We cannot underestimate the challenges that come with changing our approach to drug addiction
28 June 2018
Spokesperson on Health
Speaking on the National Drugs Strategy, Labour Party Health spokesperson, Alan Kelly has said that we must take a health-led approach to the drugs issue.
Speaking in the Dáil, Deputy Kelly said:
“We should not be debating the new drugs strategy a year after it was launched. It is kind of crazy. There is so much talk about the need to address this issue and we are debating the strategy a year late. We talk a lot about new politics but this is as an example of where it is not working.
“The new national drugs strategy is rightly called Reducing Harm, Supporting Recovery, and I welcome the shift in tone towards caring for people who suffer from addiction, which is an illness. Therefore, it makes sense to take a health-led approach to the drugs issue but we must not underestimate the scale of the challenge.
“The number of cases of people in treatment for drug addiction has increased steadily since 2007. Back then, there were 5,259 people in treatment for addiction, not including alcohol. In 2015, that figure was 9,710. That is an increase of 84%. The number of new cases each year has also gone up, from 2,431 cases in 2007 to 3,650 cases in 2015, representing an increase of 50%. These are just the people in treatment. We know that many more people are affected by addiction but are not included in these numbers. Some are not because they do not want to admit to or make public their use of illegal drugs. They do not want to show the impact drugs have had on them. Others are not included because the State simply does not offer them any services. Therefore the number is far higher than recorded.
“The issue concerning the figures is that the services are not at the same level outside Dublin or one or two other main urban areas. I say this as a Tipperary Deputy. I welcome in particular that the Department of Health engaged in a much more comprehensive consultation process on the strategy this time round . It is important that the Department continue to engage in serious listening exercises because drug use has changed and it is affecting people across Ireland in new ways. The Department needs to continue to listen to how addiction is affecting communities and families across Ireland. This is not an problem specific to one period but is iterative and continuing.
“We used to see the drugs issue as concentrated in urban areas where there was a concentration of social housing. Now the drugs issue is nationwide. Proportionately, villages and rural areas may be even more affected by addiction than some urban areas. I am not sure if anyone has said that before in this House. Some villages in rural counties probably have a higher percentage of drug abuse than inner city Dublin. There is a smaller sample but a bigger problem proportionately.
“The level of service provision in the State is nowhere near that required to tackle the addiction issue. The new strategy will need to be backed up by serious investment in services if even half of the intended actions are going to be implemented. Otherwise it is just wishful thinking. Ireland's level of opioid addiction —to heroin, among other substances — is much higher than in other western European countries. Opioid addiction affects seven in every 1,000 people here, compared with four in every 1,000 across Europe.
“Most of the State's infrastructure for dealing with drug addiction is focused on opioids. This has been the case since the heroin epidemic of the 1980s. In addition to that serious problem, the situation on the ground has moved on. Cocaine and crack cocaine are prevalent and highly addictive. We have few detoxification and rehabilitation options for people. Amphetamines, cannabis and ecstasy are all widely used. There also continues to be abuse of solvents. People are becoming addicted to sedatives or tranquilisers, which they may or may not have acquired on prescription.
“Drug dealing has changed too, with people ordering drugs online through so-called dark web websites, and even getting drugs delivered by post. This kind of thing has spread addiction to every corner of Ireland, including every village. There is a risk of drug addiction becoming totally out of control unless the Government puts in the necessary resources to get a grip on the issue. There is obviously a divide between legal and illegal drugs in this mix. We could mention tobacco and alcohol, which are legal, are also associated with addiction.
“One of the actions under the national strategy is for the consultation on the potential decriminalisation of the personal possession of illegal drugs. This consultation is currently ongoing. I understand that more than 14,000 submissions from the public have been received to date. I welcome this because it is clear evidence, if any were needed, of the level of public interest in and concern over the issue of drug misuse.
“The most important point I want to make to the Minister of State is that there is a real opportunity for Ireland to take a new approach to the whole issue of addiction. One does not often get to spend much time in government but if there is one issue regarding which the Minister of State has an opportunity, it is this. Countries such as Portugal have achieved a major reduction in the use of opioids and much fewer drug-related deaths because they changed strategy. There is something wrong, however, with the focus on the question of what substances should be legal or illegal. That is not the real issue; the real issue is how we treat people who have an addiction. The Labour Party's proposal is that we should decriminalise the person who is addicted to drugs. It should not be a criminal offence to be in possession of a small amount of soft drugs when one is addicted to them. Fear of a criminal record should never stop a person from seeking the medical help he or she needs. The vicious drugs gangs involved in drug dealing of course need to remain outside the law. Garda resources should be freed up to deal with them. At present, by contrast, Garda time is taken up with minor cases where people who are addicted to drugs are found in possession of small quantities. If we make it clear that possession of drugs by addicts will not be a criminal offence, we can focus on getting people into treatment for addiction. In Portugal, people are offered the choice of medical and social supports instead of getting a criminal record and facing a judicial sentence, which hangs over them for the rest of their lives. This is the option we should be discussing for Ireland but it will not work if there are not the services put in place to help people deal with addiction.
“A wide range of services is needed to deal with different types of drug addiction and different groups of people. For example, different services are needed for long-term heroin users compared with services for young people. The real test of the national drugs strategy will be whether the Government is ready to put the serious resources into the front-line services that actually help people to escape from addiction and to move forward with their lives.
“Massive cuts were implemented in services since 2008 and none of the funding has been restored proportionately. Staff working in drugs services have had their pay cut and frozen. Since they are in the community and voluntary sector, funded through section 39, about which we all know, they are not getting the pay restoration that public servants are getting in the HSE.
Rent costs and insurance costs have increased and many of the services are on their knees. At the same time, as I said at the outset, the number of people presenting to services with drug addiction problems has grown enormously.
“Simply decriminalising substances in the absence of funding for addiction services would be a dereliction of duty by the Government and the Minister of State and would lead to anarchy. There is a need for the creation of proper working conditions for those who provide addiction services. They need proper working conditions like me, the Minister of State and everyone else. There should be some standardisation among addiction workers to ensure minimum quality standards. That would involve a lot of training and the development of addiction practitioners. It would also have to include pay grades and career opportunities equivalent to those enjoyed by HSE workers. That is simply not the case now. It is part of the problem when it comes to the provision of services because we cannot get the people.
“The new national drugs strategy is going to be health-led but the HSE is not in a position to lead on this topic. We need to think outside the box because if we just throw it in as part of the mix of what the HSE is meant to be doing, we will still be here. We will have a nice, shiny document but no implementation. Therefore, we need to think outside the box and create a different format and pathway for dealing with this issue.
“There are political challenges to do with drug addiction that require clear political leadership. This returns me to my point that we do not always get to be in government for long. This is the opportunity of the Minister of State, who I acknowledge has a passion for this issue. She should please try to deal with it. She needs to deal with it and put up the money to develop addiction services. She should put in place the right format and the right organisation and should ensure it provides services nationwide and not just in Dublin.
“Services in many of the prisons are simply not working. The number of prisoners addicted to drugs who are not being provided with the services they need will become a significant issue. I also believe many of the people working in the Prison Service are being treated appallingly where they have to deal with prisoners in this situation but the backup services are not available. When they do find people in possession of drugs, sometimes they feel they are the ones who are getting into more trouble than those who are bringing them in or carrying them within the prisons. The whole issue of drugs in prisons, how those who work in the Prison Service are being treated and the lack of services has been left behind. It will blow up in our faces.”