IRELAND New Developments, Trends and In-Depth Information on Selected Issues
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2004 NATIONAL REPORT TO THE EMCDDA by the Reitox National Focal Point IRELAND New Developments, Trends and in-depth information on selected issues REITOX Table of Contents Summary ....................................................................................................................3 Part A: New Developments and Trends...................................................................8 1. National Policies and Context .......................................................................8 2. Drug Use in the Population..........................................................................19 3. Prevention .....................................................................................................24 4. Problem Drug Use.........................................................................................30 5. Drug-Related Treatment ...............................................................................40 6. Health Correlates and Consequences ........................................................51 7. Responses to Health Correlates and Consequences................................58 8. Social Correlates and Consequences.........................................................71 9. Responses to Social Correlates and Consequences ................................81 10. Drug Markets .................................................................................................83 Part B – Selected Issues .........................................................................................94 11. Buprenorphine: treatment, misuse and prescription practices............94 12. Alternatives to prison targeting to drug using offenders......................96 13. Public Nuisance: definitions, trends in policies, legal issues and intervention strategies.......................................................................................110 Part C ......................................................................................................................121 14. Bibliography ............................................................................................121 15. Annexes ...................................................................................................131 2 ACKNOWLEDGEMENTS This report is very much the result of collaborative work within and outside the Drug Misuse Research Division. We would like to thank very sincerely those people working in the drugs area who gave generously of their time to inform us about recent developments in their areas of work. It is not possible to name all these people but the agencies with which they are affiliated are acknowledged as follows: Department of Health and Children; Department of Community, Rural and Gaeltacht Affairs; Department of Justice, Equality and Law Reform; Department of Social and Family Affairs; Department of Education and Science; An Garda Síochána; Forensic Science Laboratory; Customs Drug Law Enforcement; Health boards and drug treatment facilities; Voluntary and community groups and academic researchers. We would specially like to thank the following: Mr Tony Barden, Dr Joe Barry, Mr Robin Broni, Ms Miriam Conway, Ms Caroline Corr, Dr Des Corrigan, Mr John Craven, Dr Mary Cronin, Mr John Fitzmaurice, Ms Mary Henue, Dr Timothy Jackson, Ms Mary Johnson, Mr Dermot Kavanagh, Dr Eamon Keenan, Dr Alan Kelly, Mr John Kelly, Ms Louise Kenny, Ms Martina Kidd, Ms Mairead Lyons, Fr P. McVerry, Mr David Moloney, Mr Cathal Morgan, Ms Louise Mullen, Ms Alice Murray, Ms Frances Nangle, Dr Ian O’Donnell, Dr Dan O’Driscoll, Ms Aileen O’Gorman, Dr Paul O’Mahony, Dr O’Sullivan, Mr Andy Ogle, Mr John Power, Ms Fionnuala Rafferty, Ms Patsy Richardson, Ms Veronica Ryan, Dr Bobby Smyth, Ms Kathleen Stack, Dr Bríon Sweeney and Dr Lelia Thornton. Finally we would like to express our sincere thanks to our colleagues at the Drug Misuse Research Division: Mary Dunne who compiled this document and managed its production; Louise Farragher, Brian Galvin, Fionnola Kelly, Ena Lynn, Joan Moore and Damien Walshe who provided a stimulating interdisciplinary milieu, some of the benefits of which, we hope, appear in these pages. Dr Hamish Sinclair Head of Division This report was written by: Johnny Connolly Martin Keane Jean Long Brigid Pike Hamish Sinclair Please use the following citation: Drug Misuse Research Division (2004). 2004 National Report to the EMCDDA by the Reitox National Focal Point: Ireland; new developments, trends and in-depth information on selected issues. Health Research Board, Dublin. 3 Summary This report, written following EMCDDA guidelines1, is divided into two parts. The first part (Part A) provides an overview of new developments and trends in the drugs area in Ireland for 2003 and in some cases the first six months of 2004. These are covered under the following headings: 1. National policies and context 2. Drug use in the population 3. Prevention 4. Problem drug use 5. Drug-related treatment 6. Health correlates and consequences 7. Responses to health correlates and consequences 8. Social correlates and consequences 9. Responses to social correlates and consequences 10. Drug markets The second part (Part B) examines three specific issues considered to be important at a EU level. The three issues are: 1. Buprenorphine: treatment, misuse and prescription practices 2. Alternatives to prison targeting to drug using offenders 3. Public nuisance: definitions, trends in policies, legal issues and intervention strategies The following are a number of new developments and key findings in the drugs area in Ireland that occurred or were made available during 2003 and the first six months of 2004. • The National Drugs Strategy 2001–2008 and An Agreed Programme for Government (2002) continue to provide the Irish government’s framework for addressing the drugs issue. • Despite calls from a variety of sources for the merging of the national strategies for alcohol and drugs, the government has continued to prefer co-ordination rather than integration. • A co-ordinating framework within each Garda (Police) District, to liase with the community on drug-related matters and to act as a source of information for parents and members of the public, has progressed during the last 12 months. • Since 2002 initiatives have been set in train to access additional public funds and to identify and tap into new sources of funding for social inclusion issues, including drug misuse. These include the establishment of the RAPID programme and the Dormant Accounts Fund Disbursements Board, and exploring possibilities in relation to using the monies and assets seized by the Criminal Assets Bureau and harnessing corporate social responsibility. • In light of the acknowledged growing prevalence of substance misuse (both illegal drugs and alcohol) among young people and children, aged 18 and under, public debate on the issue has been frequent and widespread. Among contributions to the debate have been explorations of approaches to deterrence – the use of diversions such as promoting sport and the arts, and providing alternative recreational 1 A copy of the EMCDDA guidelines is available from the EMCDDA’s website at www.emcdda.eu.int The guidelines require each Focal Point to write their National Report in a prescribed format using standard headings and covering each topic using a check list of items. This helps to ensure comparability of reporting across the EU. 4 opportunities – and proposals for the provision of clearer structures, guidance and support for young people. • The debate over the advantages and disadvantages of substitution therapies and harm reduction strategies versus abstentionist approaches to drug treatment, already highlighted in the 2003 National Report, has continued over the past 12 months. Two recently-emerging issues have been the question of the most appropriate treatment regime in prisons, and the need for responses targeted at poly-drug users. • In terms of drug use within the general population one in five adults (15-64 years) report ever using an illegal drug, one in eighteen report use within the previous year while one in thirty-three report use in the previous month. • Cannabis is the most commonly used illegal drug in Ireland. One in six adults (15- 64 years) have used cannabis in their lifetime. This increases to one in four for young adults (15-34 years). • Prevalence of other illegal drugs is lower and confined largely to the younger age groups. Almost twice as many men (24%) as women (13%) reported ever using an illegal drug. • In terms of problematic opiate use the most recent national estimate of the number of opiate users is 5.6 per 1000 persons aged 15-64 years. Rates are higher for men than women in all age categories. • Opiate use is still predominately a Dublin phenomenon. The rate of opiate use in Dublin in 2001 was 15.9 per 1000 persons aged 15-64 years and outside Dublin the rate was just under 1.2 per 1000 persons aged 15-64 years. • Process evaluation reports that an overloaded curriculum and industrial relations issues are obstacles against the implementation of Social, Personal and Health Education (SPHE) in secondary schools. • Evaluation of SPHE reports that a greater proportion of first year students in secondary school receive SPHE than students in third year. • Community groups are increasing their use of technology through websites to disseminate drug prevention information to communities. • Research into selective prevention education in schools reports that children relate well to local parents