The Department of Health has published its annual report for 2015 on progress in implementing the actions included in the National Drugs Strategy.1 The report is a descriptive account of activities over the period – in some cases they are reported at a national level, while in others they are reported at the level of the Community Healthcare Organisations (CHOs).2

Where there has been no change, the report tends to repeat the 2014 content. No reference is made in the report to the key performance indicators identified in the NDS and neither is there any overall assessment of the level of progress made in achieving outcomes. The overall messages under each pillar remain the same as in the 2014 report.2

This article focuses on some of the changes reported to have happened under each of the five pillars over the 12-month period.

Supply reduction

Overall progress in delivering on the supply reduction actions continued to be made in relation to local supply reduction initiatives, and compliance with EU-level obligations and operations. In 2015 there was progress made on policy and legislative initiatives, including the Road Traffic Bill 2016, the Public Health (Alcohol) Bill 2015, and the proposed bill to amend the Misuse of Drugs Act to restore the government’s power to declare substances to be controlled. Furthermore, some progress was made on activities that had been affected by the difficult economic situation: 

• Forensic Science Ireland (FSI) received €1 million additional funding in the 2016 estimates for additional staff members.
• Funding was also allocated for a new forensic science laboratory. Construction is due to start in 2019.
• The DNA database was launched late in 2015 and is being used by the Gardaí and FSI.
• Some steps were taken to meet the need for an integrated system to track the progression of offenders with drug-related offences through the criminal justice system. A Chief Information Officer was appointed with responsibility for developing the concept of a ‘justice and equality information hub’; approval was given for three ‘Pathfinder’ projects to prove the concept. 

Prevention

This area of the strategy deals with both illicit drugs and alcohol. It continued to be the case that since the start of the strategy, most progress was made in setting up education programmes and drug policies in schools, developing youth interventions and facilities in out-of-school settings, and developing online prevention and help services. Work was on-going in progressing programmes targeting families experiencing difficulties owing to drug/alcohol use and the children of drug users. Work was also under way on selective prevention measures to reduce under-age and binge drinking.

Treatment and rehabilitation

Activity under the treatment and rehabilitation pillar is mainly illustrated by using examples of activities from CHOs. The overall message for 2015 was the same as in 2014 – the development and improvement of the range, integration and availability of treatment and rehabilitation services were reported to be on-going, as was improvement in access to these services. With regard to a drugs intervention programme (incorporating a treatment referral option) for young people who come to the attention of the Gardaí as a result of their drug use, Gardaí now have an information leaflet to give to young people.

No further action was reported since the last report in relation to the following actions:

• While work was reported to be well under way with regard to training programmes for all involved in the provision of substance misuse treatment services, treatment guidelines for treating blood-borne viruses had yet to be published.
• In response to the issue of drug-related deaths, the findings of the naloxone demonstration project were still awaited.
• No progress was reported in relation to the development of a National Overdose Prevention Strategy nor to the review of the regulatory framework in relation to prescription drugs.
• A statutory regulatory framework for the provision of counselling within substance misuse services continued to be delayed because counselling was not one of the 12 health and social care professions designated under the Health and Social Care Professionals Act 2005. 

Research and information

Many activities under this pillar were on-going. 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 were all under continuous development. The HRB National Drugs Library continued to promote the use of evidence in drugs work and provide resources to those working in the area. In line with the EU Early Warning System, a communication protocol for notification of drug use emergencies was being further developed.

The 2015 research work programme of the National Advisory Committee on Drugs and Alcohol was the same as for 2014. Progress was hindered owing to the lack of a researcher and a reduced budget. However, there were some specific developments: 

• The development of indicators for harm reduction, public expenditure and drugs and crime, was under way. In 2015, for the first time, data on drug treatment in prisons were included in the report on prisons provided to the EMCDDA.
• The HSE was finalising a plan for the establishment and rollout of the Individual Health Identifier (IHI). 

Co-ordination

There was little change in relation to this pillar, with many of the proposed structures already in place. Some progress was made in developing engagement with specifically identified at-risk groups, including Travellers, new communities, LGBTs, the homeless and sex workers. A subgroup of the National Coordinating Committee for Drug and Alcohol Task Forces reviewed and updated the 2009 NDS Traveller Framework Document, and was identifying lead agencies to implement the recommendations in the document. 

1 Department of Health (2016) National Drugs Strategy 2009­–2016: progress report to end 2015. https://www.drugsandalcohol.ie/25365/

2 Delivered through the HSE and its funded agencies, the nine Community Healthcare Organisations provide the broad range of services that are delivered outside of the acute hospital system, i.e. primary care, social care, mental health and health and wellbeing services. https://www.hse.ie/eng/services/publications/corporate/CHO_FAQ.pdf

3 Pike B (2015) National Drugs Strategy [NDS] 2009–2016: progress in 2014 Drugnet Ireland (55): 12– 13. https://www.drugsandalcohol.ie/view/journal_volume/Drugnet_Ireland/Issue_55,_Autumn_2015.html