Dáil Éireann Debate, Wednesday - 7 April 2004
15 Mr. Rabbitte asked the Minister for Health and Children the steps he is taking to provide a preventative programme to reduce the level of opiate related deaths, especially in the Dublin area where the death toll from opiates is running at the same level as from traffic accidents; and if he will make a statement on the matter. [10783/04]
Amharc ar fhreagraThe 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 national drugs 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, compared with 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 recent 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 clients' 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 and 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. Co-abuse of alcohol, cocaine and benzodiazepines is closely monitored by the clinicians treating an individual. Every effort is made to modify the clients' use of other drugs thereby minimising the risk of overdose. For opiate users outside 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 designed a series of posters and leaflets, directly addressing risk factors contributing to overdose and how individuals can best provide assistance to those who may have overdosed. This initiative was piloted last month in all the addiction centres in the health board area and is due to be extended to GPs and health centres in the area in the coming months. 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. There are protocols in place for the transfer of those who are engaged in substitute treatment whilst in prison to facilitate their take-up for treatment on release and so reduce the risk of overdose among released prisoners who misuse opiates.
Drug-related deaths are recorded by the general mortality register of the CSO, based on the international classification of diseases code system. Other countries have developed dedicated systems for recording drug-related deaths and it is important, for the purposes of comparative analysis, that the Irish system is capable of generating an equivalent level of information. That is why one of the actions contained in the national drugs strategy calls for the development of an accurate mechanism for recording the number of drug-related deaths. Overall responsibility for this action rests with the Coroner's Service and the Central Statistics Office.
