On 2 July 2020, Frank Feighan TD for Sligo-Leitrim was appointed Minister of State for Public Health, Well Being and National Drugs Strategy. This follows on from the publication of Programme for Government: our shared future (1). The new Programme for Government commits to taking a health-led approach to drugs misuse and continuing to deliver on the existing national drugs strategy (NDS), Reducing Harm, Supporting Recovery (2017–2025) (2).

The new Government divides its commitments into a set of four and a further set of 24 actions, all of which are in line with the NDS.(2) The reason for having two separate sets is unclear; hence, they are dealt with together for the purpose of this article. Where relevant, the article puts them in the context of the existing strategic action plan for 2017–2020 embedded in the NDS.

The new Government divides its commitments into a set of four and a further set of 24 actions, all of which are in line with the NDS.2 The reason for having two separate sets is unclear; hence, they are dealt with together for the purpose of this article. Where relevant, the article puts them in the context of the existing strategic action plan for 2017–2020 embedded in the NDS. 

Programme for Government commitments

When examined alongside the strategic action plan (2017–2020), most of the commitments in the new Programme for Government can be linked to existing actions and reflect progress made on their delivery since 2017. While one deals with a specific service (the re-establishment of the Galway city community-based alcohol treatment service), the others are broader in nature. 

New actions

There are some actions that deal with new developments in Irish drug policy: a new topic, target group, or approach to addressing the needs of people who use drugs. This is not to suggest that there has been no activity already in these areas in terms of delivery on the ground, rather that they were not part of the 2017–2020 strategic action plan but reflect changes in the field. 

There are seven new actions:

1  A representative of the National Oversight Committee for Reducing Harm, Supporting Recovery will be included in the implementation and monitoring arrangements for the new national mental health policy launched in June 2020, Sharing the Vision: a mental health policy for everyone.3

2  The Government will seek to retain the specific actions taken to support increased and improved access to opioid substitution services during Covid-19, so that pre-Covid waiting times in accessing these services are reduced.4

3  The regulations and legislation that apply to cannabis use for medical conditions and palliative care, having regard to the experience in Northern Ireland and Great Britain, will be examined. Cannabis use for medicinal purposes did not feature in the strategic action plan for 2017–2020. However, since the strategy was launched in 2017, it has been the subject of a scientific review and legislation. In 2017, Cannabis for medical use: a scientific review5 by the Health Products Regulatory Authority was published. On 26 June 2019, legislation was passed to allow for a Medical Cannabis Access Programme to operate in Ireland on a pilot basis for five years.

4  A citizens’ assembly to consider matters relating to drug use will be convened. The development of the NDS involved extensive consultation with stakeholders and the public. In line with this, the Drugs Policy Unit of the Department of Health and the Health Research Board have collaborated on an annual drug forum to support evidence-informed practice and service delivery; promote participation of communities, service users, and their families in national structures; and strengthen the implementation and performance of the NDS.

5  The coercion and use of minors in the sale and supply of drugs will be legislated against. This is a new policy commitment for Government. A Private Members’ Bill on the topic lapsed in January 2020 with the dissolution of the last Government.6

6  A 24-hour helpline, based on the FRANK helpline in the United Kingdom, providing advice and assistance to people who use drugs and their family members, will be established. As part of Drugs.ie, the Health Service Executive currently runs a drug and alcohol helpline for anyone with a question or concern related to drug and alcohol use. The times are limited to office hours, Monday to Friday.

7  A ‘Good Neighbour’ policy for drug treatment centres to address any concerns held by local residents and businesses alike will be ensured.

A further four actions indicate a new focus or target group for existing actions:

1  The potential for an information campaign on the health impacts of steroid use, particularly on young men, will be examined. This is a new focus in relation to the existing action plan. While people who use steroids were mentioned in the existing action plan as a new service-user population at needle exchange programmes, steroids were not identified as a specific target for prevention and harm reduction activities.

2  That women can face barriers to accessing and sustaining addiction treatment, arising from an absence of childcare or the presence of domestic violence, will be recognised and targeted interventions aimed at responding to their needs will be developed. While domestic violence is noted as an issue facing women who use drugs in Reducing Harm, Supporting Recovery, it does not feature in its action plan. Childcare is recognised as a barrier needing to be addressed in one of the actions in the plan, but this new action recognises other barriers by specifically noting domestic violence.

3  Support for step-down accommodation to prevent high-risk single people and families from exiting treatment into homelessness will be significantly increased. This is a broadening out of an existing action to include high-risk single people.

4  Harm reduction and education campaigns aimed at increasing awareness of the risks of drug use and the contribution of drugs to criminality will continue to be resourced. This is a continuation of existing work but the focus on the contribution of drugs to criminality is new. 

Commitments to a policy direction

Three of the actions indicate a move from exploring an issue in the strategic action plan to a commitment to a particular policy position:

1  To increase and support drug-quality testing services, particularly at festivals

2  To support the rollout of access to and training in opioid antidotes

3  To implement the recommendations of the Working Group to Consider Alternative Approaches to the Possession of Drugs for Personal Use and to review the alternative approach adopted after its first year of implementation in order to ensure that it is meeting its aims. However, the health diversion approach launched by Government in August 2019 as the approach being adopted following the Working Group’s report is not referred to specifically in the document. 

Support for existing actions

Ten of the actions are either the same, variations, or continuations of those in the strategic action plan:

1  Build on recent initiatives at Junior and Senior Cycle and support secondary schools in introducing drug and alcohol awareness programmes, particularly in relation to the hazards of casual drug use.

2  Examine approaches to identifying at-risk young people and vulnerable groups to interrupt their potential trajectory into problem drug and alcohol misuse.

3  Expand services for pregnant and postnatal women affected by substance use, and their children.

4  Create a path for people in rehabilitation from drug addiction to access education and training facilities in their local areas.

5  Progress the National Clinical Programme for Dual Diagnosis and work to develop joint protocols and referral pathways.

6  Support the Drug Related Intimidation Reporting Programme, developed by the National Family Support Network, in partnership with An Garda Síochána, to respond to the needs of drug users and families facing the threat of drug-related intimidation.

7  Develop health and social interventions, based on an inclusion-health approach to target people who are homeless and in addiction.

8  Ensure in-reach supports and pathways to access to treatment for homeless, Traveller, and new communities are available.

9  Increase the number of residential treatment beds for those stabilising, detoxing, and/or seeking drug-free services.

10     Reduce the number of lives lost through overdose by opening a pilot medically supervised injecting facility in Dublin city. 

Drug and alcohol task forces

Finally, underpinning the NDS and its delivery, there is ongoing commitment to support the work of the drug and alcohol task forces in identifying local need in communities and supporting targeted initiatives. 

Concluding comment

Overall, the new Programme for Government indicates an ongoing commitment to a health-led approach to meet the needs of people who use drugs, undertaking a similar set of actions to those within the NDS, and to be delivered under existing structures. The current strategic action plan expires at the end of 2020 but the new Programme for Government would indicate that any new version for 2021 and onwards will be closely aligned with its predecessor. 

2 Department of Health (2017) Reducing Harm, Supporting Recovery: a health-led response to drug and alcohol use in Ireland 2017–2025. Dublin: Department of Health. https://www.drugsandalcohol.ie/27603/

3 Department of Health (2020) Sharing the Vision: a mental health policy for everyone. Dublin: Government of Ireland. https://www.drugsandalcohol.ie/32228/

4 See articles in this issue of Drugnet Ireland on Ireland’s response to Covid-19 for people who use drugs.

5 Health Products Regulatory Authority (2017) Cannabis for medical use: a scientific review. Dublin: Department of Health. http://www.drugsandalcohol.ie/26784/

6 Misuse of Drugs (Amendment) Bill 2019 sponsored by John Curran TD. Further information available at:
https://www.oireachtas.ie/en/bills/bill/2019/97/