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Keane, Martin (2010) Provision of social support for people with drug addictions. Drugnet Ireland , Issue 32, Winter 2009 , p. 18.

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The Comptroller and Auditor General recently reported on his examination of publicly funded treatment and rehabilitation services for people with drug addictions.1Issue 31 of Drugnet Ireland presented the report’s findings with respect to drug treatment.2 This article presents the findings with respect to provision of support for people seeking, receiving or following treatment for addiction in the key areas of

  • accommodation
  • education, training and employment
  • childcare
Accommodation
Drawing on data from the National Drug Treatment Reporting System (NDTRS), the report states that some 7% to 8% of those entering or re-entering treatment each year are recorded as homeless, and a further 3% to 4% are in some form of unstable accommodation. Being homeless or living in unstable accommodation can undermine the gains that would be expected from engaging in drug treatment.3
 
The report recommends that separate accommodation be provided for drug users in treatment and for those who have completed treatment and wish to pursue a drug-free lifestyle; this would support recovering drug users by reducing the risk of relapse. The report highlights the role of step-down facilities in supporting those who have completed treatment, and notes that the Health Service Executive (HSE) currently funds 29 step-down beds for people recovering from drug addiction. It also notes that demand for accommodation places for recovering drug users far exceeds the number of beds available.
 
An evaluation of one of the HSE step-down projects showed the positive outcomes that can be achieved by recovering drug users.4 Of 12 former clients who completed that programme, six were living independently, two were living with a family member or a partner and four were living in further transitional housing. Self-reporting by these clients and their key workers suggested that they were no longer abusing drugs and were in education, training or employment.
 
The C and AG report highlights the importance of collecting data on the percentage of people using step-down facilities who progress to independent living. The report also calls for national monitoring of waiting times for access to transitional or long-term accommodation by those undergoing rehabilitation.
 
Education, training and employment
The report notes that, consistently, around 60% of those commencing treatment report that they are unemployed, 20% report being in paid employment and 4% report participating in FÁS or other training schemes. Since the introduction of the FÁS Special Community Employment (CE) scheme designed to provide vocational training for recovering drug users, there has been a consistent shortfall in the uptake of places, with a decline from 90% in 2004 to 83% in 2007. The reasons for this decline are not clear and, as the report points out, the decline ‘occurred at a time when the numbers in drug treatment were increasing’.
 
The report notes that FÁS now draws up Individual Learner Plans for people registering with them and suggests that this approach could potentially fit well with the individual care plans that might be developed with key workers to help those in drug treatment access structured and suitable education and training interventions at the appropriate time. The report also suggests that the effectiveness of projects under the Special CE scheme should be evaluated.
 
Childcare
According to the report, 15% of those entering treatment for drug addiction in 2007 were living with dependent children. The report notes that the current provision of childcare services for drug misusers is limited, in that:
 
·     the Health Service Executive does not provide childcare facilities on most addiction service premises;
·     community and voluntary groups provide limited childcare facilities; and
·     very few Special CE projects provide childcare for participants.
 
The report cites the following recommendations made by the Working Group on Drugs Rehabilitation:
 
·     An audit of gaps in childcare provision for children of drug users should be undertaken.
·     Childcare services for children of drug users should focus on the developmental needs of children.
·     Parenting programmes for drug users should be developed and implemented.
 
The report concludes by proposing a means by which these issues can be acted on within the broader framework of treatment and rehabilitation:
 
·     Protocols developed for interagency work should cover referral and reporting to social support providers, e.g. local authority housing department and FÁS.
·     Waiting times for accessing social support services should be formally monitored and reported on.
·     Comprehensive care planning would help to identify the extent to which those receiving treatment require assistance with accommodation.
 
 
1. Comptroller and Auditor General and Department of Community, Rural and Gaeltacht Affairs (2009) Drug addiction treatment and rehabilitation. Special report, Value for Money 64. Dublin: Office of the Comptroller and Auditor General. www.audgen.gov.ie
2. Long J (2009) Comptroller and Auditor General report on drug treatment. Drugnet Ireland, (31): 13–14.
3. Keane M (2007) Social reintegration as a response to drug use in Ireland. HRB Overview Series 5. Dublin: Health Research Board.
4. Juniper Consulting (2008) Step-Down programme George’s Hill: evaluation report. Dublin: Focus Ireland.

 

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