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Substance Misuse

Dáil Éireann Debate, Wednesday - 18 December 2013

Wednesday, 18 December 2013

Ceisteanna (3)

Maureen O'Sullivan

Ceist:

3. Deputy Maureen O'Sullivan asked the Minister for Health the rationale behind having those in addiction put into mental health services as opposed to general health services; the resources that are being considered for persons who will be impacted by the possible reduction of tablets when related new legislation is implemented, as there are concerns among front-line workers of increased risks to those currently misusing tablets; and if he will make a statement on the matter. [54126/13]

Amharc ar fhreagra

Freagraí ó Béal (6 píosaí cainte)

This question is about addiction and substance misuse and abuse and the general health issues in that area, as opposed to the mental health issues. In particular, I refer to the forthcoming legislation on the tablet issue, which is very welcome, and the planning implications for those who are currently abusing tablets.

I take it the Deputy is referring to persons who have drug addiction problems. Persons who have such difficulties, whether due to misuse of prescribed medicines or the use of illicit drugs, can access treatment through their GP or their local drug addiction service. In accordance with "A Vision for Change", the national mental health policy, the mental health services are responsible for providing services to persons who have both substance abuse and mental health problems. Mental health services are available on referral from a GP or through emergency departments.

Medicines which have a high potential for misuse are controlled under the Misuse of Drugs Acts. A person who has a controlled drug in his possession for the purpose of sale or supply is guilty of an offence. My Department is finalising major amendments to the misuse of drugs regulations. The proposals include stricter prescribing and dispensing controls on certain prescription drugs which are being traded illicitly, including benzodiazepines and Z-drugs, as well as creating the offence of unauthorised possession of such drugs. Due to the complexity of the draft regulations, it has been necessary to have two rounds of consultations with stakeholders and interested parties. Arising from the latest consultation process, the draft regulations are being reviewed. When this review is completed, the Government's approval will be sought to notify the draft regulations to the European Commission and member states under the technical standards directive.

It is intended that the draft regulations will be so notified before the end of the first quarter of 2014. The EU notification period may take up to three months to complete. Following its completion, the Government's approval will be sought to the relevant statutory instruments. The Deputy referred to the need for additional treatment services for persons who may be affected by the proposed regulations. I understand her point and it is something I will attend to and keep under review.

There is no doubt there have been changes in the drugs scene. For many years drug abuse equalled heroin abuse, before it moved on to cocaine abuse. Then there were the head-shop products, and recently we have seen an influx of snow blow and high-strength cannabis. Beneath all of that there is increasing use of tablets, both licit and illicit. The national drug-related deaths index showed that the generic group of benzodiazepine drugs are those most commonly found in polysubstance poisoning deaths. In the course of the consultations, front-line workers expressed their concern that when the legislation is introduced, welcome as it is, there will be a need to consider treatment services for those who are caught up in that tablet scene. That is the point of my question. There is quite a long lead-in to the legislation, and the European Commission also must express its view on it. It would be useful to commence planning for the services that will be provided for that group.

The additional time that has been afforded to me in the consultation process will certainly be used to address some of the issues the Deputy raised. She is correct that some of the people involved, including project workers, have expressed certain concerns to me. While they support the changes and the new regulations I intend to introduce, there are ancillary issues which they wish to have addressed. I understand their point and I will continue to meet and engage with them.

In addition, the Deputy will be aware that next January we will set up a new consultative process across the system for bolstering the national drugs strategy. Previously, we had certain processes that worked well. They had to be reviewed, and we have done that. A new national co-ordinating committee will be set up in January and on 16 January I will host a conference to which all of the interested parties will be invited, including project workers, national drugs task forces and people involved nationally and locally. That will be an important focus for us. The issue the Deputy raises, which she has raised previously in the House, will certainly be addressed at that meeting, as well as the issue of alcohol in the context of that forum.

When people have alcohol problems it is seen as a general health problem. There are people with mental health issues who take up substance misuse, which exacerbates the mental health problem. There are also people who take up substance misuse and that develops into mental health problems for some, while for others it does not. I have been involved in a particular area, which includes those who are active in addiction who have suicidal ideation. It is the Oasis Deora Counselling Centre, and I am on the board. It is the only centre that will counsel those who are active in addiction and have a mental health issue or suicidal ideation. It is very difficult and extremely challenging counselling, but I have no doubt that it has prevented some people from going further with suicidal ideation. The funding for that organisation is minuscule compared with the funding for other organisations involved in suicide prevention. That centre is the only one that will counsel people who are active in addiction and will provide crisis counselling at the point at which people need it.

I value the Deputy's insights in that regard and I take her point about funding. We are doing everything we can to ensure there is adequate funding across the board, both through the HSE addiction services and also in the form of the funds for which I, as Minister of State, have responsibility.

I agree with the Deputy's point regarding the interaction between mental health services and drug treatment services. We will have an opportunity to address those issues early in the new year.

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