as further validation may still need to be carried out.

A report which was published last year and was conducted in the Dublin City Coroner's Office by a degree student in social care from the Dublin Institute of Technology detailed the outcome of the total inquests which were held during 1998 related to deaths which occurred between November 1992 and July 1998. The report implicated methadone in 37 deaths, while only three of these deaths were from the sole misuse of methadone. The remainder of these deaths resulted from the ingestion of a cocktail of drugs of which methadone was a part.

Multiple drug use is the norm amongst the drug abusing population and where deaths occur in this population it is often difficult to ascribe a specific cause although drug abuse is identified. In most of the post mortems where methadone was identified, other substances such as heroin and or benzodiazepines and sometimes alcohol were also identified. In October 1998 strict new regulations relating to the prescribing of methadone came into effect. Currently, a major study is under way, analysing in more detail those deaths that appear to be drug related. This study will examine the position both before and after the new regulations came into effect. I understand that the results of this study will be available towards the end of the year.

Methadone maintenance is the most evaluated form of treatment of heroin addiction. Around 300,000 people are on substitution treatment, mainly methadone, in the European Union. There is clear and consistent international evidence that this form of treatment achieves significant reduction in heroin use and crime and a lower risk of premature death including death from overdose. Methadone maintenance has been found to be effective in reducing the spread of HIV through intravenous drug misuse and counselling and length of time in methadone treatment are both factors associated with a more favourable outcome.

A recent independent evaluation of drugs services in the Eastern Regional Health Authority area found that methadone treatment programmes managed to effect approximately a 70% reduction in heroin consumption on aggregate in those attending treatment. Such a reduction in heroin use has been reported to be associated with a similar reduction in criminal behaviour. A number of satellite clinics informally reported rates of around 40% returning to work. It is generally acknowledged that treatment is more likely to achieve success where methadone programmes are part of a wider treatment regimen which includes counselling, aftercare 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.