Home > Dail Eireann debate. Adjournment debate - Health services [Heroin].

[Oireachtas] Dail Eireann debate. Adjournment debate - Health services [Heroin]. (05 Jul 2011)

External website: https://www.oireachtas.ie/en/debates/debate/dail/2...

Deputy Gerry Adams: Tá mé fíor bhuíoch díot, a Cheann Comhairle, as seans a thabhairt dom labhairt ar an ábhar tábhachtach seo. Beidh mé ag caint faoi dhruganna agus daoine bochta atá faoi bhrú ag druganna.

Several weeks ago, Councillor Paddy McQuillan and I visited the Louth community drug and alcohol team in Drogheda. We met the staff, members of the north-east regional drugs task force and a group of addicts who are on methadone to control their heroin addiction. I was impressed by the commitment and professionalism of the staff who provide a first class service with limited resources and who are struggling to meet the needs of a growing number of drug and alcohol addicts. I commend and thank them for their work.


Drug and alcohol misuse has taken up to eight lives in the Drogheda area in recent years. The former heroin users whom I met were young men and one young woman. They were honest about the dreadful impact the drug has had on them and their families and the connection between heroin and drug addiction and crime. One former user described the experience as being like groundhog day, chasing the money, chasing the dealers and chasing the drug. When that cycle is complete, they begin the process all over again.


The drug and alcohol team in Drogheda has only been in place since last April. I have no doubt from my conversation with the former heroin users that the centre has been a lifeline for them. The project consists of one co-ordinator, one project worker, one community employment support staff member and one counsellor who provides six sessions a week. According to statistics for 2010 from the Health Research Board, 76 individuals presented for treatment at the centre. Of these 60% suffered heroin addiction, 28% had issues with alcohol, 17% with cannabis and 7% with cocaine. Some 71% of the above have been identified as early school leavers and 60% use more than one drug. Some 33% are injecting drug users and 8% began injecting under the age of 19 years.


There are obviously policing and other issues around the availability of illegal drugs. These statistics only scratch the surface of the problem. We will return to that another day. The reality is that many individuals who initially presented with one problem actually have more than one. Some are addicted to up to four substances. Those with whom I spoke told of many more users in the area who have not sought help.


The Louth community drug and alcohol team work hard to provide a service which helps those affected by drug and alcohol misuse. The biggest gap in current services lies in the absence of a second level 2 methadone prescribing general practitioner. There is only one methadone prescribing general practitioner and, consequently, the waiting list for methadone treatment in Louth stands at 18 months compared with ten days in Dublin, which discourages individuals going on the list. Even if an addict manages to get on the list, he or she is expected - this is the way the system works - to maintain his or her drug using lifestyle to qualify for treatment. This means that the current system is encouraging ongoing heartache, illness, further family breakdown, crime and, in some cases, overdose which can lead to death or suicide.


I urge the Minister to appoint a second level 2 methadone prescribing general practitioner quickly. This would have an immediate and beneficial affect on the management of heroin treatment in Louth. The community drug and alcohol team also needs a dedicated project worker who can provide the essential family support that is part of dealing with drug misuse in the community. The problem of heroin misuse is severe and requires urgent attention and additional financial support. I urge the Minister to take these simple measures and enhance the work of a dedicated group of professional health workers who are making a significant contribution to society and to assist those recovering addicts who are confronting their problems and need help to put them behind them.


Deputy Róisín Shortall:I thank the Deputy for raising the issue. The HSE provides methadone as an opiate replacement to support those who are addressing their heroin misuse problem. Methadone is a controlled drug regulated under the Misuse of Drugs Regulations 1998. Only GPs who are trained as level 1 or level 2 for methadone prescribing are permitted to participate. The HSE, through the Irish College of General Practitioners, facilitates GPs to train at level 1 and 2. Level 1 GPs can provide methadone in a community-based setting to stabilised patients who do not require methadone clinic services. The HSE encourages all GPs to take part in this training. Level 2 GPs are trained to offer the full range of treatment services to opium dependent patients including assessment, initiation of treatment when appropriate and stabilising a drug user.


Persons receiving methadone treatment are registered on the central treatment list, operated by the Drug Treatment Centre Board. At end April 2011, the central treatment list recorded 9,289 patients attending treatment in clinical facilities within the HSE Dublin north east region. There has been a focus over the past year or two on increasing the availability of drug treatment services outside Dublin. Significant progress is now being made by the HSE. Additional services have been provided in the south east at Wexford town, Waterford and Kilkenny, in the southern area at Cork and Tralee, in the mid-west at Limerick city and in the north east at Dundalk. The HSE is progressing plans to provide methadone facilities in the midlands, Drogheda and Wexford county to address waiting lists and times in these areas.


Approximately two-thirds of those in receipt of methadone continue to receive their service in clinics, with the remainder under the care of GPs. I would like to see an increasing transfer of clients from clinics to GPs in coming years, subject to the agreement of the service users and adherence to good clinical practice. The acquisition of GPs for the methadone treatment programme is not an easy task. The HSE has advised that it has identified two potential level 2 GPs who are available to commence in the Drogheda area. An additional level 1 GP has also been identified and the HSE is awaiting return of a signed contract from the person concerned.


The Louth Community Drug and Alcohol Team is funded by the Department of Health through the north east regional drugs taskforce. The taskforce has allocated just over €116,000 in 2011 to the Louth Community Drug and Alcohol Team. This funding enables it to employ two members of staff. Both staff members are actively involved in one-to-one work with individuals with an alcohol and-or substance use issue, and this also includes working with family members and concerned persons. Louth Community Drug and Alcohol Team provides services and supports for people in active addiction, particularly those who are hoping to stabilise, reduce or become totally drug or alcohol free. Working from a harm reduction perspective through individual supports and group programmes the service also supports the delivery of a needle exchange service in Drogheda. It also strives to provide families with adequate information and support on addiction related issues, including the provision of information to the wider community. The two full-time staff work alongside sessional counsellors, trainees, volunteers and placement students to provide a low-threshold tier 2 or 3 service. Unfortunately, there is no funding available to support an additional family support worker. I again thank the Deputy for raising the matter.

Adjournment Debate - Health Services

5 July 2011
Vol. 737 No. 3

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