JOINT COMMITTEE ON HEALTH AND CHILDREN díospóireacht -
Tuesday, 1 Jun 2010

Regulation of Psychoactive Substances: Discussion with Department of Health and Children and HSE.

Chairman

We will meet with officials from the Department of Health and Children on recently signed regulations under the Misuse of Drugs Act banning certain substances and with officials from the HSE on the national drugs awareness campaign under the national drugs strategy on the dangers of psychoactive substances. All the officials are welcome.

We will hear from the officials first after which I will go to the committee for a series of questions. I congratulate the officials on the work they have done. Certainly the statutory instruments have had almost immediate effect as we have seen across the country. All sides of the House congratulate them on the initiatives taken and, more importantly, on the efficacy of those initiatives. Our concern is to ensure that what they have done is not circumvented and that the public continues to be vigilant and aware of the dangers these substances present, particularly to vulnerable people. I invite Ms Marita Kinsella to begin.

There is a slight change in procedure. I remind members of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the House or an official either by name or in such a way as to make him or her identifiable.

By virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of their evidence to the committee. If witnesses are directed by the committee to cease giving evidence on a particular matter and they continue to so do, they are entitled thereafter only to a qualified privilege in respect of their evidence. Witnesses are directed that only evidence connected with the subject matter of these proceedings is to be given and they are asked to respect the parliamentary practice to the effect that, where possible, they should not criticise nor make charges against any person or entity by name or in such a way as to make him, her or it identifiable.

Ms Marita Kinsella

I thank the committee for inviting us to make a presentation on the recently made statutory instruments under the Misuse of Drugs Act 1977 to bring a number of psychoactive substances under control. I am the chief pharmacist at the Department of Health and Children and I work with my colleagues Ms Mary O'Reilly and Ms Gillian Treacy in the controlled drug legislation unit. We are accompanied by our colleagues from the HSE, Ms Alice O'Flynn, assistant national director, social inclusion, and Mr. Joe Doyle, national rehabilitation co-ordinator.

The Misuse of Drugs Act 1977 and regulations put in place a structure to control the import, export, production, supply and possession of a range of narcotic and psychotrophic substances listed in the Act. The Act also allows the Government to make an order to declare additional substances to be "controlled drugs" and the Minister for Health and Children makes regulations under the Act to impose controls on the import, export, possession, supply of controlled drugs as the controls may be specific to individual substances because the level of risk may vary from substance to substance.

At its meeting on 2 March, the Government approved a proposal from the Minster for Health and children to make a declaration order under the Misuse of Drugs Act 1977 to declare a range of legal high substances to be controlled drugs. Following that, the statutory instruments were drawn up and were notified and sent to the EU Commission on 1 April in accordance with the EU technical standards directive. These directives require member states to notify the EU Commission and other member states if a member state proposes to introduce technical regulations that might have an impact on trade. As a consequence, there is usually a three month notification period or, standstill period, for the notification.

However, in light of the growing concerns around the health risks associated with the substances, a separate application was made to the EU Commission to see if it would consider us using an urgency procedure to allow the legislation to be brought in without the necessity of waiting for the three-month standstill period. The EU Commission accepted our application for use of the urgency procedure and on 10 May we received notification that we could proceed to implement the legislation without awaiting the expiry of the three-month period. On 11 May, the Government made the Misuse of Drugs Act 1977 (Controlled Drugs) (Declaration) Order 2010 (SI 119 of 2010), declaring a large number of substances, including a large number of legal high substances to be controlled. On the same day the Minister for Health and Children made three statutory instruments applying different controls to the substances.

The legislation covers a large range of legal high substances that were on sale in head shops. They covered the synthetic cannabinoids, which were the spice compounds which are usually sold as a smoking mixture, BZP and piperazine derivatives which were often sold as party pills, mephedrone and some other similar substances were often sold as bath salts or plant food and two other substances GBL and 1,4 BD. The legislation recently introduced brings approximately 200 individual substances under control. The vast majority of substances that were on sale in head shops that were of public health concern were controlled in that legislation.

The process of introducing controls under the Misuse of Drugs Act is complex, particularly for substances which have legitimate uses and where those substances have the potential to be misused. Some of the substances on which we introduce controls have legitimate uses. Two of the substances, the BZP derivatives are used in the manufacture of medicinal products and the two substances, GBL and 1,4 BD, are very widely used in the chemicals industry, in pharmaceuticals and also appear in many consumer products such as paints, cleaning products, toiletries, food products and so on. Consequently it was necessary for us to engage with other Departments and organisations to ensure that the level of controls were appropriate but also proportionate to the risk associated with the substances.

Controlling substances under the Misuse of Drugs Act is an ongoing process which involves a good deal of national and international co-operation and engagement. Substances are scheduled in accordance with international conventions and EU Council decisions and where there is evidence that the substances are causing significant harm to public health in Ireland. At national level we work closely with a number of Departments including the Department of Justice, Equality and Law Reform, the office of the Minister for drugs, the National Advisory Committee on Drugs, the Garda, the customs service, the Forensic Science Laboratory, the Irish Medicines Board and the Health Research Board. All of these bodies work together to monitor emerging trends in the development of new psychoactive substances. We engage regularly with bodies such as the European Monitoring Centre for Drugs and Drug Addiction and the United Nations Office of Drug Control. In addition to the recent controls introduced by the Minister for Health and Children, the Minister for Justice, Equality and Law Reform is bringing forward a draft criminal justice psychoactive substances Bill, the aim of which is to ensure that the sale and supply of substances which are not specifically proscribed in the Misuse of Drugs Act, can be an offence. The Minister for Health and Children will keep the list of controlled drugs under close review and has indicated that if individuals seek to circumvent the controls on legal high substances, if there are public health concerns with those substances, approval will be sought from the Government to bring additional substances under control and to ban additional substances.

Ms Alice O’Flynn

The HSE welcomes the opportunity to appear before the joint committee and to provide this update on the national drugs awareness campaign under the national drug strategy on the dangers of physcoactive substances available through head shops. The note outlines the work that has been done to develop this phase of the national drugs awareness campaign. As members are aware, the HSE has responsibility for all health promotion campaigns to combat alcohol, drugs, obesity and so on and utilises the health social marketing approach in the development and execution of these campaigns.

With regard to the national drugs awareness campaign, we work closely with the Department of Community, Rural and Gaeltacht Affairs which has the lead co-ordinating role on the national drugs strategy interim 2009 to 2016. The previous national drugs awareness campaign focused on creating awareness of the facts to dispel the myths around cocaine use with the tagline "the party is over". The HSE began working in November 2009 to develop this present campaign to create awareness of the facts, dispel the myths in relation to recreational drugs available legally in Ireland through head shops and — or the internet. Research with the target audience, those in the age group, 15 to 40 years who purchase recreational drugs available through head shops and — or the Internet was carried out. Following consultation with relevant stakeholders and working with an advertising and media agency, a fully comprehensive, fully integrated communications campaign to address this issue was developed.

The campaign focus and target audience was informed also by relevant national and international policy and research, such as the national drugs strategy itself, the European Monitoring Centre for Drugs and Drug Addiction annual report 2009, new drugs difficulties in hitting a moving target, the EMCDDA No. 9 2009 report and the latest drug trends in Europe, HRB compares the Irish situation with the European findings. The campaign will be mounted through the following media, display areas in pubs, clubs, wash-rooms and festival laminates, for example OXYGEN and Electric Picnic and the radio.

The target market, we know, are heavy listeners. The radio plan includes a focus on youth stations as well as regional stations to achieve national and regional coverage. In the cinema, use of the campaign in cinemas nationally will broaden the reach of this campaign. Using a combination of search and display, the campaign messages will be delivered on-line to the target audience and will drive to the site, www.drugs.ie being promoted and information sources, parent information leaflets, z-card information for the target audience. Local and regional spokespeople will support the campaign by acting as a resource and local and regional drug task forces will line up their local campaigns with the national campaign key messages.

The HSE was ready to mount this campaign, as outlined, but given the recent changes in legislation outlawing a number of previously legal substances and the proposed legislation being brought through the office of the Minister for Justice, Equality and Law Reform, we need now to revisit and change some of the information and key messages, for example, one of our key taglines would have been “just because it is legal does not mean it is safe”. We must ensure the central message and information to support the campaign is factual, accurate and lands with the target audience, thereby increasing credibility. This work to take the new legislation into account is now under way. It has implications only for the content and key messages. All other aspects of the planning of the campaign will stand. We are planning to have the campaign ready to go live by the end of June.

I have outlined the details of the campaign and members will see which aspects require change. The campaign's aim is to create awareness of the facts to dispel the myths on recreational drugs available. It will now be available illegally in head shops and the Internet. Obviously the headline has been struck through, so that members will see that. The campaign objectives remain the same in terms of communicating the message that recreational drugs may have significant negative, mental and physical health effects. The audience remains the same, the primary audience is people aged between 15 years to 40 years who buy and use these drugs through head shops and the Internet. The secondary audience is equally important and that is parents and service providers. The objective is to create awareness of the risks of drugs available in Ireland, provide factual information on recreational drugs available in Ireland, information on the possible detrimental health effects, mentally and physically, of these drugs.

The key message is that legal does not mean safe; herbal does not mean safe. Herbal highs are not necessarily herbal, many are synthetic. The strength and side effects of recreational drugs available in Ireland through head shops and or the Internet can be even more unpredictable than their legal counterparts. There is increased risk to mental and physical health when recreational drugs available in Ireland through head shops — Internet are used with alcohol or any other drugs. The requirement in terms of the campaign is to have positive empowering messages, to conduct appropriate research to inform the campaign development, which we have done, to develop appropriate research methods to support the campaign evaluation process, to develop an integrated sustainable social marketing campaign with a capacity to run over several years, to develop an integrated media campaign response with supporting information resources to support the target audience and local initiatives. A further requirement is to promote the website www.drugs.ie as a source of information and referral and to use existing HSE help — information lines and to ensure all resources and communication signpost to the available services.

The campaign will be evaluated. Post campaign awareness and knowledge of target audience will be benchmarked against pre-campaign figures. We will quantify levels of campaign material distributed and requested by collating website statistics in terms of traffic to sites, search items, live helper. We will review the media coverage of the campaign and the stakeholder involvement. The plan also includes updating facts about the drugs booklet, parent information guide and promoting the website, www.drugs.ie. To give members an idea of what the www.drugs.ie website looks like, we have done a cover page at the bottom of the note.

Chairman

Thank you Ms O'Flynn. We will take a series of questions, starting with Deputy Reilly.

Deputy James Reilly

I welcome the delegations from the HSE and the Department of Health and Children. I find it interesting that the EU Commission advised on 10 May that the legislation could be implemented without the need to avail of the expiry of the three month period. The UK did a similar thing last year. We waited a long time to proceed. Will they tell us why they waited so long? This issue has been raised since last year. While the legislation is welcome, we pointed out that in the past unless we had a ministerial directive that required all substances in the head shops to be passed by the Food Safety Authority and the Irish Medicines Board, we would be continually chasing the head shops. That is the case, because since the ban, they have produced a new substance called "amplified", a cocaine substitute which was purchased on Saturday in a head shop in Malahide by a concerned citizen and given to me. I will hand it over to the Garda Síochána, but having consulted the poisons information centre in Beaumont, they confirmed that this is a cocaine substitute. The legislation will continue to chase the producers though their illegal laboratories unless we put them behind the eightball and insist that everything they sell is passed by the Medicines Board and the Food Safety Authority of Ireland. Similarly, stated in large writing on the back of the package is the following "an exquisite white bath salts, use with plenty of water, not for human consumption."

The Bill awaited from the Minister for Justice, Equality and Law Reform is very important so that gardaí can form the opinion it is intended for human consumption. While I agree with the thrust of what is happening today and particularly with the HSE information campaign, the legislation is tardy and incomplete. It is by ministerial directive that these teams can help. If the Department of the Environment, Heritage and Local Government were to issue a directive to bring head shops under planning legislation so that they could only open between 9 a.m. and 5 p.m. and could not open within 10 km of a school, a club or a pub, we would go a long way to putting these people out of business. At this committee we are trying to protect our young people and children from being exploited by ruthless individuals who care not about the health consequences of the substances they produce. These are causing regular visits and admissions to hospitals all around the country. Perhaps the delegations can comment on the delay and how they would feel about the Irish Medicines Board and the Food Safety Authority of Ireland having a role in this area. Head shops can then carry the burden of costs because they would have to pay the Food Safety Authority of Ireland and the Irish Medicines Board to perform checks to ensure the substances they sell are safe.

Deputy Kathleen Lynch

I welcome both delegations and I agree with Deputy Reilly. No matter what the drug is or who the supplier, we will always chase after them because their sole purpose in life is to create substances that people find attractive. In that regard, my question for Ms O'Flynn and Mr. Doyle is whether the HSE has employed chemists to examine the baseline substances that should be outlawed in all of these drugs. There must be a baseline chemical that substitutes for cocaine or other drugs. Surely the legislation should deal with the baseline chemical rather than trying to constantly add substances to the list when they are being cleverly reproduced under another guise and in a different mix. Any chemist could probably tell us that a combination of chemicals will give us X, Y and Z. Perhaps we should examine outlawing these rather than outlawing the end product.

Today we are specifically dealing with head shops. Is there research on how many children arrive at the accident and emergency unit having drunk too much or having taken too many legally prescribed drugs, a major problem in the area I come from? What are we doing about that problem? I see far more of this than addiction to head shop products.

While I agree with Deputy Reilly's comments, I am not certain that moving head shops ten miles from the nearest school or club is the solution. If people are persistent they will find these head shops and we can only do so much to protect children. I welcome the campaign today. This is about education and trying to keep as many as possible of our children safe. I would like to see further research into the number of children arriving in the accident and emergency units, how many under age people arrive in accident and emergency units because of over-indulging in drink and how many arrive having consumed legitimate prescription drugs. That research would tell us much about what our children are up to. The drugs matter must be dealt with by education. Hopefully this will deal with 60% because there will always be people who indulge.

Deputy Charlie O’Connor

I wish to be associated with the welcome extended to our guests at this important meeting. It struck me that I have been agreeing with Deputy Reilly for the past 16 years since we first joined the health board together and I agree with him today. Without ambushing the delegation, we have been following the head shop phenomenon like the fire brigade. I have received many calls in the town where I live, where we had head shops. I am a member of the local drugs task force and the issue arose. We wondered when this will be dealt with and people were concerned about it. All of us in our constituencies, certainly in the Dublin region, received many calls from concerned parents upset about this. I also received calls from schools. There seemed to be quite a delay in dealing with this and I am glad we have caught up. We need to maintain the pressure.

While it is not within the remit of the HSE or the Department, there was surprise that local authorities could not take action on the setting up of these premises. Local authorities made it clear to me that planning regulations do not apply in that respect. Does the Department or the HSE have a view on this? We have come a long way in recent weeks and it is important to do so. People want us to maintain pressure and to ensure that, as the evidence produced by Deputy Reilly suggests, other more innovative ways are not being found to slip these products in.

I do not agree with the approach that the best way to get rid of head shops is to burn them down. That has occurred in a number of places. The problem is that other businesses are affected and I am not prepared to go down that road. It is important the Department and the HSE understand there is concern about this matter in communities.

Deputy Jan O’Sullivan

I welcome the two delegations and support previous speakers. This will be difficult because there is a good deal of money to be made from these substances. People will find ways around this. Deputy Reilly has shown that they are already doing this. Is it possible to insist on labelling of all of these materials so that we know exactly what is in them? Deputy Kathleen Lynch referred to having them specifically examined. It should be legally required that all these items display the substances clearly. Regarding bath salts or other products not for human consumption, are they not in breach of advertising regulations? They are falsely advertising something. Is there not a way of legally catching them? Perhaps the delegations are not the correct people to put the question to but it is a question that needs to be asked.

This is a major uphill struggle and it is sad to say that so many young people are seeking ways of getting high. I remember a campaign entitled "High on Life", which was relatively effective. The problem is that young people are using these substances, whether legal substances such as alcohol, or illegal. One does not need to remove the reference to legal drugs because alcohol is a legal drug, although not to those under 18 years of age. As Deputy Lynch rightly pointed out, it is as much the cause of misery to young people as other drugs.

Is Ms O'Flynn using young people in the campaign? Young people are most likely to respond to other young people. The behaviour of a young girl who is totally unable to control her actions is more likely to be influenced by another young person than by an older person. What a younger person says will have more effect than a lecture given by an older person about the damage she is doing to herself. Are young people being used in the campaign?

I have a question on detox facilities. During the discussion on the legislation to ban these substances it became apparent that a lot of people have become dependent on substances that are no longer legal. Those people have to have somewhere to go but the only place of which I know for adolescents is the Aisling Centre in Kilkenny, though there may be others. We have been campaigning for a detox centre in Limerick but funding has not been made available so far, though there is a centre in Cork. It is difficult for parents to get any help for teenage children who are addicted to substances. I am not sure if such things are within the brief of the witnesses present but I would be grateful if they would try to respond to that point. It is vital we put support services in place for all young people who have been using the products from head shops and need help to get back on track.

Deputy Rory O’Hanlon

I thank Ms O'Reilly and Ms O'Flynn for their contributions. I welcome the legislation and the fact that the European Commission short-circuited the application process and did not make people wait for three months. I am very concerned at the speed of the development of head shops and the increase in the number of people who use them. I am especially concerned about young people who bought substances without any idea of the effect they would have on their system. We all saw the side effects in our own towns.

We do not appear to have done as well as we might in the area of education. We certainly cannot say our education service has been as successful as we would have liked when we see the misuse of drugs throughout the country. It is not just a city problem as it affects most small towns and a variety of drugs are used. A lot of responsible people in towns, such as town councils, parents' groups, community groups and schools, are anxious that the problem be addressed. Does the HSE have a programme to co-ordinate these groups? Perhaps there could be a group representative of the various interests, acting with the support of the HSE to ensure young people are aware of the risks and dangers of the misuse of drugs.

How are we succeeding in comparison with other European Union countries?

Deputy Beverley Flynn

I welcome the two groups. I share the concerns expressed by my colleagues about the development of head shops and agree on the need to stay ahead of the game. In the event of a new substance coming on stream, would it be possible to add it to a declaration order, thereby outlawing it? Could this be done daily, weekly or monthly as the need arises? Head shops have existed in the capital for a lot longer than they have been in my home town but when they sprang up in every town and village around the country we seemed to get our act together by putting in place the declaration order and the statutory instruments fairly swiftly. Are gardaí raiding head shops that are still open? Are they examining what they are selling to see if they are in breach of the law as it currently stands? What sort of inspection regime exists to ensure they are compliant?

Ms Kinsella said the use of substances for legitimate purposes was a complex area. Can she explain how this is controlled and regulated? How does it operate in practice? I imagine that a loophole could be found and exploited in this area and it is important to be ahead of the game.

Senator Phil Prendergast

I welcome the two groups. When a child or young person is admitted to an accident and emergency department with an overdose there is a system to identify whether it is as a result of the legal, illegal or accidental use of drugs. How many young people have presented in such circumstances and what is the follow-through once they cease to be an acute case? Are they referred to a psychiatric unit? Are all the different effects of the various psychoactive substances known? I am not aware of any research suggesting people are left with a lifelong psychiatric disorder.

What additional resources have been put into training policy advisers in local and regional units and in the medical services in current and evolving matters relating to these substances?

Senator Mary M. White

I welcome the delegation. Any education campaign has to start when people are very young. People do not realise that human beings have a propensity to addiction. I heard that fact quite recently at a meeting of this committee and it is very frightening. The key is to provide education from the earliest age, such as age four or five, so that children know from then that alcohol or drugs can destroy their lives.

It is very easy for any of us to become addicted. In my study on suicide I refer to international research proving that alcohol consumption weakens people's ability to think themselves out of depression. Some 60,000 people self-harm as a result of depression. Some people may be able to survive taking alcohol but others become addicted and their lives, and those of the people around them, are destroyed. We should frighten people at a young age. One cannot compare cigarettes to other drugs but the campaign in the 1980s to make the public aware that smoking was bad for health was successful. Many people smoke but the overall acceptance is now lower. In my generation cigarette smoking was fun. We did not know how serious it was until the campaign told us it destroyed one's health and that a smoker ran a very high risk of dying from lung cancer. The earlier the intervention the better when it comes to treating addiction.

Chairman

A wide variety of questions have been asked. I will put one or two points to the witnesses. All of us have seen those shops close down in our constituencies. Is there anything better than anecdotal information in terms of the number that have closed since the statutory instruments were put in place?

Deputy O'Connor referred to the need to engage the planning system in the process. The planning system was powerless to address those shops that were set up in premises that were previously permitted to operate as shops. In cases where they were opened in a space that previously functioned as an office or other use, is it Ms Kinsella's understanding that the planning authorities would then have the power and opportunity to refuse a change of use because of the type of substances that were being sold?

My final question relates to the methadone programme. There is some suggestion that people who are involved in the programme were found to have been using those substances as well in recent times. What is the impact of that in terms of the health and well-being of the individual and also in terms of the operation of the methadone programme?

Ms Marita Kinsella

I thank the members for their questions. We will work our way through the significant number of questions. One issue that was raised by both the Chairman and Deputy Flynn related to the outcomes in terms of the Garda's approach to the matter. We sought an update from the Department of Justice, Equality and Law Reform and the Garda in advance of attending today's meeting so that we would be able to provide that information. On the day following the introduction of the legislation the Garda visited all 102 head shops in the country and requested that the proprietors of the shops would voluntarily provide their merchandise to the garda who was visiting. The Garda also visited a number of wholesale outlets and, again, the same approach was taken. They understand that 36 head shops are currently operating, but that number is subject to fluctuation. The comment from the Garda has been that the introduction of the legislation has had a significant impact on the area and that it has had a significant impact on public perception as well in that people now understand issues about the legality of the products and also the potential dangers of purchasing them.

Deputy Reilly referred to the time taken to bring forward the legislation. Drafting legislation is a complex process which involved obtaining a lot of chemical expertise to ensure we were identifying the appropriate substances that are in this country and also establishing the risk base in order to bring those substances under control. Because the misuse of drugs legislation is criminal legislation it means that it must be very clear, as the courts must be clear about what substances are controlled under it. That takes a bit of time. Another complexity is that certain substances had legitimate uses which meant that we had to engage widely to ensure that the controls placed on those substances would not unnecessarily interfere with the industries using them but also at the same time would introduce appropriate control for those particular substances.

With regard to the notification process, the legal advice we received is that it was necessary to notify the legislation particularly because some of the substances have legitimate uses. The reason the notification process is so important is because if legislation is not notified it can have consequences for its enforceability. For example, if legislation were to be introduced that had not been notified, and if the court found that the legislation should have been notified but was not, the legislation would not be enforceable against an individual whom the Garda tried to prosecute. A consequence of that could be that we would have controlled a number of substances but the legislation would no longer be enforceable until such time as notification had been completed. As a consequence of that it was felt that the safest way forward was to undertake notification. I cannot comment on the view in the United Kingdom on notification. Our position is that we want to ensure the legislation is fully enforceable against individuals who are in breach of it.

Deputy Lynch raised an interesting point about being able to keep ahead of the game and identifying chemicals that have the potential to be abused. The legislation we introduced put in place a number of generic definitions. That means it is not an individual substance that is controlled but the definition covers a group of substances so that any small changes to the chemistry of the molecule will still be covered by the legislation. In this country and in Britain we are lucky that our legislation allows for that. In other European Union member states the law does not allow for that provision so it is much more onerous for them to list individual substances whereas, increasingly, our legislation and the British legislation is moving to use generic definitions, especially to address the issue raised about being able to make minor changes to a molecule in order to circumvent the legislation.

Deputy O'Hanlon inquired about a comparison with other EU member states. We work closely with a number of other member states. Controlled drugs are such an international issue that we share a lot of information. Our legislation is very much on a par with the United Kingdom and because of our land border we are keen to ensure that our legislation is as close to that in the UK as possible. We have gone ahead of a number of countries in terms of the types of substances we have controlled. To date, not all EU member states have taken the action we have to bring under control the range of substances we have.

Deputy Flynn referred to the legitimate use of some of the substances and how we ensure there are appropriate controls in that regard. Under the Misuse of Drugs Act there is a provision that allows for a licensing system for certain substances. Obviously not everything that is a controlled drug is illicit. There are many controlled drugs such as morphine that have valid medicinal uses and as a consequence we must put structures in place to allow for that. If substances have legitimate uses they may be controlled differently in the misuse of drugs legislation. There may be controls on their import and export. In other words, they are subject to a licence issued by the Minister for Health and Children. That allows us to ensure that only licensed authorities such as universities and pharmaceutical manufacturing facilities that are using the substances are allowed to legally import and export them. There are control mechanisms around the legitimate use of certain substances so that we can balance such use while at the same time ensuring that controlled substances do not go astray.

Deputy Reilly made an important point about developing a system to ban substances until they are approved by the Irish Medicines Board and the Food Safety Authority of Ireland. One of the significant issues in terms of trying to ban substances in advance, before one makes them legal, is that it would hamper to a certain extent the ability of valid, legitimate industry to be able to innovate if it was proposing to develop any new substances and it were necessary to get approval in advance from various State agencies to carry out the necessary tests to better understand those substances.

The other complexity in that regard is that the substances concerned do not technically fall within the definition of medicines because they do not have any valid medicinal uses. They have an effect but they do not have any beneficial use to a patient. Neither do they fall within the definition of food because they are clearly not food substances. One of the difficulties with the substances is that they do not fall within the structure of existing frameworks, especially in terms of the medicines and food legislation which is highly regulated at a European level. We do not have the same scope to introduce national provisions on medicines and foods. It would necessitate significant engagement with the European Union and other member states to introduce controls on those substances via those channels.

Deputy Jan O'Sullivan raised a point about the labelling of the substances and the breaching of the codes of advertising. It is a very good point. We were very concerned about the fact that there was almost no information on the labelling of the products. To an extent, this was done deliberately to circumvent medicines and food legislation and other legislation that might apply. The Misuse of Drugs Act does not delve into that and does not have provisions to deal specifically with the labelling of substances. However, we understand there may be other legislation under the remit of the Department of Enterprise, Trade and Innovation that may be appropriate. We can engage with the Department on that.

With regard to breaches of advertising standards, the Misuse of Drugs Act really only prohibits the advertising of a controlled substance. It does not refer to the advertising of substances before they are controlled. We would not be best able to advise on this as a consequence. It can be examined further.

Senator Prendergast asked about the long-term effects of some of the substances in question. Since some of the substances are so new, we have very little published information on their effects, either on the evening they are taken or six months, a year or a number of years thereafter. Ireland must work with the international community to add to the body of knowledge. We understand research may be ongoing in a number of the universities and within the HSE to try to better understand their effects. We know the ones that were controlled may have similar effects to amphetamines or cannabis substances. We have an idea as to what their long-term effects may be but we really do not know for sure because they can be quite different from some of those associated with controlled substances.

Chairman

That was a comprehensive answer.

Ms Alice O’Flynn

With regard to the time it has taken us to get to where we are, there is extensive research to show that, in terms of mounting campaigns such as this, it is very important to mount one that has both local and regional buy-in, in addition to a central message. In the campaigns we have mounted to date, it has been very important for us to work with both service users and service providers, in the HSE and the community and voluntary sectors, to move the campaign from the ground up and from the top down. This is with a view to ensuring the messages and information issued are credible to the target audience. This takes a little time. With regard to the content of the campaign and the different media we are to use, that time has been well spent.

I have grouped the issues raised by the members. A number of questions were asked about information for young people and the kind of information available. It was stated that information needs to be available early and that training is required in information awareness. I am sure members will know of the SPHE programme in schools, which is now in some primary schools. While issues arise in regard to the consistency, content and delivery of the programme, we note that, on the basis of our consultation with service users and parents, it is seen as a very valid vehicle for providing information.

Our campaign, through www.drugs.ie and our own website, and what we are to do through radio, cinema and the Internet, which is so popular among young people, will provide very concrete information for young people. It will also provide information in the language people are using everyday, both in and outside school. We are very conscious of that.

Members asked whether we provide training and about the resources we are putting into training for colleagues delivering services. We have a national addiction training programme that is provided to the range of colleagues working in addiction services, both statutory and in the community and voluntary sectors. The thrust of the programme is to provide training and information for colleagues on the substances people are using illegally and legally and their effects on physical and mental health when combined. We are revamping the programme to ensure it coincides with the changes in regard to the legislation. We are also revamping it to ensure it is delivered in situ rather than at training events. In the current climate, the latter is no longer realistic or feasible. In the evaluation of training programmes we have delivered in the past, people said they are much more sustainable if the training actually happens at local level rather than having people attend main training events.

I want to address the question on whether people who have been using these substances, perhaps with alcohol, cocaine, methadone, heroin or opiates, are presenting to our emergency departments. This is very much a factor. Our emergency consultants have already brought this to our attention. One or two have written articles for some of the medical journals on this issue.

We are piloting a screening assessment and brief intervention tool that is to determine what substances people have been using when they present at emergency departments. It is intended to follow up on how problematic the substances have been for those presenting and to refer them, if necessary, to a counsellor or for further information, support or advice. This is a very important development in our services. We are piloting it in some of the emergency departments. Heretofore, it has been piloted through counsellors in GP practices across the country. The evaluation of this project was very positive.

Senator Phil Prendergast

Where is it being piloted?

Ms Alice O’Flynn

It is in Cork and Waterford at present.

A question was asked on whether those in methadone treatment are using some of the substances sold through head shops. There is anecdotal evidence to suggest it is the case. Perhaps Ms Kinsella will want to comment on this. In the research we have looked at on what is called "leakage" in regard to methadone, Ireland compares very favourably with other countries in terms of having methadone spilling out into the general system. We need to ensure this trend continues. Some might say the protocol on the prescribing and regulation of methadone in Ireland is quite strict and rigid but research shows that Ireland compares very favourably with other countries.

Deputy Jan O’Sullivan

I asked about detox. Can anyone answer that question?

Chairman

I will come back to Deputy O'Sullivan.

Deputy James Reilly

It was done in Britain last year. We do not need to reinvent the wheel for the legislation; they are dealing with the same substances.

My remarks were misinterpreted. I did not ask for the Irish Medicines Board or the Food Safety Authority to ban them, I asked that they not be available for sale, like the packet in my pocket, unless they have been approved by the Irish Medicines Board or the Food Safety Authority.

EU cooperation in innovation was mentioned. Anyone who creates a new product must go through various stages to have their product approved to go on the market. EU cooperation to protect children must be a priority.

Deputy Jan O’Sullivan

I did not get an answer to the question about detox. I also want to ask about the 36 head shops that are currently operating. Presumably it is primarily the job of the Garda but is there any information that any of the head shops are trying to sell goods illegally? Are they being monitored by the Department of Health and Children or the HSE?

Deputy Beverley Flynn

My question also related to the 36 head shops that remain open. The fact that two thirds of the head shops closed after the change in the legislation is a great success story. Where are the 36 shops? Are they in one location? Are some of the shops owned by a group of people or are they in individual ownership?

The Garda requested co-operation and for people to voluntarily offer their products. If someone is selling an illegal substance, it will not be displayed in a glass case for the gardaí to look at when they come in. How energetic was the Garda in ensuring it had a sample of every product on sale? How can those 36 shops legitimately stay open when the legislation obviously scared the hell out of everyone else? What are they doing that makes them feel so safe and secure?

Deputy James Reilly

There are 36 head shops open today but when I rang yesterday there were 33. How many were open at the beginning of last week and the week before that? Did most of them close down and are they are now reopening?

Chairman

It seems to indicate that the numbers could fluctuate. We will try to wrap up with this if we can.

Ms Alice O’Flynn

On detoxification, the Aisling Centre and the number of beds, my colleagues who are delivering services in substance abuse, such as consultant psychiatrists, tell me it is too early to say if detoxification is an appropriate response or is required. Certainly, we have been working on the need to ensure people are aware of the possible side effects and the presenting symptoms.

In terms of detoxification, the HSE is currently looking at where beds are available so there would be a more even spread around the country to respond to the population. We are also looking at the cost per bed for detoxification because we have found from the audit we did that this varies depending on the agency. That can be because detoxification is defined differently by different agencies. We are examining being much more specific in terms of detox, with a more specific spectrum, while looking at reasonable costs to pay to provide that service. A number of those services are provided through the community and voluntary sector. We are sitting down with that sector to examine the costs for a bed unit for this area.

Deputy Bobby Aylward

There is a centre in Ballyragget in north Kilkenny that is doing a great job. I have received correspondence in the past week, however, that states the centre is finding it hard to keep going because funding has been cut. It was seen as a very professional centre. If we cut back on units like that, are we on the right track? It should be funded so it can keep going. People come from all over the country to that centre and its record is proven.

Ms Alice O’Flynn

I am aware of that centre. When I mentioned to Deputy Jan O'Sullivan that we sit down with our colleagues in the community and voluntary sector to look at the services they provide and how much they cost, this centre is included in our discussions. We do not want to cease funding to those services but we must be realistic and recognise the economic environment we are all working in. We must ensure the funding we have is used in the most cost effective way. That is why we are doing the audit.

My colleagues are at the end of the telephone line regarding any of the agencies we fund. People can pick up the phone to speak to the necessary person in the HSE to make clear their concerns about the effects of reduced funding on the services being provided.

Deputy Bobby Aylward

I will meet staff from the centre next week so I will pass on that message.

Ms Marita Kinsella

A point made by members was the ability to deal with new and emerging substances. We are conscious that this is a business for particular people and they are keen to ensure it continues. The Minister has clearly indicated that if individuals try to circumvent the legislation, we will bring forward further orders to declare additional substances to be controlled. We are working closely with the Garda, Customs and Excise and the Forensic Science Laboratory to identify products like those identified by Deputy Reilly so we can bring them under control. We are feeding into the European process because if substances are appearing at EU level, they will appear in Ireland as well. We are working to identify new substances as quickly as possible.

We are not in a position to speak on behalf of the Garda but I understand they were successful in their visits to head shops. They said they obtained an unquantifiable amount of substances during the first few days after the legislation was introduced. It was brought in quickly so they needed to act quickly to take the substances out of circulation as soon as possible. They were successful in this.

The latest information we have is that 36 head shops are currently operating but that is subject to fluctuation. The Garda is monitoring the position closely. It is important to note that the head shops do not only sell psychoactive substances, they might also sell novelty items such as bongs and various pipes that are not currently illegal. They may also have other aspects to their business which would not be controlled under the Misuse of Drugs Act.

Deputy Reilly raised two points. He asked about the UK introducing the legislation before us. The time delay was the shortest possible. We did control a very large array of substances. Of course we look at the UK legislation and keep as close to it as possible. Obviously the framework for our legislation is different and we have to ensure that if substances are included in the legislation that it is done correctly and has the desired effect. We do not always follow exactly what the UK has done. We look at the substances it has controlled but we have to translate how that would work in an Irish context. We also have to consult nationally and ensure that substances relevant to Ireland are controlled, bearing in mind the feedback from the Garda, the customs service, the Department of Justice, Equality and Law Reform and other organisations that have made comments on the legislation and how to implement it into Irish law. We undertook a significant amount of consultation to ensure the legislation was as watertight as possible.

The medicines legislation was mentioned — I apologise if I misunderstood the original question — and the requirement that products and product labelling be approved before placing on the market. The requirement already exists in law that entities wishing to place products, particularly medicinal products, on the market must seek approval from the Irish Medicines Board or the European Medicines Agency. These entities deliberately try to present their products in such a way that they fall outside the medicinal products legislation because they are labelled as bath salts. Deputy Reilly read out a description of how they are describing their product. It is very difficult for us to prove that product is for human consumption when it is clearly stated that it is not. They would say they do not give any information to suggest that it is for human consumption. Even with the legislation in place and the requirement that entities seek approval for medicinal products to be placed on the market, they would still endeavour to breach that requirement. The most effective way of controlling import, export, production, supply and possession is under the Misuse of Drugs Act because that legislation is broadranging and creates very significant offences and penalties for those who breach the legislation.

Deputy James Reilly

The question I asked was whether there are more head shops open today than two weeks ago.

Ms Marita Kinsella

The only information we have from the Garda, which we received yesterday, was that there are 36. We understand that a couple of weeks ago, soon after the ban, the number was around the same. We have not heard of significant changes but maybe the Garda would be better able to advise on that matter.

Deputy Beverley Flynn

Are most of the products imported or are they manufactured here? I heard a wholesaler arguing on the radio about a month ago that these products contributed significantly to improving our balance of payments deficit. It is a crazy argument. When he was asked to quantify in hundreds of millions of euro what was involved, the amount was hugely significant, but I do not know if there was any truth in it. It would be interesting to know.

Chairman

Does Deputy Aylward wish to ask a question?

Deputy Bobby Aylward

Deputy Flynn asked it already. In regard to the products in the head shops, that is, the products on the shelves up front and those behind the scenes, can the Garda investigate what is actually being sold below the counter?

Chairman

Can we deal briefly with those issues before we wrap up?

Ms Marita Kinsella

It is difficult to say for certain where the substances are coming from but we understand that some of the synthetic substances are coming from China and possibly places in eastern Europe. We understand that there may be certain entities involved in producing product here. For example, some of the herbal smoking products may have been sprayed with a chemical that would give the effect. That would have taken place in Ireland and the packaging would have been done here. Much of the synthesis is probably not happening here but the packaging is done here. In terms of ownership, we understand there are certain entities that would probably own a significant number. The Garda is monitoring them carefully and would be concerned that substances that are now illegal are not being sold from head shops. Obviously, we cannot say what is the nature of their business but the Garda will be watching that.

Chairman

I thank the witnesses. They have brought great clarity to the issues before the committee. I compliment all the witnesses on the work they have done and on the ongoing work. We have reason to be grateful to them and the Minister for what has happened.

The joint committee adjourned at 6.35 p.m. until 3 p.m. on Tuesday, 15 June 2010.