Home > Dail Eireann debate. Topical issue debate - Drugs dealing.

[Oireachtas] Dail Eireann debate. Topical issue debate - Drugs dealing. (27 Nov 2014)

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

Deputy Róisín Shortall: I thank the Minister for Health, Deputy Leo Varadkar, for coming to the House to respond to this debate. I do not need to tell him that we have very serious problems in Ireland with substance misuse. Obviously, the number one problem is alcohol but all the evidence indicates that the number two problem is the misuse of prescription drugs, particularly benzodiazepines and Z-drugs. Vast quantities of prescription drugs are available on our streets. We have all seen the effect of this in Dublin city centre, in particular, and the serious anti-social activity that goes with it. Street trading and related activity are clearly very intimidating for the public. This behaviour undermines the efforts of health professionals to find a long-term path to recovery for those people who are using drugs. Of course, the practice is damaging to businesses and tourism in the city centre.

There are two principal sources for the prescription drugs. One is the over-prescribing of them in our health service and the second is uncontrolled imports. The current law is very weak in both of these respects. Obviously, benzodiazepines have a very important role to play in the treatment of people with mental health issues but the figures show that, by European standards, we have prescribing rates that are much higher than average. When it comes to imports, in many respects the hands of the Garda and customs officials are tied because of inadequate legislation.

Almost two years ago, when I was in the Department of Health, I initiated a renewed focus on the problem of the overuse of benzodiazepines and Z-drugs. A number of measures were initiated, including a project where the PCRS tracked the prescribing patterns of general practitioners. There was intervention among general practitioners whose prescribing pattern was particularly out of kilter with the pattern among the rest of the general practitioner population. A review of the regulations under the misuse of drugs legislation was initiated and provided several measures to help curtail the availability of the drugs on our streets. These measures included new import and export controls, new possession offences and stricter prescribing and dispensing requirements. The Department conducted consultations with interest groups in the summer of 2012 and took on board any issues raised. The Department amended its plans to reflect this process. Preliminary draft regulations were shown to me before I left office in September of 2012. However, for some reason it took an entire year thereafter for a draft set of regulations to be published on the Department's website.

Over three years ago, the projected date for the completion of the new regulations was the following January. Now, two years later, according to replies to recent parliamentary questions, the date is still next January. It is not clear to me what exactly is holding up the regulations at this stage. The unit dealing with this legislation was among the best in the Department in my experience so I cannot believe the fault lies there. Other senior officials should be well aware of the problem. It is not unknown for these prescription drugs to be traded right outside the front door of the Department on Hawkins Street. The Minister may even have seen this occurring himself.

This is a serious drug problem that can be dealt with effectively. The Government is now two years late with the necessary legislation and it is time this was made a top priority in the Department. I hope the Minister will make it so.

Minister for Health (Deputy Leo Varadkar):  I thank the Deputy for raising this matter. Benzodiazepines are a class of medicine available on prescription which are commonly used to treat anxiety, sleep disturbance and insomnia. They are known to be associated with dependence and withdrawal symptoms and consequently are primarily recommended for short-term treatment only. They are a very valuable treatment option when used correctly. However, there is increasing evidence of the inappropriate use of benzodiazepines in Europe, a problem which is not particular to Ireland.

Under the Medicinal Products (Prescription and Control of Supply) Regulations, it is an offence for a person, except where the person is a pharmacist or working under the personal supervision of a pharmacist, to supply a prescription medicine. These regulations also make it illegal for prescription medicines to be supplied by mail order or over the Internet. Additional levels of control are applied to medicines which have a high potential to be misused by means of regulations made under the Misuse of Drugs Acts. These regulations impose restrictions on the production, supply, importation and exportation of controlled drugs, such as morphine, methadone, amphetamines and benzodiazepines. A person who has in his possession a prescription medicine containing a drug controlled under the misuse of drugs legislation for unauthorised sale or supply is guilty of an offence under that legislation. Different levels of control apply to drugs controlled under the misuse of drugs legislation, dependent on their therapeutic value and potential for abuse.

The Department has been reviewing the misuse of drugs regulations to introduce stricter controls on benzodiazepines. In particular, it is proposed to apply formal import and export controls on benzodiazepines, thereby making it an offence for a person to import or export these drugs without a licence. The introduction of these controls will also provide comprehensive national information on the level of use of benzodiazepines and trade in benzodiazepines. It is also proposed to introduce stricter prescribing and dispensing controls for benzodiazepines, as well as an offence for a person to possess benzodiazepines without entitlement - for example, a prescription - thereby assisting the Garda and customs service in enforcing the law on the illicit importation of and dealing in benzodiazepines.

Following a consultation process, a draft amendment regulation was prepared and made available for further consultation on the Department's website. Submissions were received from a wide range of organisations and individuals, including doctors, pharmacists, the Pharmaceutical Society of Ireland, the Irish Pharmacy Union, private and public hospitals - both from medical practitioners and pharmacists - nursing homes, drug treatment centres and experts in addiction services.

 These submissions raised a number of legislative issues which require further consideration before finalising the amendments. The process is taking longer than anticipated because it is a complex and technical body of work. Some further work is required and the objective is to finalise the text of the draft regulations early next year.

Once the draft regulations are ready, they will be subject to a three month EU notification period under the Technical Standards Directive before they can be signed into law. This is because of the implications of the proposed regulatory changes on trade in pharmaceutical products.

No doubt the scale and nature of the drug problem in Ireland is constantly evolving. The emergence of new psychoactive substances, the increased strength of cannabis and the prevalence of poly-drug use represent serious challenges for our services in responding to the needs of vulnerable groups. The response of the HSE has involved the re-orientation of its addiction services in order to develop a comprehensive integrated addiction treatment service capable of dealing with all substances. The HSE continues to co-operate with local community representatives, particularly in the Dublin city centre area, and liaise with local gardaí to minimise any negative public order issues that may arise.

Deputy Róisín Shortall: The Minister's response is disappointing. There is no sense of urgency at all from him in this regard. This is a major problem across the country but most prevalent in the Dublin city centre area. The Minister will get that feedback from all of the local drugs task forces as well. Prescription drugs, after alcohol, are the biggest problem that communities are dealing with.

One would have to ask why no action is being taken on this. This is at the same stage as it was at two years ago. The draft regulations were almost ready to go in January 2013. Here we are, almost two years later, and the issue does not seem to have moved on at all. Is there a problem with resources in the Department? Is the Minister allocating staff? Is Deputy Varadkar personally saying to his staff that he wants this to be a priority? It is a priority for everybody else working in this area. It is certainly a priority from the point of view of the gardaí. The law is too weak for them to tackle the problem in an effective way.

One must ask if there are vested interests coming into play here. Why is it that the Minister is not tackling the problem? It is in his hands to do something effective about this problem and yet it does not seem to be given any priority. There was a report in 2002 which was left to gather dust and my concern is that the same will happen with these draft regulations.

The solution is largely in the Minister's hands. I am appealing to him to take this issue seriously. It is devastating a lot of lives and is causing a lot of problems. It is in Deputy Varadkar's hands to make a meaningful difference to the problem and I ask him to act on it as soon as possible.

Deputy Leo Varadkar:  As Deputy Shortall will be aware, staff are allocated by the Secretary General, not by me personally.

Deputy Róisín Shortall:  Priorities are set by the Minister.

Deputy Leo Varadkar:  This regulation is not on my desk and I have not seen it yet. I am not holding it up. It is delayed elsewhere and I undertake to ask some questions about that.

The feedback that comes from the different groups in the local drugs task force, many representatives of which I have met in the past few weeks, is mixed. There are quite a number of them who take the view that criminalising possession of all drugs is not the way to go and it is not the case that everyone takes the view that criminalisation is the way to go.

Deputy Róisín Shortall:  That is not what is proposed. I ask the Minister to read the file.

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