Joint Committee on Health and Children díospóireacht -
Thursday, 9 Jul 2015

National Drugs Strategy: Minister of State at the Department of Health

Co-Chairman Deputy Jerry Buttimer

I apologise to the Minister of State's officials, staff, those in the Gallery and Members of the Seanad for the delay. Parliamentary democracy insists on votes being held. I welcome the Minister of State at the Department of Justice and Equality, Deputy Aodhán Ó Ríordáin, to our meeting. This is his first visit to a committee meeting involving the Joint Committee on Justice, Defence and Equality and the Joint Committee on Health and Children. I thank him for his presence and for agreeing to hold a joint meeting of these committees with regard to his new brief and the national drugs strategy.

The committees had an interesting first session this morning and I thank Mr. Packie Kelly and Mr. Tim Murphy from Teach na Daoine and the Cavan-Monaghan drugs awareness project for their presentation. We are keen to consider several proposals with regard to the issues raised this morning.

My Co-Chairman, Deputy Stanton, has made a proposal which we will discuss at the end of our meeting. I call on my Co-Chairman to make a few remarks.

Co-Chairman Deputy David Stanton

On behalf of my colleagues on the Joint Committee on Justice, Defence and Equality, I welcome the Minister of State and his officials. Like my Co-Chairman, I apologise to everybody for the long delay in reconvening the meeting. My committee has done a lot of work on this area. Recently, a number of us visited Portugal to look at the Portuguese approach to the drugs issue. It has dissuasion committees where people are not actually put into the criminal justice system. For small amounts of drugs for personal use, people are sent for education and rehabilitation, treatment and so on and that seems to work pretty well. It ensures the Portuguese police can put more of its resources into tracking down dealers and sellers of drugs.

Today's meeting of the two committees is historic and it is one of the first times this has happened. It shows how seriously we take the issue of drugs. This morning we heard an interesting presentation by people from Monaghan on so-called legal highs. At the time, I pointed out that the monitoring committee of the European Union had told us that two or three legal highs are being detected each week, that there are 450 of these, which are monitored by the agency, and that the number is growing exponentially. We are in a new drugs era. The idea of somebody selling drugs on a back street is gone and people now use the Internet, the dark web, and social media. A while ago, someone told me that people use drones and all kinds of technologies to sell this stuff. There are labs across the world churning out different types of very dangerous chemicals which we are now, unfortunately, beginning to experience here. Therefore, we must treat this matter extremely seriously. We welcome the fact that we now have a dedicated Minister of State. There is no better person than the Minister of State present to lead this initiative. A number of months ago, my committee recommended a dedicated Minister of State when we examined the issue first. I look forward to the engagement and to what the Minister of State has to say to us.

Co-Chairman Deputy Jerry Buttimer

We are having a joint sitting in accordance with Dáil Standing Order 84 and Seanad Standing Order 72. I wish to advise that by virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of the evidence they are to give to the committee. If they are directed by it to cease giving evidence on a particular matter and continue to so do, they are entitled thereafter only to qualified privilege in respect of their evidence. They are directed that only evidence connected with these proceedings is to be given and asked to respect the parliamentary practice to the effect that, where possible, they should not criticise or make charges against any person or an entity by name or in such a way as to make him, her or it identifiable. Members are reminded of the long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the Houses or an official by name or in such a way as to make him or her identifiable.

I ask Members, witnesses and people seated in the public Gallery to switch off their mobile phones or leave them in airplane mode. I invite the Minister of State to make his opening statement.

Minister of State at the Department of Health (Deputy Aodhán Ó Ríordáin)

I welcome the invitation to address members of the Joint Committee on Health and Children and the Joint Committee on Justice and Equality on the national drugs strategy. I am delighted to have been given the opportunity to take on a ministerial role in this area. I see it as a vital role that needs the attention of a dedicated Minister. From my work as a teacher and principal in Dublin’s north inner city, I am aware of the devastating consequences of drug abuse and the damage it causes in communities. I am deeply committed to doing all I can in my role, as Minister of State, to ensure that drug users are given the support they need to overcome addiction and once again live fulfilling lives.

Since taking up my new role, I have met many people who share my concern about the extent of the drug problem in Ireland. A lot of people have said that they would like to see a change of attitudes to addiction and a more compassionate health oriented approach to those who are dependent on drugs. Too often those afflicted by addiction suffer from stigma and a lack of public understanding and education which can hold back their recovery. It is against this background that I am delighted that the justice committee is inviting public submissions on its drug policy review, with particular reference to the question of whether an alternative approach to the possession of small quantities of illicit drugs for personal use should be considered. I very much welcome a discussion on this important issue.

The national drugs strategy aims to tackle the harm caused to individuals and society by the misuse of drugs through a concerted focus on supply reduction, prevention, treatment, rehabilitation and research. The strategy encourages inter-agency working in a difficult cross-cutting policy and service area.

The oversight forum on drugs, which I chair, monitors the progress in implementing the strategy. As part of the work of developing a new strategy to cover the period from 2017 onwards, I intend to carry out a comprehensive assessment of the extent to which the current strategy has provided an effective policy response to the drugs problem. I will speak in more detail later about my plans in this area.

In order to have an informed evidence-based approach to drug policies, we need accurate information on the nature and extent of drug use. The national drugs prevalence survey, which is carried out by the national advisory committee on drugs and alcohol, is a key source of such information. Fieldwork for the fourth wave of the survey in 2014-2015 is at an advanced stage. I look forward to the first results bulletin becoming available later this year. This will give the key findings on drug use and will enable comparisons with the three previous surveys undertaken in 2010-2011, 2006-2007 and 2002-2003.

The nature and scale of the drugs problem is constantly changing. While levels of illegal drug use stabilised between the 2006-2007 and 2010-2011 surveys, drug use in Ireland has increased over the past decade. Cannabis is now the most commonly used illegal drug in Ireland with 6% of those surveyed reporting use of the drug in the year prior to the survey. The increasing trend towards polydrug use, involving a combination of alcohol, illicit drugs and prescription medication, is a major concern for me and the Government. Our treatment services are also seeing an increase in the use of benzodiazepine and z-drug. The fact that this often occurs in the context of multiple substance use is a particularly worrying trend.

Unfortunately, because of the hidden nature of heroin use, we do not have good data on its usage in Ireland. We know that there are in the region of 9,800 people in methadone maintenance treatment, which is an indicator of the extent of the problem. The NACDA is currently undertaking a survey, which will provide us with an up to date estimate of heroin users later this year. Even without this data, I am satisfied that heroin represents a substantial element of our drug problem and I am determined to find the most effective way to tackle this blight on communities.

I have already highlighted the multi-sectoral nature of our response to the drug problem. I would like to pay tribute to An Garda Síochána and the customs service for their role in the significant drug seizures that we have seen in recent years. The continued disruption of the supply of illicit drugs remains a key priority and this is also reflected in An Garda Síochána's policing plan for 2015.

The emergence of new psychoactive substances, specifically designed to circumvent drug controls, has been a matter of particular concern in recent years both in Ireland and at international level. The Misuse of Drugs Regulations and the Criminal Justice (Psychoactive Substances) Act 2010 have had a significant effect in closing head shops and reducing the supply of the substances. Recent research conducted by Trinity College shows a significant fall in recent and problematic use of head shop drugs among young people, following the national ban that was introduced in 2010, a measure which had cross-party support.

I met the UK Minister for Policing, Crime, Criminal Justice and Victims, Mr. Mike Penning, during the British-Irish Council summit meeting in June. He was keen to discuss with us the practical impact of banning so-called legal highs, as the UK Government has introduced a Psychoactive Substances Bill, currently going through its Parliament, which is modelled on the Irish experience.

The problem of new psychoactive substances is a constantly changing phenomenon. New substances are emerging all the time. We continue to monitor the problem through our national early warning system which enables authorities to identify new drugs, describe new trends in use and report the serious and unusual consequences of drug use.

I view it as vitally important to continue to highlight the potential dangers associated with taking illegal drugs. Evidence-based awareness raising and prevention programmes also play a key role in promoting healthier lifestyles and changing attitudes. Education programmes, such as the SPHE, facilities and services for young people in disadvantaged areas and diversionary programmes for young people at risk, all help to equip young people to make more positive lifestyle choices. However, the drug problem is a wider societal issue and cannot just be addressed within the educational system. As I often say, children and young people do not live in schools. Parental involvement and community concern play a role in protecting young people against substance misuse. Young people have been handed this problem by a previous generation and we should resist the temptation to blame such young victims who are merely continuing and mirroring what their parents and grandparents practised.

I am delighted to confirm that funding of €1 million will be allocated from the Dormant Accounts Fund later this year for substance misuse prevention. Grants of between €30,000 and €50,000 will be available for proposals developed by drug and alcohol task forces to mobilise communities to tackle drug and alcohol-related issues.

As I mentioned earlier, approximately 9,800 people are currently availing of opioid substitution treatment. The number of new entrants to treatment whose main problem drug is heroin is in decline. However, services are seeing an increase in the number of people whose main problem drug is cannabis, as well an increasing incidence of poly-drug use. The HSE is committed to achieving improved health outcomes for problem drug users and has reoriented its services in recent years to cater for those with poly-drug use issues.

Waiting times for access to services, particularly outside Dublin, have been considerably reduced. The latest figures indicate that in the region of 95% of clients over 18 are accessing treatment within one calendar month of assessment, while almost 100% of under-18s are accessing treatment within a week. Additional funding of €2.1 million has been provided in the HSE budget for 2015 for measures targeting vulnerable drug users, bringing the total allocation for addiction services to almost €109 million. The extra funding includes support for an additional 53 beds, creating 439 new treatments.

The Government has also stepped up the effort to reduce drug-related deaths. In 2012, there were 633 drug-related deaths in Ireland. While there has been a small decline in the overall number compared to 2011, drug-related deaths remain at an unacceptable level, and every death is a tragedy in its own right.

I especially welcome the HSE-led pilot project on naloxone which has been launched recently. Naloxone is an antidote used to reverse the effects of opioid drugs such as heroin, morphine and methadone upon overdose. This innovative project involves training lay persons, such as the family and friends of a drug user, in administering the naloxone injection to overdose victims. Research shows that providing increased access to naloxone for people likely to witness an overdose is an effective way of reducing overdose deaths. I have no doubt that lives can be saved as a result of this initiative. We have an overdose problem in Ireland. I think we have the third worst rate of overdose in Europe.

There is a problem with street injecting in Dublin and elsewhere, which is unhygienic and unsafe for both drug users and the general public. Medically supervised injecting facilities exist in a number of other countries, and have been suggested as a response to the problem of street injecting in this country. I have recently received a draft legislative proposal in relation to this matter, and I have asked my officials to examine the issues in more detail.

Those struggling with drug problems are often the most marginalised in our society. They may have multiple, complex, interlocking needs, such as poverty, housing, poor health and education. This underlines the importance of services working together, through a client-centred approach, to foster client progression. The Government is committed to the full implementation of the national drugs rehabilitation framework, which aims to ensure continuity of care for the recovering drug user through shared care planning.

I would like to outline for committee members my priorities for the remainder of the lifetime of this Government. The first relates to the Misuse of Drugs Acts. In March of this year, the Minister for Health brought forward emergency legislation to deal with an adverse Court of Appeal decision regarding the Misuse of Drugs Act 1977. The ruling had the effect of decontrolling all substances that had been controlled by Government order, including ecstasy, new psychoactive substances and benzodiazepines. This meant that it was no longer an offence to possess these substances. The Oireachtas passed emergency legislation on 11 March to restore the controls on such substances by placing these in the Schedule to the Act. I intend to bring forward another Bill by the end of the year to amend the Misuse of Drugs Act so as to allow the Government to declare substances to be controlled, thereby meeting our EU and international obligations to control substances that are dangerous and have the potential for abuse.

The Bill will clarify the provisions under which Ministerial orders and regulations are made. This will once again allow regulations to be made and, if necessary and appropriate, allow the introduction of stricter or less strict controls on substances that are already covered under the legislation.

Second, as Minister with responsibility for the national drugs strategy, I will be leading the development of the drugs strategy for the period after 2016. My intention over the coming months is to lay the groundwork for a concise and focused policy, placing a clear emphasis on the practical implementation of actions. An examination of the approach to drugs policy and practice in other jurisdictions will also help to identify any additional evidence-based approaches which might be considered in an Irish context. The development of the new strategy gives us the opportunity to have a constructive and wide-ranging public dialogue on our current drug policies so that we are in a strong position to develop a fit-for-purpose response to the drug problem which will meet challenges into the future.

I will endeavour to answer any questions that members of the joint committee may have.

Co-Chairman Deputy Jerry Buttimer

I thank the Minister of State. In the absence of Fianna Fáil, I will now call on Deputy Ó Caoláin.

Deputy Caoimhghín Ó Caoláin

I welcome the Minister of State, Deputy Ó Ríordáin, and congratulate him on his appointment. I wish him success in his new role and responsibilities. It is a welcome decision of the Government to appoint a Minister of State dedicated to the task of addressing this need. It is only regrettable that nobody was in that position over the previous four years.

In my questions to the Minister of State, I wish to concentrate on the specifics concerning the earlier presentation by voices representing my own community and their experience in dealing with this matter. There is a big question mark over so-called legal highs. The real question is whether they are legal. Most certainly, they should not be legal.

We are discussing this question against the backdrop of two tragic deaths. As I said earlier, this is not an abstract issue. It has affected people whom I know personally. The friends who made presentations here this morning are dealing with these matters on a continuous basis. The community has been deeply affected by the almost epidemic presence and accessibility of these substances.

I note that the Minister of State met with the UK Minister with responsibility for policing, crime, criminal justice and victims, Mike Penning, during the British-Irish Council summit meeting last month. There is concern in my community as to the effectiveness and fitness for purpose of existing legislation here. Yet we note that the British legislation, the Psychoactive Substances Bill, which is going through Parliament but has not yet been enacted, is modelled on the Irish experience. That is a fact; it is not just the opinion of the witnesses we heard earlier, Mr. Packie Kelly and Mr. Tim Murphy. I can advise the Minister of State that I have personally met senior representatives of An Garda Síochána in the Cavan-Monaghan division who tell me that the existing legislation is inadequate to allow them to address the growing scourge of packs of dangerous substances. That is the view of senior members of An Garda Síochána, which must be factored in. I would be concerned, if any other jurisdiction were modelling legislation on what we currently have, if the reality is that our legislation is deficient and incapable of properly allowing the policing service in this State to deal with the problem. I sincerely ask the Minister of State to ensure that a serious review of this situation is undertaken. In his closing remarks, he spoke of bringing forward another Bill by the end of this year to amend the Misuse of Drugs Act. The 2010 Bill effectively contributed to the closure of head shops across the country. That legislation listed some 200 banned substances, and the methodology is to continue to proscribe and add to the list over the intervening period. We must face the fact, however, that we simply cannot keep up.

As Deputy Stanton, the Chairman of the Joint Committee on Justice, Defence and Equality, put on record here this morning, new substances are being created at a rate of two per week and people who have the chemistry know-how are working continuously to create these substances. We simply will not be able to deal effectively with this situation if we are always trying to catch up. We will never catch up. We need to find a way of getting in front of all of this with some form of blanket legislation that provides that substances are illegal until they are determined to be legal, acceptable and having a valid purpose. That would allow the Garda - and any other police service, where comparable legislation came into effect - to deal with the issue as it must. I ask the witnesses to expand on what they hope the amended legislation will achieve by the year end.

I did not realise the passage of time. If I am allowed to reflect on one last point, the Minister of State in his contribution said that waiting times, particularly outside Dublin, had been considerably reduced. We placed some attention on this issue earlier this morning, but some of the difficulties concern the fact that people who are users of these substances and who may have underlying mental health issues are not able to access mental health services while they are users. They can only be assessed and assisted when they are absolutely "clean", which is the word used, and no longer using these psychoactive substances. Those qualified to make the assessment are then able to deal with them as standalones in their own right. There is an absolute need to look at this issue, because the required pathways to secure the help that is badly needed are not there.

This is a life-or-death situation which is, in real terms, currently affecting the county of Monaghan in a serious way, but I believe it is also the experience of communities right across the country. It may not take the format of those little packs to which the Minister of State has now been introduced, but if it has not, I can tell the Minister of State with confidence, it is only a matter of time.

Deputy Seamus Healy

I welcome the Minister of State and his officials to the meeting this morning. I thank the Minister of State for his presentation and congratulate him on his appointment, which I believe to be a significant one. There is a view that, in recent enough times, we have lost focus on this issue. A leading role by the Minister of State is vital to tackling the issue, which is widespread and pervasive. It may not be understood enough at a central level, but this is a problem affecting every town, village and street right across the country. It is significant that a Minister of State is leading in this area and is firmly putting the focus back on dealing with the issues.

I wish to focus briefly on the future. A number of important things need to be done. The Minister of State indicated some of them in his presentation. The most significant one is the drug strategy after 2016 into the future. It is absolutely essential that we have an inclusive discussion and consultation on that strategy, which involves youth and community organisations, family resource centres, those who have been at the front line in dealing with this matter and those who have been affected directly by drugs. That is absolutely essential, and I hope the Minister of State will put in place a formal structure for such an inclusive consultation.

The Garda has done a lot of good work in the area of prevention by identifying and stopping the shipment of drugs. It has also done excellent work in the area of diversion. In the past, certainly in recent enough years, we have to a large extent lost the community policing element. Unfortunately, due to cutbacks or whatever, community gardaí across the country have been transferred to other duties. In many cases, the community policing aspect is tagged on to other duties. There should be a particular focus on community policing and ensuring these gardaí are available to communities.

Community facilities and services is another crucial area in dealing with drug abuse and misuse. The availability of community centres and sporting facilities in our communities is key to our future drug strategy. There is also the question of the adequacy of the law governing this area. The presentation earlier this morning raised that issue. There is a lack of clarity on legal or herbal highs. This aspect is crucial. Those four areas - the inclusiveness of consultation on the new drugs strategy, community policing, community facilities and clarification of the law - will be vital in fighting this problem in the future.

Senator Ivana Bacik

I welcome the Minister of State and thank him for attending the committee today. I also welcome his appointment, which, as others have said, is hugely important. As a member of the Joint Committee on Justice, Defence and Equality, I welcome, in particular, the fact that the Minister of State is now in charge of developing a national drugs strategy which is to commence after 2016. I welcome the initiatives he has spoken about on prevention and education and the allocation of resources in that regard.

Coming back to the national drugs strategy, the Minister of State has given a welcome commitment to examine policy and practice in other jurisdictions and to identify any evidence-based approaches which might be considered in an Irish context as part of that strategy. The Minister of State will be aware that the Committee on Justice, Defence and Equality is undertaking a review of drug policy. As our Chairman, Deputy David Stanton, said, some members of the committee went to Portugal and looked at the Portuguese approach, which treats drug addiction as a health issue rather than a criminal justice issue. I think we are all conscious from this morning's earlier presentation of the huge harm caused to health and, indeed, life by substance misuse. We also have to be conscious that our most recent survey by the National Advisory Committee on Drugs and Alcohol shows that 25% of Irish people have taken cannabis at least once. There is clearly a huge prevalence of the use of currently illegal drugs. The abuse or misuse of substances by some people is a major health issue. What is the best evidence-based approach for us to adopt? Will the Minister of State, in his development of the drugs strategy, be looking, for example, at the Portuguese approach and that much clearer health-based model rather than the criminal justice model?

Co-Chairman Deputy Jerry Buttimer

I now call the Minister of State.

Deputy Aodhán Ó Ríordáin

How long do I have to respond?

Co-Chairman Deputy Jerry Buttimer

As long as is needed, but I have six other people who have indicated that they wish to speak as well.

Deputy Aodhán Ó Ríordáin

A wide range of issues have been raised and I appreciate the contributions that have been made. Deputy Ó Caoláin raised the issue of psychoactive substances and the effectiveness of the 2010 legislation.

We have a cultural problem with addiction in Ireland. Every family in Ireland has an addiction problem. It is in every corner of the country. There is a traditional misconception that it affects only certain geographical areas of Dublin. That is not true. It is everywhere, in every class group, every income level and every part of the country. People in a higher income bracket tend to be able to hide it better. Those in a lower income bracket cannot hide it as easily.

In 2010, there was a cultural shift in that not only do we have a cultural acceptance of misuse of alcohol, which is a dangerous cultural problem, but we also have a cultural problem with our view of cannabis in certain sections of society. Head shops were prevalent in 2010 and schoolchildren in uniform were lining up outside head shops where they could legally purchase substances which were very dangerous. We had crossed a cultural border in the acceptance of that type of activity. The legislation introduced in 2010 was effective in closing down the head shops. There have been 260 controlled substances since then. I agree with Deputy Healy that we are constantly trying to catch up with a very sophisticated and lucrative market because it is only necessary to change one small component of a substance and re-package it. The system is trying to catch up with it. I attended an interesting presentation during the week by a member of An Garda Síochána at the north inner city drugs task force who said he has had conversations with women in his area who ask him how can they tell their children to get a poorly paid job in a department store if they have the option of earning €1,000 per week selling zoplicone on the corner of their street. The vehicle to address this is the Misuse of Drugs (Amendment) Bill 2015 that will come before the House this year. I agree about the challenge in doing that.

I accept that we have challenges in the area of treatment. I am trying to be as open as possible to meeting groups and drugs task forces and those who meet service users and people in recovery and have identified several gaps. One gap appears to be between the moment of realisation for a person with a substance abuse problem and the moment when treatment kicks in. There is an expectation that the person’s behaviour or substance intake will change before the person can enter a mainstream programme. There are varying degrees of agreement or disagreement as to whether that really is a gap. We have to identify how we interact with an individual who, for the first time, has had that light bulb moment that life cannot continue in this manner and that he or she needs assistance. Crossing the threshold of a centre involves making a major personal change and calling out for help has a massive effect on self-esteem. Are we engaging with those people effectively and practically at that moment? I am not sure we are. There is also an aftercare issue. Are we just putting those on methadone programmes into cold storage for ten or 20 years, or do we deal with them as people with massive potential, who can work through their recovery and play a significant and important role in society?

We have a cultural problem in how we view people in recovery. It is not edifying to call them by nicknames, which we do. We have to challenge and move beyond that behaviour. They are sometimes very poorly treated by the media and in political circles and we have to move beyond that type of victim blaming. Anyone else with a medical problem would not be treated in such a manner and it does really inhibit them and their potential to recover.

I agree completely with Deputy Healy about the national drugs strategy and inclusive consultation because there are many people with much to say and the nature of the drug problem has changed completely since 2009. We are working with a strategy developed for 2009 to 2016. Ireland was a completely different place in 2009 and the drug issue was completely different then, as is the nature of what young people do now. I do not want to focus only on young people because people of all ages take illegal substances but young people engage in poly drug use, taking benzodiazepines mixed with alcohol and cannabis, which is much more potent and dangerous than it may have been ten years ago. It is a massive problem. I met a man aged 21 in a detox centre in Fingal last month who had been addicted to cannabis for nine years. This weighs heavily on my thoughts when trying to come up with a new drug strategy. I am not convinced we need a seven year one; we need a tighter one, a more focused number of years when we can make a difference through what we are trying to do.

I take on board Deputy Healy’s comments about policing. I intend to hold a conference on 29 July in the Mansion House in order to bring as many stakeholders as possible into one room at the one time. I cannot wait for a review of the national drugs strategy to put a proper political focus on the nature of the problem in Ireland, which is a very serious one. What I hear in different parts of the country terrifies me about the nature, prevalence and danger of drug use because we are not giving it the attention it needs. I intend to bring a paper to Cabinet as soon as I possibly can and not to wait for the review of the national drugs strategy to do so. I will do that most likely in the autumn. This committee can certainly help me in that process. On 29 July, in conjunction with the new Ardmhéara of Dublin City, Councillor Críona Ní Dhálaigh, I want to host a conference and start that thought process about how to feed into the snapshot of the nature of the drug problem in Ireland.

Although Senator Bacik had to leave to vote in the Seanad, I will deal with her issue about the Portuguese approach. I do not see any point in persisting with dealing with people who are caught in a possession of a substance for personal use through the criminal justice system. It is a complete waste of Garda time and of the system. Under the Portuguese model there is an intervention, there can be sanctions but it is a waste of everybody’s time and efforts to approach a person with an addiction issue who has a substance for personal use and decide that person is a criminal. That person has a medical need and should be dealt with in that manner. We have a lot of hearts and minds to win on that. The committees’ consultation process is very useful because as soon as the word decriminalisation is used, people think one is talking about legalisation. They are two very different things. Our terminology has to be carefully used and sculpted. We have to use international models. The value system and dynamic in every country is different. A legislative approach cannot be taken from one country, stuck into another and expected to work. When the Oireachtas Joint Committee on Justice and Equality held discussions on prostitution, it was told not to take the Swedish approach without taking its value system of counselling and education, and the entire package. If we were to go down the Portuguese route, it could not be only a legislative change; it would have to be an entire package of measures.

Deputy Catherine Byrne

In his opening statement the Minister of State said we do not have a database for the number of people using heroin. I know he received a copy of draft legislation from the Ana Liffey project about safe injection rooms. I support that.

I get many calls from parents telling me about the needles and drug-related things that are thrown all over the place when they bring their children for a walk in the park or to a playground and in school grounds. On a number of occasions I have met parents whose young children have picked up syringes. That is a real problem, particularly around the inner city. I hope the Minister of State will give due consideration to the draft legislative proposals from the Ana Liffey drug project because I think this is a step in the right direction not only for the people living in the area but for the users. It might also give the Minister some significant data on the numbers who use heroin.

I continually make the point on the social, personal and health education curriculum. I honestly think we need to change the model and look at ways that we can identify in the classroom how drug abuse is destroying young people's lives. We need to be more effective on the ground and get the message out. If young people at school do not get a graphic lesson on the effects of drugs, when they are out of school and into their 30s they are lost in the system and one cannot deal with them. Building self esteem comes not only from parents and education but from the community. I think that is very important.

I have a number of questions related to the task forces. Deputy Dara Calleary tabled a parliamentary question in June about the national drugs strategy budget. We hear all the time about the reduction in the money allocated to the community, but the reply to this parliamentary question included a table setting out the funding from 2010 to 2015. In my area, six different bodies receive local drug task funding and yet after huge sums of money have gone to them, we still have a significant drug problem. I wonder if this is due to the duplication of services. In some areas I see the same people accessing all of the services and nobody knowing who is doing what. The money is going into the services but nobody is tracking who is availing of the services. The services are duplicated in each of the areas.

I have a bugbear about young pregnant women with addiction issues who give birth in maternity hospitals to babies with addiction to alcohol and to drugs. We need to encourage these young pregnant women and help them because the substance abuse is not only killing them but affecting their unborn children. I have reservations around how these young women who have both alcohol and drug addictions are being treated when they go into the maternity hospitals.

Deputy Finian McGrath

I strongly support the joint sitting of the Joint Committee on Health and Children and the Joint Committee on Justice, Defence and Equality. I welcome the Minister of State, Deputy Ó Ríordáin and I have always supported the principle of having a Minister directly responsible for the drugs issue. I feel strongly that we need somebody in politics, a political director, to pull all the different agencies together. I also firmly believe we need somebody outside the political sphere that will pull everybody together and deal with the day-to-day issues. The Minister of State who is focused on the drugs issues has responsibility for asylum and other issues. We need to ensure we have a strong national director who will push the Departments and the services every single day of the week.

We have been discussing the drugs crisis but we have not put enough emphasis on the reasons young people take drugs. When one sits down with young people to observe and talk to them - in a previous day job I worked with young people - about the reason they took drugs, they will say it is for the buzz, to deal with anxiety, low self esteem, lack of love and affection in their personal and family life. Many of them come from very dysfunctional families where there was a lot of violence and aggression. The constant theme of these young people is the constant pain in their lives. As part of any strategy, we have to deal with theses issues to prevent those people going down the drugs route. One needs to get in early.

The Minister of State mentioned that we have 9,800 people on the methadone treatment programme. It is great that these people are in a programme and I welcome that, but do we have numbers for those outside the system? To deal with a major national problem we need accurate information on the numbers.

We need to address the impact of drugs on communities. At present the Joint Committee on Justice, Defence and Equality is doing a report on gangland crime and the widespread intimidation that goes on in some communities. We have dealt with horrific stories. We need to focus on the completely innocent victims of these drug gangs who live in the community and make life a living hell and total nightmare for others. We need to look at the impact of drug gangs as part of the overall response.

I was a member of the delegation that accompanied the Chairman of the Joint Committee on Justice, Defence and Equality, Deputy David Stanton to Portugal to learn about their approach to drugs. We got a very good insight into the problem. We saw at first hand the alternative approach to the aftercare and social integration of drug addicts. I think we should examine their model seriously as an option. From the political perspective I was also fascinated that Portugal has decriminalised drug use. The Minister of State referred to the forthcoming debate on decriminalisation and legalisation of drugs because it will frighten the bunnies and will be open to public opinion.

In Portugal there was all party agreement to do this and it was totally under the radar of public opinion.

Co-Chairman Deputy Jerry Buttimer

There is a vote in the Dáil.

Deputy Finian McGrath

I am almost finished. It was taken as a natural progression that drug use would be dealt with through early intervention by the heath system rather than the criminal justice system.

The Minister of State referred to the 633 drug related deaths in 2012 in Ireland. That is a very high figure. However he failed to mention the number of deaths as a result of gangland murders and violence in the community.

Sitting suspended at 12. 58 p.m. and resumed at 1.15 p.m.

Co-Chairman Deputy Jerry Buttimer

I call Senator John Crown.

Senator John Crown

I welcome the Minister of State and his officials. I really wish the Minister of State well. This is perhaps the greatest example of a situation where we need first thinking. This is a classical example of society, and not just Irish society, looking at something in a certain way for 50 or 60 years, seeing the evidence stacking up, ceiling high, that what we are doing is wrong but continuing to do it. In medicine and in science, we believe in empiricism and in testing something and if it fails, we say that it failed and that it is time to try something else. In terms of dealing with drug policy, we have not been good at that. Effectively, we are doing the same kind of things now that were done in the 1950s and 1960s with subtle nuances. When I say "we" I do not mean we in Ireland, I mean globally in the western world in the way we tackle the problem. I am not making any personal criticisms or, indeed, any professional or systems criticism of the way we do things in Ireland, because we do it pretty much the same way that most other people do it and we do it wrong.

I am a parent. I have four children and I hope none of them takes drugs. I do not want anybody to think I am saint, which means that I am somehow soft on drugs or that I am some kind of an aging hippy - I am aging - who has got some kind of liberal ideas because I do not; I am very anti-drugs. I would cast a weather eye on people using drugs in any sphere of my life and would do everything I could to stop them doing it. I think we all have that as a goal. I made a few suggestions over the past eight years about different ways of doing it, and one takes a certain amount of personal criticism for that. People assume that somehow one is soft on drugs or one is soft on drug users. I am absolutely well aware of the devastation caused by drugs to individuals, their families and society at large.

The war on drugs has cost hundreds of billions of euro. One would have to say it is as unqualified a failure as we have ever seen internationally in anything. The number of people who are using drugs in most countries is higher than it ever was. There have been very few instances of countries where drug use has systematically gone down or the number of people whose lives are damaged by drugs has gone down.

The major emphasis on interdiction and criminalisation and the metric of success being the street value of the stuff police have in whatever part of the world when they have the great photo opportunities with all the great big bags of stuff they have seized is irrelevant. The metric has to be how many people are taking drugs, how much they are using, what kind of drugs are they using and the cost of the devastation to their health, their families and society. That is what we really should be looking at. The Minister of State has already given us many hints that he is looking at the alternative approach, one which is best exemplified by the Portuguese, by other selective centres in Scotland and by other places that have gone into a harm reduction approach and a medicalisation approach for many of the drugs but one of the key things is to look critically at being brave enough to say to people that we may end up reducing some of the emphasis on police and on naval vessels and that we may do something rather different in the way we are trying to tackle the problem. It is not because we have given up, that we do not care, that we are pro-drugs or that we are liberal but because what we have done in the past has not worked. That is a hard message to get across because people assume that if one is not being über tough on drugs or sounding like someone from the Tennessee state house, that somehow one is some kind of a communist.

It is critically important to dissect this problem into the many problems which it is. In the cancer world, it has dawned on us over the past 20 years that diseases which we thought were unitary in fact comprise many different kinds. Drug use is a similar analogy.

We cannot hope to tackle cocaine abuse in the same way we would seek to tackle heroin, marijuana, alcohol or tobacco use. We need to see all of these as interrelated issues.

I might be accused of a certain inconsistency in these matters in that I would not hesitate to tighten the noose on the tobacco industry and make it ever harder for it to sell its products. We should be aiming for zero tolerance on tobacco use. It is achievable if we give ourselves a 20-year timeframe and a clear statement of purpose that it will no longer be legal to engage in for-profit commerce in tobacco after some future debate. That type of timeframe would facilitate farmers to switch to other crops, give investment houses time to invest in something else and allow factories scope to retool and so on. At a time when the world is desperately short of food, we could use the bioprocessing capacity currently taken up with tobacco production for something other than growing cancer-causing, addictive drugs. In the case of alcohol, my view is that we should, as a society, be aiming for a huge reduction in the volume we consume. However, these matters are another day's work and I will not go into them today.

My views are somewhat different when it comes illegal drugs. In the case of opioids, which are a special problem on their own, I did some research during my first year as a member of this committee; we met with many individuals and stakeholders and participated in on-site inspections. I came away from all of this convinced that we must regard opioid use as its own particular problem. People with an opioid addiction have a medical illness, and the treatment for the withdrawal phase of opioid addiction is opioids. We need to get people desensitised and ultimately off the drug, but when somebody has an acute withdrawal, the treatment they really need is an opioid of some kind or they will get terribly ill. We need a strategy of harm reduction, which will inevitably involve medicalising the use of heroin and heroin-like drugs in a bigger way than we currently do. The physical manifestations of the illness and withdrawal are such that people, especially if they are in relatively low-income situations, will do anything to get the drug, with all the social chaos this causes not only for themselves, but also for their families.

I wish the Minister of State well in his undertaking and would be delighted to meet with him again for a more leisurely chat about these issues. I reiterate that when it comes to tackling drugs misuse, each aspect of the problem needs to be dissected and examined on its own merits. There will be no single solution.

Deputy Maureen O'Sullivan

This is the second time today and the third time this week that I have discussed this particular issue with the Minister of State. I thank the Chairman for facilitating me, as a non-member, to participate in the meeting. I wish the Minister of State well with the conference to which he referred. It is important to hear the voices of those affected by this issue. However, his predecessors, as we know, also held conferences; it is time now for concentrated action. The national drugs strategy is not keeping up with reality, which the Minister of State knows from the projects he has visited and as he will have heard at the north inner city drugs task force meeting the other day.

The Minister of State referred in his opening statement to the need for legislation. There was reference to new Z drugs, such as zopiclone, which has the brand name Zimovane. The minute these types of drugs appear, they must be tested and immediately banned. We know, however, that as soon as they are controlled, other drugs will appear. Whatever legislation is put in place, it must include a mechanism whereby whenever a new substance appears, there is immediate testing of it. I acknowledge that the testing centres are under fierce pressure, which is another issue.

The Minister of State referred to people accessing treatment. The problem is that so many who need it are not, for a variety of reasons, accessing any treatment. In the case of a person who presents at accident and emergency with chest pains, for instance, we could string off a list of procedures and treatments they might be offered. When somebody presents at a hospital suffering from the effects of alcohol or drug abuse, there is usually some emergency treatment administered and the person is then discharged. More often that not, that person will be back in the accident and emergency department many times again. We are not providing enough treatment opportunities and options at that particular point of access, which, in many cases, is the main point of access to the health system for people in addiction.

The Minister of State gave a very blasé answer this morning to my question about alcohol services, saying he had never heard of a project that did not claim to be struggling. I am asking him to examine those projects where the evidence is that they are doing well. Staff and clients at Áit Linn are very excited about his upcoming visit. I met a group from that facility the other day who are in recovery from alcohol addiction. They spoke about the economic cost of their alcoholism by way of accident and emergency visits, hospitalisation, missed work, doctor visits, medication and so on. The cost of their residential treatment was either paid for by themselves or covered by the medical card and they are now back in work and paying their taxes. Some have their own businesses and are employing people. Furthermore, there is a knock-on beneficial effect for their families and communities and, in many cases, they are supporting others in recovery. Áit Linn receives funding of €150,000 a year. We need such a facility in every town in the country such is the extent of the abuse of alcohol and drugs in our society.

There has been talk since 2010 about making naloxone available for the treatment of patients with drug overdoses. Will the Minister of State indicate whether there is any progress in that regard?

On the question of decriminalisation, it is important that age be given due consideration as a factor. There are extenuating circumstances to consider when a young person is caught with a small quantity of an illegal substance. When we are young, we think we are immortal and will never be caught out. It is a totally different scenario when an adult is habitually engaged in criminal behaviour around drugs. Our emphasis must be on supporting young people to get off a criminal path that will have massive implications for their future.

The Minister of State mentioned the changing nature of the drug culture and the need for urgency in addressing the issues. I urge that he consider replicating on a broader scale those projects, some of which he has seen or will soon see for himself, that are working and making a difference.

Deputy Aodhán Ó Ríordáin

I thank members for their contributions. I agree with Senator John Crown's sentiments about it not being enough to continue on with what has been handed down to us but that we must instead form a logical view of what is happening and what needs to be done. As I said earlier, there is no point in clogging up the courts system and criminalising people for what is a medical need. There can be a lot of tough talk around this issue, which is really pointless. We have an understanding of the issues facing people who live on the edges of society and the excesses that can sometimes arise in their behaviour. Tough talk offers great one liners for journalists to latch onto but essentially amounts to meaningless and vacuous commentary which does not address the reality of the situation.

Continuing down the road of the Just Say No policy is a waste of time because a lot of young people do not listen to that message. Some are affected by the call and respond accordingly, but many others do not. I agree with Deputy Catherine Byrne that the education component is very important in terms of setting out our stall, but it is not really the most effective way of reaching young people. If children were influenced to that extent by everything they are told in school, we would not have the issues we have.

I am instinctively an advocate for the idea of medically supervised consumption rooms. I am in favour, too, of a decriminalisation model, but it must be one that suits the Irish context. That is a crucial point. I referred to the different legislative approaches taken in different countries. We must ensure any provisions we bring in will work in this country and in the context of Irish dynamics.

There is a huge amount of work to do in terms of raising public awareness. Deputy Finian McGrath mentioned the 633 people who died from drug misuse in 2012. It is an appalling statistic. If it applied to road deaths, there would be a massive public awareness programme arising out of it. We need to look at how to hone our message, but there remains work to do on what that message should be. This is an issue that impacts people of all ages, young, middle-aged and older. Deputy Maureen O'Sullivan made an interesting point about age being a factor in decisions around criminal sanctions. Some people have taken drugs all their lives and do not make a connection in their own heads with the tragic stories that enter the public realm from time to time.

Consequently, I do not know; I am willing to listen and learn as to how best to approach this matter. I accept the Deputy's point about how the Government is constantly trying to catch up with a lucrative and sophisticated industry. The Deputy and I are aware, from the area she represents and which I used to represent and in which I used to teach, that this is an extremely lucrative industry. It is not a casual, recreational activity in which people get involved but is a parallel economy. It employs people, one can make money out of it, people derive power from it and it has a hierarchy within it. Why would one spend one's time in education or further training when is a lot of money to be made within this parallel economy? As there is a huge amount of empowerment to be gained from doing that, the question is how should that also be tackled. I acknowledge the Deputy mentioned that the previous Minister held a conference in early 2014 and I understand the focus was mainly on the issue of alcohol. My intention is not to allow this conference, which is to be held at the end of the month, to feed into the national drugs strategy necessarily but to let it feed into a paper I wish to present to Cabinet, which basically will outline Ireland's current position in this regard. As for waiting for the national drugs strategy, such a strategy will be produced anyway. Governments and the political system will deliver that anyway. However, I wish to provide a snapshot in time of the nature of our drug problem, how important it is, how dangerous it is, and how serious this is. I want people to say things like people are not showing up, to refer to the drugs task forces, the gaps in the service, the aftercare and all the rest of it. I believe we can get to the bottom of these issues at the conference at the end of the month.

Deputy Caoimhghín Ó Caoláin

In picking up on Deputy Maureen O'Sullivan's point about trying to dovetail analysis and banning with the presentation or the advent of a new substance, I note it probably is extremely difficult. I refer the Minister of State back to the earlier point I made. Is it at all possible to be out ahead of it? Without wishing to repeat everything I stated earlier, I suggest a general ban on human use or absorption of substances that are not actually deemed legal and within approved purpose might be a means by which the Garda would be better able to carry out its function in the face of the presentation of new substances on a continuous basis, which is the case and unquestionably will continue to be the case. I refer to when a new substance presents and the definition as to whether it is psychoactive. The laboratory testing will make a determination as to whether the chemical structure of the new substance is comparable with existing psychoactive substances. However, of itself, it perhaps cannot decide that it is; it can only tell one what is the make-up of the substance and that it is similar to known psychoactive particles. Is there a way, within the existing or the new legislation the Minister of State is planning, of having legal certainty whereby one could allow for the prosecution to proceed on the basis of the laboratory testing and of all the available information? Is there a way to ensure beyond reasonable doubt that this comparable make-up to known psychoactive substances is sufficient to proceed? It is the case that some of these are challenged, there is uncertainty and it is unknown, particularly in respect of synthetic cannabinoids. As I stated in the earlier session, these are not the same but are mimicking what something else we know of can and does do. Can the legislation be amended to ensure the laboratory test is adequate confirmation of the purpose, the intent and the effect of the use of these substances?

I refer to the role of the mental health services in treating induced psychosis or other presenting crises such as, for example, suicidal ideation. I made the point earlier that there is not immediate access. There must be an amendment to the existing brief regarding mental services in order that people are not turned away only to then go back to a community-based or similar service within the community. There must be some access to professional help and services, not awaiting the person to be off the particular drug in which he or she is involved. For all of this, increased investment in treatment and support is needed. Finally, I refer to the establishment of inpatient stabilisation and detoxification facilities. Are these matters the Minister of State will proactively consider in the new amending Bill he proposes to bring in before the end of this year? He should provide members with greater certainty as to what he intends to do.

Deputy Aodhán Ó Ríordáin

Prior to the court case earlier this year, the Minister had the power to control substances. It was the court case that caused the confusion and the emergency legislation and that is why we are in this position. If I might suggest, the pre-legislative stage in this committee or committees would be key to teasing out those issues, be it the justice committee, the health committee or whichever committee is deemed appropriate. Collectively, across the House, there is a determination to deal with and nail this issue and to be on top of it. I completely accept the point made by the Deputy that when one is dealing with a highly sophisticated industry, which can change a small component of whatever substance it is and then repackage, reproduce and distribute it, one is constantly playing catch-up. The Government wishes to have as robust a legislative framework as possible to deal with that. My understanding of the 2010 legislation is that psychoactive substances effectively were banned and that there is a list of those which were not in order to give a legal structure around it. I suggest the pre-legislative stage here at this committee or in joint sittings of committees might be the best way to tease that out. However, on the Deputy's question, I certainly have an open mind as to how best we can deal with the issues he has raised.

One of the Deputy's questions pertained to the issue of mental health and addiction and a new strategy. That absolutely will be a central part of the new strategy and I believe it is key to it. Earlier, I mentioned the interaction I have had with people, including those in recovery and their families and the trauma their families have also gone through sometimes is overlooked. As I mentioned at the outset of my presentation, I believe it should be acknowledged that every family in Ireland has had an addiction problem. Therefore, every family has suffered from it, every family understands it and every family needs to be helped through that process too, because it is not just the person in recovery who needs assistance; it also is the people who care for the person in recovery.

Co-Chairman Deputy David Stanton

As we are almost at the end of the meeting, I thank the Minister of State and his officials for their attendance today. It was an interesting and engaging meeting. I noted one or two points. The Minister of State initially spoke about a focus on supply reduction, prevention, treatment, rehabilitation and research and then he spoke about inter-agency working in a difficult cross-cutting policy and service area. This encapsulates the challenge and as someone mentioned earlier, the Sports Council has a full-time chief executive officer who is focused on sports and on sports only. Perhaps there is a need for somebody, perhaps somebody already is doing this, to pull together everybody, all the agencies and Departments, and to work with the Minister of State on a full-time basis. This might be something worth considering.

I also wish to mention the issue of youth work. The Minister of State or perhaps someone else earlier this morning noted that students do not live in school, which is a good comment as they do not. They live in communities and in homes. Very often, if youngsters are engaged in out-of-school formal youth settings, one can have outreach there as well and this is an area that might be expanded and explored and which might be worth considering. Deputy Maureen O'Sullivan mentioned this earlier but in Portugal, members noted the importance of the local treatment centres.

People have somewhere local to go so they do not have to travel long distances for treatment.

I wish to bring the Minister of State's attention to the amazing work done by the Churchfield Community Trust in Cork and ask him to visit it at some stage. The Cornmarket Project in Wexford also does amazing work with people who are really challenged. I visited both and have met the people involved. Next week representatives from Churchfield Community Trust will come before the Joint Oireachtas Committee on Justice, Defence and Equality to make a presentation on the very impressive work they do. Colleagues have said such work is being done throughout the country.

The Minister of State said many people have multiple complex interlocking needs such as poverty, housing, poor health, education and mental health issues. The challenges are massive. I speak for all colleagues when I say that the sense I have is that everybody is behind the Minister of State in the work he wants to do and he has full support. If I am wrong I ask people to pick me up on it, but I sense a real impatience to get on with it, that the Minister of State should do what he needs to do and that he will not have resistance. People will be impatient to get on and have this dealt with. This is above politics. It is life and death for many people and we want to give the Minister of State fair wind to get on with it. The idea of committees coming together like this is useful because it is cost-cutting. As Chairman of the Working Group of Committee Chairmen I will explore with colleagues whether we can do this to give the Minister of State further support.

Co-Chairman Deputy Jerry Buttimer

I thank members of both committees for their presence and participation. I thank the Minister of State and his staff and departmental officials. I also thank those working on the committee and the two clerks for organising the meeting.

The joint committee adjourned at 1.40 p.m. until 11.45 a.m. on Tuesday, 14 July 2015.