Pádraig Rice, An Cathaoirleach: We have received apologies from Deputy David Cullinane, for whom Deputy Graves is substituting, and Senator Nicole Ryan... This evening, the committee will consider issues relating to alcohol in the drugs strategy. To speak to the context, the committee thought it really important to have a discussion on the central role of alcohol within the drugs strategy. Alcohol is the most widely available drug in Ireland. The majority of drinkers in Ireland consume alcohol in a way that is risky for their health. In 2024, the average alcohol consumption of people aged 15 and over was 9.4 litres. While alcohol use rates are falling and there has been a 14% decrease since the passage of the Public Health (Alcohol) Act 2018, consumption is still too high. In fact, alcohol consumption would need to fall by a further 35% to meet the HSE's guidelines on low-risk alcohol consumption. There are also a huge number of admissions to hospital every year, some 40,000, and a large number of deaths, four every day, relating to alcohol. This presents a huge cost to the Department of Health. The estimated costs to the Department associated with alcohol total approximately €2.35 billion a year. There are a lot of issues to consider in relation to the effects of alcohol, the impact it has and the cost to the State. That will be the subject of our discussions this evening.

To commence the committee's consideration of this matter, from the Coalition for Better Alcohol Policy, I welcome: Ms Paula Leonard, the CEO of Alcohol Forum Ireland; Dr. Noel McCarthy, professor of population health medicine at Trinity College Dublin; Dr. Nazih Eldin, chairperson of the North East Regional Drug and Alcohol Task Force; and Ms Edel Furey. From the Department of Health, I welcome: Dr. David Leach, assistant secretary; Professor Mary Horgan, Chief Medical Officer; Mr. Jim Walsh, principal officer; Mr. Matthew Doyle, principal officer; and Dr. Aisling Sheehan, national lead for alcohol and mental health programmes in the HSE.

Members and witnesses are reminded of the long-standing parliamentary practice that they should not criticise or make charges against any person or entity by name or in such a way as to make him, her or it identifiable, or otherwise engage in speech that might be regarded as damaging to the good name of the person or entity. Therefore, if witnesses' statements are potentially defamatory in relation to an identifiable person or entity, they will be directed to discontinue their remarks. It is imperative that they comply with any such direction.

I invite Ms Leonard to make the opening remarks on behalf of the Coalition for Better Alcohol Policy. She has five minutes.

Ms Paula Leonard: I thank the Chairperson and members of the committee for the opportunity to appear here today. We are here today to represent the Coalition for Better Alcohol Policy, which is a broad and diverse coalition of youth work, social inclusion, disability, community, medical, health and social work organisations and professional associations that came together earlier this year to advocate for meaningful inclusion of alcohol within the national drugs strategy. Speaking for so many organisations about a drug that causes multiple harms across multiple areas of Irish life is a challenge so today we will focus specifically on areas where coalition members have identified gaps in services and in policy. I am joined by Professor Noel McCarthy, Ms Edel Furey, whose partner was diagnosed with an alcohol-related brain injury just this year, and Dr. Nazih Eldin, chairperson of the North East Regional Drug and Alcohol Task Force.

A total of 16 drug and alcohol task forces are represented within the coalition.

Much progress was made over the lifetime of the previous national drugs strategy, within which alcohol was included. It is important to acknowledge the work of our colleagues in the Department of Health and the HSE in that regard. For us, however, it is quite simple. More action, better policy, better co-ordination and strong political leadership are needed. We are calling on the Government to ensure that increased funding is dedicated to the reduction and the prevention of alcohol harm in Ireland.

While all committee members will be aware of this, it is worth acknowledging that alcohol is, in fact, a drug. It is a neurotoxic, cancer-causing and addictive substance. Chemically, it is a depressant and is the drug that results in the highest numbers of deaths and causes the highest levels of harm in Ireland. According to the HRB, alcohol-related deaths represent 5% of all deaths. Alcohol is the eighth leading cause of death in Ireland.

We welcome the fact that the Department of Health has indicated that alcohol will be included to some extent within the new strategy. We welcome the announcement earlier this year by the Minister of State, Deputy Murnane O'Connor, of an additional €1 million in 2025, rising to €1.8 million in 2026, to expand alcohol and drug treatment services across the new health regions. We are here to ask the Government to ensure that: alcohol is clearly named as one of the priorities within the strategy; that clear action areas around prevention, education, early intervention and community-based supports are identified; and that key performance indicators are agreed for alcohol. It is worth noting that one of the ten recommendations in the evaluation of the last national drugs strategy launched by the Ministers in July recommends that the new strategy should "Strengthen the integration of alcohol within the [new] national drugs strategy".

There is a need for clarity within the Government and the Department of Health with respect to leadership on and responsibility for driving drug policy and action to prevent and reduce alcohol harm. The primary remit of the drugs policy unit is largely in regard to illicit drugs. The tobacco and alcohol control unit indicates that its remit with respect to alcohol extends only to matters relating to the Public Health (Alcohol) Act. At present, alcohol policy within the Department is spread across a number of units, namely the office of the Chief Medical Officer, the tobacco and alcohol unit, the Healthy Ireland unit and the drugs policy unit. External to the Department of Health, many important aspects of alcohol policy fall under the remit of other Departments, including the Department of justice, and Revenue. This ongoing fragmentation leads to a lack of clarity, consensus and co-ordination. We feel, therefore, that the recommendation from the evaluation of the national drugs strategy to "Establish mechanisms for interdepartmental collaboration, reflecting the need for systemic alignment across housing, justice and health sectors" is needed...

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