Home > Social reintegration as a response to drug use in Ireland: An overview

Keane, Martin (2007) Social reintegration as a response to drug use in Ireland: An overview. Drugnet Ireland , Issue 24, Winter 2007 , pp. 5-6.


A new research report examining the association between aspects of social exclusion, problematic drug use and social reintegration as a response to this type of drug use in Ireland was launched on 6 November by the Alcohol and Drug Research Unit (ADRU) of the Health Research Board (HRB).1    

 

Social exclusion, in the form of homelessness and insecure accommodation, inadequate education and poor employment skills, is closely associated with problematic drug use. As a response, social reintegration has emerged as a key aspect of drug treatment and rehabilitation in order to provide responses to accommodation, education, and vocational training and employment support requirements of problem drug users.

 

Social reintegration of problematic users is not a new concept; indeed, it has been around since the early 1960s.2 The first attempt to include social reintegration measures in Irish drug policy occurred in the 1971 Report of the working party on drug abuse.3 Subsequent drug policy development in 1991, 1996 and 2001 emphasised the importance of linking vocational training and employment skills with drug treatment.4-6 Since 2000, the Council of the European Union has urged member states to improve availability of, and access to, social reintegration services for drug users, and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and National Focal Points (NFPs) have been asked to monitor and report on the accessibility and availability of such measures in members states throughout the EU.7,8

 

This Overview brings together information on the association between unemployment, homelessness and problem drug use in Ireland and examines how drug policy and practice have responded to this situation. This information comes from in-depth interviews with service providers, an exploration of research and evaluation and policy documents and an analysis of data from the National Drug Treatment Reporting System (NDTRS). The main findings from an extensive literature search indicate that failure to address unemployment and homelessness among drug users can undermine treatment gains and lead to social exclusion.

 

Early chapters include an executive summary and details of the background and structure of the report and the data sources used. Chapter three presents the background to the development of social reintegration as a concept and examines the extent to which drug policy and practice in Ireland have understood the concept. Despite policy proposals to improve educational levels and employability among drug users in Ireland since the early 1970s, in practice, social reintegration measures have developed unevenly and at a much reduced rate, compared to drug prevention and treatment services. Consequently, there is a clear need to extend the discourse of drug responses to include social reintegration.

 

Chapter four examines the employment status of problematic drug users in Ireland, how drug users perceive employment and the barriers they experience when trying to improve their chances of finding employment. The key findings to emerge include the following:

 

 

 

 

  • Of cases commencing treatment for problematic drug use in Ireland in 2003, just under 20% were in employment, compared to the national average of 65%, and 61% were unemployed, compared to the national average of 4.6%.
  • Drug users who are employed use their main problem drug less frequently and report better drug treatment outcomes than their unemployed counterparts.
  • Drug users view employment as an important part of recovery and do not see methadone maintenance as a barrier to being employed.

 Homelessness and drug use are strong indicators of social exclusion. Chapter five presents research from Ireland that shows the levels of social exclusion experienced by homeless drug users. For example:

  • In 2003 almost 7% of drug users entering treatment in Ireland were homeless. 
  • When drug users are homeless they are likely to increase their drug use and progress to patterns of chaotic drug misuse.
  • Homeless drug users associate their experiences of emergency hostel accommodation with their more chaotic periods of drug use. They have poorer physical and mental health than homeless people who do not use drugs.

 

Policy and practice have often been slow in the past to respond to the accommodation needs of homeless drug users. Chapter six presents examples of recent shifts in policy and practice on drugs and homelessness which suggest that the situation is improving. For example, the National Drugs Strategy6 recognises that the provision of accommodation is an integral element of drug treatment and the 2006 homeless preventative strategy9 calls on all agencies working on behalf of drug users to work together to improve services.  

 

Vocational rehabilitation is about developing the personal competencies and improving the employability of the recovering drug user. Chapter seven presents the theory behind vocational rehabilitation and chapter eight presents the evidence to show that treatment outcomes can be improved when clients are assisted in developing their vocational skills.

 

  • Evidence suggests that vocational training contributes to a reduction in drug use.
  • Completion of vocational programmes is strongly associated with obtaining employment and improved personal and social functioning.
  • Supported work interventions and dedicated employment counsellors are effective at getting drug users into employment.
  • Evidence from vocational rehabilitation interventions in Ireland suggest that participants have made educational and vocational progress by improving their literacy, achieving accredited training certificates and progressing to work placement and, in some cases, paid employment.

 

Chapter nine develops the concept of employability and provides a framework for service providers to map the progression of clients in vocational training projects. The main themes to emerge indicate that enhancing employability involves matching the attitudes and capabilities of the individual, the needs and expectations of employers and the demands of the labour market. Enhancing employability for drug users also requires an inter-sectoral partnership approach from service providers, and problematic drug use needs to be brought under control through treatment if recovering drug users are to have a realistic chance of enhancing their employability.

 

Finally, chapter ten presents a model of social reintegration that predicts the different phases of recovery that drug users can experience. The model developed by Buchanan10 outlines six phases to social reintegration for problem drug users. The first four phases signal changes in the individual and in their use of drugs as they move from chaos to eventual control. The later three phases suggest that, while recovering drug user’s move towards ‘normal living’, individuals and agencies in the wider society need to change their attitudes and behaviour towards recovering problematic drug users. The model provides a useful framework to conceptualise the symbiotic changes that must take place on the part of the drug user and the wider society, if the vision of social reintegration is to be realised.

 

The publication of this Overview is timely in that it follows the recently launched report of the Working Group on Drugs Rehabilitation.11 That report sets out the structural arrangements required to respond to homelessness, inadequate education and poor employment skills among current, stabilised and former users. It is hoped that the evidence presented in this Overview on both the social risks of homelessness and unemployment and the ways in which these risks can be reduced will help to inform the implementation of the rehabilitation strategy. (Martin Keane)

 

1. Keane M (2007) Social reintegration as a response to drug use in Ireland. Overview 5. Dublin: Health Research Board.

2. United Nations Single Convention on Narcotic Drugs, 1961 (Article 38, sections 1 and 2).

3. Working Party on Drug Abuse (1971) Report of the working party on drug abuse. Dublin: Stationery Office.

4. Department of Health (1991) Government strategy to prevent drug misuse. Dublin: Department of Health.

5. Ministerial Task Force on Measures to Reduce the Demand for Drugs (1996) First report of the ministerial task force on measures to reduce the demand for drugs. Dublin: Stationery Office.

6. Department of Tourism, Sport and Recreation (2001) Building on experience: National Drugs Strategy 2001–2008. Dublin: Stationery Office.

7. Council of the European Union (2000) EU Action Plan on Drugs 2000–2004. Brussels: Council of the European Union.

8. The Alcohol and Drug Research Unit (ADRU) is the Irish Focal Point and reports annually, to the EMCDDA on the drug situation in Ireland.

9. Pillinger J (2006) Preventing homelessness: a comprehensive preventative strategy to prevent homelessness in Dublin, 2005–2010. Dublin: Homeless Agency.

10. Buchanan J (2004) Missing links? Problem drug use and social exclusion. Probation Journal, 51(4): 387–397.

11. Working Group on Drugs Rehabilitation (2007) National Drugs Strategy 2001–2008: rehabilitation. Report of the working group on drugs rehabilitation. Dublin: Department of Community, Rural and Gaeltacht Affairs.

Item Type:Article
Issue Title:Issue 24, Winter 2007
Date:October 2007
Page Range:pp. 5-6
Publisher:Health Research Board
Volume:Issue 24, Winter 2007
EndNote:View
Related URLs:
Subjects:MA-ML Social science, culture and community > Social costs and benefits > Social costs and benefits of substance use
VA Geographic area > Europe > Ireland
L Social psychology and related concepts > Interpersonal interaction and group dynamics > Social support
MA-ML Social science, culture and community > Social position > Social equality and inequality
L Social psychology and related concepts > Interpersonal interaction and group dynamics > Social isolation
J Health care, prevention and rehabilitation > Rehabilitation > Vocational rehabilitation (employment / occupation)
J Health care, prevention and rehabilitation > Substance use prevention > Substance use harm reduction

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