In Ireland, the Joint Committee on Health scrutinises the work of the Department of Health and its agencies. It is responsible for examining health policy, the future planning of health services, and proposed changes to the way in which healthcare is delivered.1 Membership includes representation from the Dáil and the Seanad.2

On 19 January 2022, the Minister of State for Public Health, Wellbeing and the National Drugs Strategy, Frank Feighan TD, came before the committee to provide an update on the national drugs strategy. He was supported by Dr Eamon Keenan, the national clinical lead for the Health Services Executive’s (HSE) addiction services, and Jim Walsh, principal officer at the Drugs Policy and Social Inclusion Unit at the Department of Health. 

Minister’s opening statement

The minister identified three key messages in his opening statement to the committee. First, that drugs continue to be a major policy challenge for Irish society. Second, that the Government is committed to a health-led approach to dealing with drug use as reflected in the national drugs strategy. Specifically, he said that ‘a war on drugs is not an effective response to drug use’ (p. 2).3 Third, he commented on the effectiveness of the national drugs strategy to date, in which he referred to the midterm review and the progress made on its 50 actions. The six strategic priorities for the remainder of the strategy from 2021 to 2025 were outlined.4 

Themes discussed

In response to the minister’s statement, members of the committee raised a wide variety of issues and concerns. These reflect the heterogeneity within the committee in terms of the positions held on the best approach to address the drugs issue. A selection of the recurring themes discussed are outlined here, including cocaine and crack cocaine use; a citizens’ assembly on drugs; task force funding; cross-departmental working; decriminalisation of drug use; and new structures for the national drugs strategy. More detail is available in the transcript of the committee meeting.5 

Cocaine and crack cocaine

Concern was raised over the increase in the sale and use of cocaine and crack cocaine in Ireland. A particular focus was given to the needs of communities affected by growing crack cocaine use. A new funding stream of €850,000 to address cocaine and crack cocaine use is being allocated, according to the minister. Projects are expected to be functioning in Q2 of 2022. There was concern among committee members that the funding was inadequate to meet the growing need in this area. 

Citizens’ assembly

The minister reiterated the commitment in the current Programme for Government to hold a citizens’ assembly on drugs in the lifetime of the Government. However, some committee members voiced a strong opinion that it should be held as a matter of urgency and encouraged the minister to hold it in 2022. 

Task force funding

Concerns were raised about the funding of the drug and alcohol task forces. There were calls for increased funding so that task forces could meet the increasing need in their communities. The system through which funding is allocated to task forces was also criticised. It was suggested that it lacks transparency and resulted in an unfair distribution of funds. Mr Walsh agreed that ‘it is not fairly distributed’ and that enhancement funding was being allocated through a ‘population-based resource allocation model’ in an attempt to address this inequity.5 In a separate issue, concern was raised by a few committee members about funding for the operational costs in the North Inner City Drugs and Alcohol Task Force. 

Cross-departmental working

The minister emphasised the importance of cross-departmental working in the delivery of the national drugs strategy. Some committee members noted that experience to date on national and local bodies responsible for the delivery of the strategy (including task forces) would suggest that some departments and State bodies are not fully engaged or committed to the process. The Department of Education was singled out as being particularly difficult to engage. 

Decriminalisation

Decriminalisation of drug use was raised by some committee members and was suggested as a topic for the citizens’ assembly. It was argued that a truly health-led approach to drug use and a move away from the war-on-drugs rhetoric would require decriminalisation. There was division within the committee on this topic, with some suggestion that there remains a lack of clarity among stakeholders about the distinction between decriminalisation and legalisation. Decriminalisation was being advocated by the relevant members, not legalisation.6 

New structures for the national drugs strategy

The revised membership of the National Oversight Committee was noted, while the absence of addiction nursing representation and reduced civic society representation were heavily criticised. 

Other topics discussed

Among the other issues discussed were care plans for those in treatment; the impact of Covid-19 on services; the link between drug use, poverty, and marginalisation; drug-related deaths; dual diagnosis; prevention activities in education (including Know the Score); helpline services; supervised injecting rooms; and services for pregnant women who use drugs. 

Final comment

The Joint Committee on Health debate highlighted the ongoing heterogeneity among representatives of the Dáil and the Seanad in how best to address the challenges raised by drug use. While members advocated strongly for the health-led approach represented in the national drugs strategy, there were still those who were grounded in war-on-drugs rhetoric, with an emphasis on abstinence. It should also be noted that while the strategy is a joint drug and alcohol strategy, there was minimal discussion of the problems presented by alcohol use and the Government’s response to these.
 

1  For more information on the Joint Committee on Health, visit: https://www.oireachtas.ie/en/committees/33/health/

2  For a full list of the committee’s membership, visit: https://www.oireachtas.ie/en/committees/33/health/membership/

3  Joint Committee on Health (2022) Minister Frank Feighan: opening statement on implementation of the national drugs strategy 2021–2025 [Debate]. 19 Jan 2022. Dublin: Houses of the Oireachtas. https://www.drugsandalcohol.ie/35542/

4  Drugs Policy and Social Inclusion Unit (2021) Mid-term review of the national drugs strategy, Reducing Harm, Supporting Recovery and strategic priorities 2021–2025. Dublin: Department of Health. https://www.drugsandalcohol.ie/35183/

5  Joint Committee on Health (2022) Minutes of Joint Committee on Health debate, Wednesday, 19 Jan 2022. Dublin: Houses of the Oireachtas. Available online at:
https://www.oireachtas.ie/en/debates/debate/joint_committee_on_health/2022-01-19/

6  For a clear definition of decriminalisation, visit: https://www.emcdda.europa.eu/media-library/motion-graphic-what-decriminalisation-drugs_en