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Dáil Éireann debate -
Thursday, 28 Jun 2001

Vol. 539 No. 3

Written Answers. - Drug Policy.

John Bruton

Question:

48 Mr. J. Bruton asked the Minister for Health and Children if the Government's drug policy is based on a harm reduction model rather than a drugs free model; the way in which the Government's drugs policy compares with that of Sweden; if there has been adequate debate on the choice the Government has made to emphasise a methadone maintenance rather than a detoxification policy; if adequate detoxification facilities exist to cover all those now on methadone if they wished to come off drugs altogether; and if not, if he has satisfied himself with the adequacy of the policy in terms of making the country ultimately drugs free. [16358/01]

The overall objective of the Government's strategy in relation to drug misuse is to significantly 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 regard to treatment the objective is to provide a range of options to encourage and enable drug misusers to avail of treatment with the aim of reducing dependency and improving overall health and social well-being, with the ultimate aim of leading a drug-free lifestyle. However, it should be said that becoming drug free is not possible, in the short-term at least, for some individuals.

The National Drugs Strategy 2001-2008 which was published in May 2001 by the Taoiseach, is the result of a comprehensive review initiated by my colleague, Deputy Eoin Ryan, Minister of State with responsibility for the national drugs strategy, in April 2000. An extensive consultation process was undertaken by the review group. First, submissions were invited, through the national media and by invitation, from interested individuals and groups and approximately 190 submissions were received. This was followed by a series of eight regional consultative fora in June, which were organised to give individuals and groups an opportunity to outline their views on how effective the current strategy is and how it might be improved-adapted. Approximately 600 people attended these fora. In addition, the Minister, Deputy Ryan and the review group met 34 different interested groups. With his officials he also visited Sweden, Australia and Switzerland to see at first hand the drugs strategies of those countries and examined the drugs policies in a number of other countries. Ireland's strategy would have elements of a number of other countries' policies such as Sweden, but it is unique in that the actions and targets identified have been developed in response to Irish needs.

The national drugs strategy has been developed around the four pillars of supply, prevention, treatment, including rehabilitation and risk reduction, and research. This approach incorporates, more or less, the full range of activities which are the hallmarks of modern drugs strategies in other jurisdictions. The strategy sets objectives and key performance indicators against which progress may be monitored. 100 individual actions have been identified which the relevant bodies have to carry out in order to implement the strategy and meet its objectives.

With regard to treatment, both detoxification and methadone maintenance are well recognised treatment options for an individual with a history of drug misuse. It should, however, be pointed out that success rates for detoxification either as an in-patient or as an out-patient are generally less than 20%. Support needs to be given to those who complete withdrawal in order to prevent relapse and it is often difficult for a client to maintain abstinence from drugs.

I understand from the Eastern Regional Health Authority that there is currently a 17 bed in-patient detoxification unit at Cuan Dara in Cherry Orchard Hospital and a ten bed unit at Beaumont Hospital. A 20 bed downstream detoxification unit in St. Mary's Hospital, Phoenix Park, opened earlier this year. This number of beds compares favourably with international standards and guidelines for such facilities which indicate an average of between 0.5 and 1.5 beds per 100,000 of population. In addition, the Eastern Regional Health Authority provides resources for a post detoxification unit operated by the Merchant's Quay Project in High Park, Drumcondra. It also provides funding for a post detoxification rehabilitation unit at Cuan Mhuire in Athy.
Methadone maintenance is internationally recognised as a valid and successful part of an integrated response to the drug problem. It has also been shown that it is possible to reduce the antisocial behaviour of intravenous drug users by taking them into treatment on methadone maintenance programmes. A report reviewing the services of the then Eastern Health Board which was published in 2000 stated that methadone maintenance is one of the most widely evaluated treatments for opioid dependence worldwide. Internationally, there is a well established research and a clinical evidence-base for substitution treatment with methadone. On average, methadone maintenance is associated with lower rates of heroin consumption, reduced levels of crime and improved social functioning. A lower risk of premature mortality among maintained patients has been reported and substitution programmes have also contributed to the prevention of the spread of HIV infection. The report also found that a number of satellite clinics informally reported rates of 40% plus of those on methadone returning to work. Although it is acknowledged that this may partly be due to the current work climate which exists in Dublin it also states that this high percentage is very striking as evidence of successful social habilitation or rehabilitation.
The authority is continuing to expand its drugs services including the number of detoxification beds available to drug misusers. Other health boards are also keeping the situation under review in order to be able to respond to any drug misuse problems that may emerge.
Countries all over the world are grappling with the problem of drug misuse. There are no easy solutions but I believe that the implementation of the recommendations of the National Drugs Strategy 2001-2008 will have a positive impact on the drug situation in this country.
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