The overall objective of the National Drugs Strategy 2001-2008 is to reduce the harm caused to individuals and society by the misuse of drugs through a concerted focus on supply reduction, prevention, treatment and research with the ultimate aim of leading a drug-free lifestyle. The health related aspects of the strategy focus in particular on education and prevention and treatment and rehabilitation, including substitution treatment under the methadone protocol. The number of methadone treatment places has expanded considerably in recent years in line with the Government's commitment under the national drugs strategy. At the end of December 2003 there were 6,883 people receiving methadone treatment. This compares with a figure of just over 5,000 at the end of 2000. In the Eastern Regional Health Authority there are 59 drug treatment locations. This compares with 12 locations in 1997.
Outside the ERHA, treatment clinics have been established in the South Eastern Health Board, Mid-Western Health Board, Western Health Board and Midland Health Board. General practitioners and pharmacists also provide treatment services and their involvement has also increased over the last number of years.
The boards aim to address substance misuse by providing effective and sustainable services working in partnership with clients and with fellow service providers. All clients entering the addiction services are assessed and appropriate treatment plans are identified based on client needs. Decisions concerning the appropriate treatment for patients are made in accordance with best practice guidelines. Overdose prevention is an inherent part of the comprehensive range of services which the boards provide, including education and prevention, treatment, rehabilitation, counselling and harm reduction. International evidence supports the view that opiate users are safer in treatment; therefore every effort is made to encourage clients to engage in treatment. For opiate users outside of treatment, outreach workers and needle exchange services actively engage drug users to promote safer drug using practices to address the risks involved in terms of overdose, transmission of blood-borne viruses and unsafe sex practices. Harm minimisation is at the core of the three area health boards' outreach strategy and this includes the risk of overdose.
Building on existing initiatives, one area health board has designed a series of posters and leaflets, due to be piloted in spring 2004, directly addressing risk factors contributing to overdose and how individuals can best provide assistance to those who may have overdosed. This is taking place as part of a health promotion programme, which has been designed to promote service users taking a more active role in their own health in a range of areas. In the context of the increased risk of overdose facing opiate users who are released from prison, there are protocols in place for the transfer of those who are engaged in substitute treatment while incarcerated to facilitate their take-up of treatment on release.
The national advisory committee on drugs, NACD, has recently published a study on the prevalence of opiate misuse in Ireland. The study estimates that 14,452 people were using heroin in 2001. Of these, 12,456 were in the Dublin area. This represents a decrease on a 1996 figure which estimated that 13,461 people were using heroin in the greater Dublin area.