Sinn Féin has the plan, vision, and determination to deal with the big challenges in healthcare. Our plan sets out in detail how we will deliver better access to healthcare when you need it, improve access to a GP when you need one, and end the crisis in our Emergency Departments.

25 Key proposals include: Implement our 5-year Community Addiction and Recovery Strategy, return funding to historic-high levels for local and regional drug and alcohol taskforces, and initiate an unprecedented investment in community addiction and recovery inpatient capacity.

9.Tackling Addiction, Empowering Recovery
Sinn Fein recognises that addiction can affect anyone. Sinn Féin’s guiding principle in our approach to addiction and recovery is that we must reduce the harmful impacts of addiction while empowering communities. We have set out comprehensive policy in our 5 Year Community Addiction and Recovery Strategy (2021) and in our policy consultation document Priorities for Change in Health and Social Care (2023).

Those working on the ground in the addiction and recovery sector are best placed to identify and resource programmes and initiatives that will benefit individuals and families in their local communities. Local community initiatives are the backbone of addiction and recovery services. This localised expertise must be allowed, and funded, to respond proactively to emerging trends within communities.

Sinn Féin would end the criminalisation of addiction. We would not seek to penalise minor possession for personal use. Consumption of drugs in a public place and sale and supply would remain illegal. We would ensure that anyone found in possession of drugs would be afforded extensive opportunities to engage with health-led services where necessary.

Sinn Féin would return funding for local and regional Drug and Alcohol Taskforces to pre-recession levels and ensure sustained and appropriate funding increases every year to continue service development. We would fund additional family support and community development workers in each taskforce area. For many people, alcohol poses no risk, but supports and signposting must be available for those who need it. Sinn Féin would support community-based services along with clinical responses to Alcohol-Related Brain Injuries.

We are proposing to further support recovery services through an unprecedented investment in publicly owned, community operated rehabilitation and detoxification inpatient capacity. We would fund an expansion of capacity equivalent to 700 residential recovery, medical detoxification, and step-down beds over a term of Government. We would ensure that people are not isolated from support by a prison sentence.

Sinn Féin would offset assessment fees for addiction and recovery services through improvements to capitation funding.

We would support people in recovery through a recovery-specific housing programme, inclusive of wraparound supports. The programme would start as a pilot scheme with 3 initial bases across the regions. Each person utilising these services would have access to an addiction counsellor and support worker.

Addiction often overlaps with mental health challenges and conditions, both as a cause and a consequence of addiction. Lip service has been paid to the need for services equipped to care for people with dual diagnoses, but this has never materialised. Sinn Féin would implement a “No Wrong Door” policy for people with a dual diagnosis and enable addiction and mental health services to deliver the care a person needs when they present to a service they trust.

Sinn Féin recognises that staff in addiction services are often overlooked and under supported. We note reports finding that those working in addiction have some of the highest work-related stress across health services. We recognise that supervision is a key aspect in social work and social care in mental health fields, yet it is often overlooked in addiction services. We would support frontline workers with supervision and counselling services to reduce burnout and the mental burden of managing trauma on a daily basis.

Sinn Féin recognises that families are disproportionately and often unfairly placed with the burden of caring for and supporting an individual in active addiction and early recovery. This can have profound and often long-lasting impacts on family members from economic hardship to violence and without support, this can increase the likelihood of addiction amongst children especially. Sinn Féin would work with existing Family Support Networks to ensure fair processes, increase funding through DATFs to ensure that a whole-family approach can be taken to addiction across the State, and ensure that families are given a secure position on consultation bodies such as the National Oversight Council.

Sinn Féin also recognises the large proportion of individuals impacted by gambling-based harm in this state. We would implement strong, evidence-based gambling regulations to ensure that the Gambling Regulator can be a proactive force to reduce harm in this state. We would ensure that the Social Fund receives contributions on a ‘harm pays’ basis, similar to the approach in New Zealand, to provide the necessary treatment supports for those who need them.

We recognise the potentially life-saving intervention that Naloxone offers to those in addiction, those utilising Opioid Substitute Treatments and those who are legally prescribed opioids. We would explore evidence-based approaches to the expansion of the availability of Naloxone to ensure that every person whose life could be saved by this drug can access it.

Sinn Féin recognises that significant barriers exist to those in recovery and that we need to work at all levels of government, across this island, to remove these barriers. We believe that across the island, those on a recovery journey have rights and these rights must be respected. To this end, we would implement an All-Island Charter of Rights for those in Recovery.

Sinn Féin will:

• Return funding to 2010 levels for local and regional drug and alcohol taskforces, and increase funding further by 2% every year
• Initiate an unprecedented investment in community addiction and recovery inpatient capacity, delivering 700 residential recovery, medical detoxification, and step-down beds over a term of Government
• Waive assessment fees for access to addiction services
• Implement a “No Wrong Door” policy for dual diagnosis
• End the criminalisation of addiction and pursue a comprehensive health-led approach
• Employ additional community development and family support workers in each taskforce area
• Deliver multidisciplinary community neuro-rehabilitation teams which will work with community
• Fund further research into gambling prevalence and behaviours and fully implement a Gambling Regulation Bill
• Work across Government to support drug and alcohol misuse educational programmes in schools, recovery-inclusive programmes in sport, social inclusion and Traveller community-specific projects, and equip frontline services and the Gardaí to focus on harm reduction in communities
• Establish a Consultatory Working Group of people with lived experience of addiction to consult on, and influence, relevant policy
• Support a whole-family approach to addiction services and work to end the postcode lottery delivery of family support services

No Wrong Door
People who present for help for dual diagnosis often fall between the gaps that exist in addiction and mental health services. An addiction may lead to the onset of mental health difficulties or a mental health difficulty can lead to people using substances as a coping mechanism. Sinn Féin would urgently implement a fit-for-purpose model of care for people presenting with dual diagnosis as laid out in Sharing the Vision. Mark Ward TD and Thomas Gould TD introduced the Dual Diagnosis: No Wrong Door Bill. This bill will ensure that no matter what door the person knocks on for help for addiction and mental health difficulties, that they are treated with dignity. A joint care plan between addiction and mental health services needs to be developed to make sure people get the care they need, when they need it and where they need it. There can be No Wrong Door for dual diagnosis treatment.

Keltoi, a trauma-informed, state-run residential facility treating addiction and mental health dual diagnosis was closed in March 2020 during Covid Restrictions and has not re-opened since. The HSE has a comprehensive, credible plan to reopen Keltoi as a dual diagnosis Centre of Excellence, but this has not been funded by the Government. Sinn Féin would re-open this vital rehabilitation service to help people to fully recover from dual diagnosis and to learn new coping skills.

Similar challenges face people who are neurodiverse or who have physical disabilities when accessing mental health services. Sinn Féin would embed clear and accountable care pathways to deliver access to mainstream and specialist services as appropriate.

Sinn Féin will:

• Legislate to obligate any Government to uphold No Wrong Door policies,
  Support health and social care services to implement No Wrong Door policies
• Re-opening of Keltoi, the residential dual diagnosis facility,
  Ensure joined care planning between services and appropriate training for inclusion