Home > Dáil Éireann debate. Topical issue debate - substance misuse.

[Oireachtas] Dáil Éireann debate. Topical issue debate - substance misuse. (20 Oct 2022)

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


Deputy Gary Gannon: I thank the Minister of State, Deputy Feighan, for attending this important discussion. I am sure we all watched RTÉ's "Prime Time" documentary the other day on Dublin's O'Connell Street. People throughout the country, having watched it, came away with the view that something needs to be done about this. The Minister of State and members of the Dáil Business Committee know I have been asking for the past year for statements in the House on the issue of the city of Dublin as a whole. Many of the issues captured by the documentary on O'Connell Street are happening on streets all over the city centre.

Following the documentary, there was something of a public outcry. There also were two fairly derogatory statements made by politicians. One I will not focus on because it was retracted and that is fine. I have more of an issue with the second statement because it comes down to the question of how we solve these issues, which I have been trying to combat for most of my adult life. I refer to the comment by the Minister for Justice during the programme that she is going to clean up O'Connell Street. Much of what she was talking about when she said that pertained to people. One cannot clean up people. Dublin City Council is not going to go out and clean up people.

This is a complex issue that requires a multitude of different responses. That is where the Minister of State, Deputy Feighan, has a responsibility. There is a policing solution for O'Connell Street, which will deal with a small part of the problem, and it should be done. There is aggressive behaviour happening on the street, with people being attacked. The perpetrators certainly should be removed by the Garda at the first opportunity and held to account. However, that is very different from what has been happening down the laneways off O'Connell Street and in streets and laneways all over this city every single day and night. There are people in various states of trauma and people taking drugs, not for recreational purposes but to alleviate suffering they experienced at some point in their life.

I need to see that the Minister of State understands this issue and will work to address the problem. Will he outline in his response how the Government and he, in his role as Minister of State with responsibility for drugs policy, are looking at helping people to remove themselves from the scourge of addiction? What types of supports are being offered? I would like to know whether the Minister, Deputy McEntee, consulted him before saying she is going to clean up the streets. Will we have a high-level task force that will make the association between addiction and mental health supports? Will we see an increase in supervised detoxification recovery beds? There is really important and intensive work needed to remove a person from situations arising from traumatic experiences. Did the Minister talk to the Minister of State about safe injection facilities, consumption rooms or the types of outreach supports that used to be available but seem not to be there any more? Such supports must be provided by people who are trained by the HSE rather than volunteers, although there certainly is good work being done voluntarily. This is intensive work that requires professional training in outreach, communication, building relationships and, when trust is established, offering the appropriate supports, which must include mental health supports.

I have been advocating for a high-level, Taoiseach-led task force on these issues. The Taoiseach does not seem to be interested in that, which is a debate for another day. Does the Minister of State, who has responsibility for drugs policy, see a role for himself in addressing these issues? I am sure he does but I would like to know what he considers it to be. I would like to understand the metrics. How are we measuring success in this field? I believe we have failed continuously. The Minister of State has said on many occasions that the Government takes a healthcare approach to drugs. That is true to a point but we still criminalise people for behaviours that are about trying to alleviate suffering. That is what people are doing when they inject themselves, smoke crack cocaine and engage in those types of really complex drug-taking. It requires a much more complex response than simply criminalising them. I ask the Minister of State to take his time in outlining his response. I look forward to coming back in after he has given it.

Deputy Frankie Feighan: I thank Deputy Gannon for raising this issue, as he has done many times both in the Dáil and privately. I thank him for his commitment to it. The issues raised in the "Prime Time" programme on drug and alcohol use on O'Connell Street fall under the remit of several Departments and agencies, including the Department of Justice, An Garda Síochána, Dublin City Council and the Department of Health. I welcome the opportunity to address this topic from a health perspective.

The Department of Health is very supportive of the 17 community-based drug services operating in the north inner city. These services, which play a valuable role in tackling drug and alcohol problems in Dublin city, receive funding of €4.4 million per annum through the local drugs and alcohol task force. Earlier today, I visited one such project, Chrysalis. I thank those involved in that project and the many other services for the incredible work they do in tackling this very difficult issue. The HSE and Dublin City Council fund the law engagement and assisted recovery, LEAR, project in Dublin city centre, which provides intensive case management services to people entrenched in street life on Middle Abbey Street, O'Connell Street and Talbot Street. The HSE also funds an assertive case management team, involving Ana Liffey and Coolmine, which works with people who are homeless and in emergency accommodation in the city centre, including outreach work with people who are on the streets.

The Government's strategic response to addressing drug and alcohol problems in Ireland is set out in the national drug strategy, Reducing Harm, Supporting Recovery. The strategy promotes a healthier and safer Ireland in which public health and safety are protected and the harms caused to individuals, families and communities through substance misuse are reduced. The strategy reflects a change in attitudes to substance misuse and promotes a more compassionate and humane approach to people who use drugs, with addiction treated first and foremost as a public health issue. It is underpinned by the key values of compassion, respect, equality and inclusion.

More than €130 million a year is allocated to the HSE for the provision of addiction services. There is significant investment in addiction services in the north inner city. Earlier this year, €850,000 was provided for a HSE-led initiative to reduce the health-related harms from cocaine and crack cocaine. Under this initiative, I confirm that €200,000 is being provided to the community healthcare organisation, CHO, area incorporating Dublin north city and county, involving seven HSE addiction services, including opioid agonist treatment, OAT, locations and other treatment and rehabilitation services.

Like the Deputy, I firmly believe that addressing the drug problem requires a multipronged approach, involving the provision of harm reduction and prevention initiatives in tandem with treatment services.

Deputy Frankie Feighan: I thank Deputy Gannon for raising this issue, as he has done many times both in the Dáil and privately. I thank him for his commitment to it. The issues raised in the "Prime Time" programme on drug and alcohol use on O'Connell Street fall under the remit of several Departments and agencies, including the Department of Justice, An Garda Síochána, Dublin City Council and the Department of Health. I welcome the opportunity to address this topic from a health perspective.

The Department of Health is very supportive of the 17 community-based drug services operating in the north inner city. These services, which play a valuable role in tackling drug and alcohol problems in Dublin city, receive funding of €4.4 million per annum through the local drugs and alcohol task force. Earlier today, I visited one such project, Chrysalis. I thank those involved in that project and the many other services for the incredible work they do in tackling this very difficult issue. The HSE and Dublin City Council fund the law engagement and assisted recovery, LEAR, project in Dublin city centre, which provides intensive case management services to people entrenched in street life on Middle Abbey Street, O'Connell Street and Talbot Street. The HSE also funds an assertive case management team, involving Ana Liffey and Coolmine, which works with people who are homeless and in emergency accommodation in the city centre, including outreach work with people who are on the streets.

The Government's strategic response to addressing drug and alcohol problems in Ireland is set out in the national drug strategy, Reducing Harm, Supporting Recovery. The strategy promotes a healthier and safer Ireland in which public health and safety are protected and the harms caused to individuals, families and communities through substance misuse are reduced. The strategy reflects a change in attitudes to substance misuse and promotes a more compassionate and humane approach to people who use drugs, with addiction treated first and foremost as a public health issue. It is underpinned by the key values of compassion, respect, equality and inclusion. 

More than €130 million a year is allocated to the HSE for the provision of addiction services. There is significant investment in addiction services in the north inner city. Earlier this year, €850,000 was provided for a HSE-led initiative to reduce the health-related harms from cocaine and crack cocaine. Under this initiative, I confirm that €200,000 is being provided to the community healthcare organisation, CHO, area incorporating Dublin north city and county, involving seven HSE addiction services, including opioid agonist treatment, OAT, locations and other treatment and rehabilitation services.

Like the Deputy, I firmly believe that addressing the drug problem requires a multipronged approach, involving the provision of harm reduction and prevention initiatives in tandem with treatment services.

Deputy Gary Gannon: I thank the Minister of State for his statement, which I will go through in my response. He refers to a multi-agency approach that crosses the Department of Justice, the Garda Síochána, Dublin City Council and the Department of Health. Will he tell me when representatives of those bodies were last in the same room to discuss this issue? If there is a multi-agency approach, when was the last time such a meeting took place and when is the next one scheduled to happen? I am fascinated to hear the answer.

I asked for the metrics in regard to reducing harm and supporting recovery.

I fully appreciate that I am asking a question of the Minister of State but what are the metrics contained in that strategy? How relevant is it today? Was it changed to address the needs, demand or the accelerated urgency post Covid, when a lot more people had become involved in complex drug-taking? A lot more people were forced onto the streets again to drink alcohol with harmful effects on them.

I wish to make a point on the moneys that are placed into the north inner city. It is the place I grew up in and I am very familiar with it. Ever since the four-tier social partnership was launched in around 1998, a significant amount of money has been placed into areas like the north inner city in combating addiction for different groups that have emerged. However, there is no real joined-up approach. Clearly, it has not been working. The Minister of State might be able to tell me what happens if, for example, a young man in the north inner city of 35 years of age has a cocaine addiction. Where would the Minister of State advise him to go to get support? People often come to me with such questions. The drugs task force is not in existence at the minute but probably has not been relevant for a very long time. Where should I tell that person to go?

Deputy Frankie Feighan: The Government admits that there are significant specific challenges facing vulnerable individuals utilising homeless and addiction services in the north inner city. The Deputy made a point about emerging trends. A group has been set up to look at emerging trends. As I said, we saw where crack cocaine was taking hold in the north inner city, in Ballymun and in Tallaght, as well as in Limerick and we addressed that with funding. I visited Tallaght only two weeks ago. Those I met said that it had made a difference. Perhaps we could have been quicker in our response. Sometimes we need to be a bit more focused on those emerging trends. We have set up that group in the Department. It is monitoring all the various trends on the ground as well. I have lead responsibility for co-ordinating the implementation of the strategy across Departments and Government agencies. A priority for the strategy to develop integrated care pathways for high-risk drug users, including people who are homeless, offenders and injecting drug users, to achieve better health outcomes. As the Deputy is aware, such people have very complex health and social care needs. It is an issue which goes across many different Departments. As I have said, different agencies including the Department of Justice, An Garda Síochána, Dublin City Council, the Department of Health-----

Deputy Gary Gannon: Have they met together yet?

Deputy Frankie Feighan: I will find out if they have met. A lot of the time it is the officials who meet. I have met my counterparts in the Department of Housing, Local Government and Heritage on a few occasions. We also have the national drugs strategy. A midterm review was undertaken, and many of the emerging issues and trends were included in that review. I will find out for the Deputy what exactly has happened, which groups have met and when they are due to meet next.

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