Deputy Aengus Ó Snodaigh: Amidst the discourse on the economic crisis the drugs crisis has been forgotten. It would be wrong for that to happen given the new report from the European Monitoring Centre for Drugs and Drug Addiction. It is a stark reminder of how serious Ireland’s drug problem is and the horrific consequences of the failures of successive Governments to make sufficient funding available. The report should serve as a wake-up call to the Government and all Members of this House of this crisis.

Comparative research by the European centre found Ireland has the worst heroin problem, the second worst ecstasy problem and the third worst cocaine problem in the whole of Europe. We also have the second highest rate of drug induced deaths. At 70 deaths per million the figure is more than three times the EU average.

That amounts to almost one death per day. Moreover, it is most likely an underestimation.

These statistics clearly demonstrate the need to afford greater resources to drug prevention, treatment and rehabilitation projects rather than reducing them. Chronic underfunding has historically been a feature of the State’s response to the drugs crisis. Despite this, drugs services have already been subject to disproportionate cuts since the beginning of the recession. It is not just the Fianna Fáil Government which is responsible for these disproportionate cuts; the current Government is also introducing cuts in these areas. Health Service Executive funding for numerous drugs projects in Dublin has been reduced by 5% for the final quarter of this year, with a promise of further reductions next year. I understand the Minister of State, Deputy Róisín Shortall, has made a complaint to the HSE in this regard. That is not good enough.

The Government must take ownership of and drive forward the State’s response to the drugs crisis. The former Minister of State, Deputy Willie Penrose, resigned his office because of the closure of a local Army barracks. I am talking about the avoidable deaths of more than 300 people per year. Does the Minister stand over the 5% cut already imposed by the HSE this year? What action will he take to ensure there are no further cuts? Schemes which have experienced cutbacks include the Inchicore needle exchange, which was shut down last year, and the Rialto early morning methadone clinic. Services such as these save lives and aid rehabilitation by facilitating participation in education and work. By doing so, they also save the Government money.

Reductions in these services will lead to higher rates of drug abuse and a higher incidence of mortality. The Government is putting great effort into convincing the public that cuts to essential services are necessary and that there is no alternative. That is not the case. I urge the Minister to examine the alternative set out in Sinn Féin’s pre-budget submission, which we presented to Government yesterday. It clearly shows that front line services can be protected and that there is an alternative. There must be a greater urgency in addressing the drugs crisis.

Minister for Health (Deputy James Reilly): It is important to note that the European Monitoring Centre for Drugs and Drug Addiction, EMCDDA, depends on individual countries to supply it with figures on drug use. Two issues arise in this regard, namely, the quality of information supplied and the timeliness of such information. The EMCDDA report is historic rather than current. The Irish content on prevalence in the 2011 report is based on the 2006-2007 drugs prevalence survey. This was an all-island survey prepared by the national advisory committee on drugs and was carried out to the highest standards. Not all contributors to the EMCDDA would have similar comprehensive prevalence surveys on which to base their figures. The drugs prevalence survey is carried out on a four-year cycle and the 2010-2011 report will be launched next week.

I acknowledge that we have had a problem of heroin use in Ireland, particularly in Dublin, for some years. Significant steps are being taken through the implementation of the National Drugs Strategy 2009-2016 to address this issue. An Garda Síochána and the Revenue’s customs service continue to prioritise their efforts to reduce the supply of drugs into Ireland and the production of drugs within the country. The further development of prevention measures aimed primarily at those deemed to be most at risk of becoming involved in illegal drug use, and at the younger population generally, is a critical element of the national drugs strategy.

There are approximately 14,500 known opiate users in Ireland, of whom 9,300 are in receipt of methadone treatment. In total, more than 12,500 people are in receipt of drug treatment. Clients can usually access methadone provision in Dublin within one month of assessment. The major focus recently has been on increasing the availability of services outside Dublin. In the past 18 months, for example, additional services have been put in place in Limerick, Tralee, Cork, Waterford, Kilkenny, Wexford and Dundalk. Increased detoxification facilities have also come on stream recently in counties Carlow, Kilkenny, Cork and Limerick. The roll-out of needle exchange services in approximately 65 community pharmacies at various locations outside Dublin began in October. Needle exchange services in Dublin are provided through HSE clinics and voluntary sector providers. This initiative will facilitate broad national coverage.

I am particularly focused on ensuring there is an increased emphasis on moving people on from drug treatment to a drug-free life, where that is achievable. Apart from the obvious benefits to those concerned, this will open up more treatment opportunities, allowing us to encourage more people into treatment. The EMCDDA notes that we have adopted “imaginative responses” in addressing the problem of new psychoactive substances and have had greater impact in dealing with this aspect of drug use. As a result of the prompt actions taken, the number of headshops has reduced from 102 to 12 and psychoactive substances are not for sale in any of these outlets.

On drug mortality, Ireland reports the third highest rate after Estonia and Norway and is just ahead of the UK figure. However, it is acknowledged that the figures from Ireland, compiled through the Health Research Board’s national drugs-related deaths index, are very accurate. This index combines information from four sources, namely, coroners’ records, the hospital inpatient inquiry scheme, the central treatment list and the general mortality register. Drug death figures in most European countries are based on general mortality register records only. Nevertheless, the number of deaths arising from drugs misuse is of great concern and underlines the importance of tackling the drugs problem in a comprehensive way.

Deputy Aengus Ó Snodaigh: I am surprised by the Minister’s response. Is he denying that cuts are being imposed which are affecting people in the communities worst affected by the drugs scourge? Is he denying the death rate? As I said, that figure is most likely an underestimation. For instance, it tends only to include those who die of overdoses, while excluding deaths arising more indirectly from drug misuse, such as in road accidents. Is the Minister claiming that the level of drug abuse is not as bad as indicated in this report? The reality is that in many communities - not only in Dublin but throughout the State, in Portlaoise, Cork, Waterford and elsewhere - the drugs problem is getting much worse. Consequently, there is a need for greater resources, not fewer.

It is not too late to address the problem. Will the Minister offer a renewed commitment to the national drugs strategy? Will he undertake to reverse cuts that have been made and to protect the sector from further cuts in budget 2012? In particular, will he renew the commitment to drugs taskforces - the infrastructure upon which the drugs strategy is based - throughout the country? Some Government Deputies have been less than supportive of their local taskforces, which serves to undermine the network of support they offer. The Department of Education and Skills has abandoned the taskforces in many areas. If that is allowed to happen, what is to stop other statutory agencies withdrawing from the taskforces?

The drugs strategy mechanisms which bring together the relevant stakeholders and actors, including the community, service providers and State bodies, are regarded as an example of best practice in this area. Will the Minister reaffirm the Government’s commitment to this multifaceted system? Will he take concrete steps to guarantee funding for schemes such as the Rialto early morning methadone clinic and the Inchicore needle exchange which have been closed as a consequence of HSE cutbacks?

Deputy James Reilly: I have acknowledged the number of deaths and that it is of great concern to us. I am underscoring the accuracy of our figures as we take them from four different sources whereas as other jurisdictions only use one, the general mortality register. I mentioned that the information is from 2006-07. There has been a reduction of €74,000 to community drugs projects supported by the HSE in the Dublin and mid-Leinster region arising form the implementation of cost-saving measures across hospitals and community services. No such reductions are envisaged in the other HSE regions and no reduction is being made in the funding provided through the Department of Health in the current year.

The Government is committed to dealing with the scourge of drugs in our community. I have highlighted how the legislation on head shops has been updated to make a further list of psychoactive substances illegal and how successful the legislation has been in reducing the number of head shops. I assure the House from the notes handed to me that no psychoactive substances are available in those that are open.

Of course, the war on drugs will continue, with the involvement of law-enforcement and customs officers. We will endeavour to have more effective treatments. I am not happy with the numbers of people who come off methadone and I am reviewing that situation. I certainly want it reflected in any new contracts given to doctors who are treating people currently on methadone.

Topical Issue Debate – National Drugs Strategy

Vol. 746 No. 4

Wednesday, 16 November 2011