The progress report for 2014 provides a narrative account of progress against each action in the NDS 2009–2016, for the year 2014.1 It indicates which actions under each pillar have been completed, where work is in under way, and where actions have been delayed or abandoned (Table 1)..

Table 1: Progress in 2014 against actions in NDS 2009–016

Supply reduction

Under this pillar, most progress has been made in relation to local supply reduction initiatives, and compliance with EU-level obligations and operations. Local initiatives included establishing and supporting appropriate drug networks and ensuring drug issues are included in the work of Joint Policing Committees, developing frameworks for tackling drug-related intimidation in the community, targeting adults in the drug trade who use children to engage in illegal drug-related activities, improving drug-related security in prisons and introducing a presumptive drug testing regime.

Work is under way in relation to several policy initiatives – legislation on drugs and driving, licensing laws to combat sale or supply of alcohol to persons under the age of 18, the Drug Court and the Forensic Science Laboratory.

Two capital projects have been put on hold owing to the difficult economic situation – developing an integrated system to track the progression of offenders with drug-related offences through the criminal justice system, and building a new Forensic Science Laboratory.

Prevention

Actions under this pillar relate to both illicit drugs and alcohol. Most progress has been made with regard to setting up education programmes and drug policies in schools, including support mechanisms in DEIS schools, and with regard to youth interventions and facilities in out-of-school settings, and developing online prevention and help services. Work is under way developing programmes targeting families experiencing difficulties owing to drug/alcohol use and the children of drug users, and also selective prevention measures to reduce under-age and binge drinking.

The adoption of the National Substance Misuse Strategy has led to a delay in the development of a framework for the design of targeted prevention and education interventions using a tiered approach, and in the implementation of a uniform set of drugs and alcohol education standards – while the methodologies are re-assessed to ensure they are still appropriate. It has also delayed the promotion of substance misuse policies and development of brief interventions in the informal education sector, tertiary institutions, workplaces, and youth, sport and community organisations.

Treatment and rehabilitation

Treatment and rehabilitation services continue to be developed on an ongoing basis, including both expanding the range of services and the groups with specific needs being targeted, for example families of drug users, drug users in prisons, and vulnerable groups such as travellers, LGBTs, new communities and sex workers. A clinical and organisational governance framework for all treatment and rehabilitation services has been developed.

Work is reported to be well under way with regard to developing treatment guidelines for treating blood-borne viruses, and training programmes for all involved in the provision of substance misuse treatment services. Policies and procedures for referrals of under-18 service users who are showing signs of substance use, and for young people arrested by the Gardaí, are also being developed. In response to the issue of drug-related deaths, a naloxone demonstration project has been rolled out.

A statutory regulatory framework for the provision of counselling within substance misuse services has been delayed because counselling is not one of the 12 health and social care professions designated under the Health and Social Care Professionals Act 2005. A statutory consultation process is now under way on the possible designation of counsellors and psychotherapists for regulation under the 2005 Act.

Research and information

In line with the EU Early Warning System, a communication protocol for notification of drug use emergencies has been developed in Ireland. The five key epidemiological indicators relating to drug use (prevalence in general population, prevalence and patterns of use of specific drugs, drug treatment demand, drug-related deaths and infectious diseases) and the associated data collection systems are also all under continuous development.

Work is under way on the development of indicators for harm reduction, public expenditure and drugs and crime, and of a system for monitoring problem substance (including alcohol) use among those presenting to hospital emergency departments, and on the roll-out of unique identifiers under the Health Identifiers Act 2014.

While the National Advisory Committee on Drugs and Alcohol (NACDA) is currently overseeing a study to estimate the prevalence of children residing with substance-misusing parents, and the conduct of two drug prevalence surveys (in the general population and the prevalence of opioid use), it has been unable to conduct rehabilitation research owing to lack of a researcher and a rehabilitation research budget. Work on disseminating research findings and models of best practice has also been hampered by lack of research staff and a reduced budget. The reform of the Coroner Service has also had to follow a more gradual, cost-neutral approach owing to the difficult national economic situation. (Brigid Pike)

1 Department of Health (2015) National Drugs Strategy 2009-2016: progress report to end 2014. https://www.drugsandalcohol.ie/23935/