© Merchants Quay Ireland 2011 Joint Committee on Health and Children A Submission From Homeless & Drugs Service 15th September 2011 www.mqi.ie © Merchants Quay Ireland 2011

MERCHANTS QUAY IRELAND Merchants Quay Ireland is a voluntary organisation working towards the elimination of homelessness and the development of effective treatment and support services for drug users. The services we currently offer include: Crisis contact centre/health promotion unit National Addiction Counselling Service for the Irish Prison Service Structured day programmes Methadone treatment 3 month residential drug treatment programme (incl. assisted detox) 3 month farm based residential therapeutic community Reintegration and employment programme Training and research services Food centre offering two meals per day and washing and shower facilities Primary Health Care services: GPs, Nurses, Dentist, Counsellors, Podiatrist. Settlement Service Transitional Housing Projects In 2010, we worked with over 5,000 drug users and people who were homeless. © Merchants Quay Ireland 2011

EXTENT OF THE DRUG PROBLEM IN IRELAND Current prevalence: Estimated levels of between 18,136 and 23,576 drug users nationally (Kelly et al 2009) Drug Use outside of Dublin: Health Research Board study estimated that drug use outside of Dublin had quadrupled over a 4 year period (H.R.B. 2004) © Merchants Quay Ireland 2011

© Merchants Quay Ireland 2011 TREATMENT UPTAKE Currently nearly 10,000 people on Methadone treatment nationally (HSE 2010) Increase from 1861 people in 1996 to nearly 10,000 people in 2010 (C.T.L. 2010) © Merchants Quay Ireland 2011

© Merchants Quay Ireland 2011 TREATMENT WORKS ROSIE Study In Ireland (2006) demonstrated: Improved physical and mental health Increased social functioning Reduction in illicit drug use Reduction in criminal and anti-social behaviour Garda Research Unit (2003) demonstrated Significant decrease in criminal activity associated with treatment engagement N.T.O.R.S: British Home Office Study (2001) demonstrated 50% reduction in criminal activity Greatest reduction among most active offenders Estimated £1 spent on treatment yielded £3 savings for the criminal justice system Increased to £9 saving when health and social welfare costs included © Merchants Quay Ireland 2011

CURRENT GAPS / OUTSTANDING ISSUES Needle Exchange Services: lack of access, particularly at regional level Waiting lists: Access to treatment extremely patchy – with waiting times of over 1 year in some areas Detoxification: Less than 50 dedicated inpatient beds for estimated 20,000 drug users © Merchants Quay Ireland 2011

CURRENT GAPS / OUTSTANDING ISSUES (cont.) Rehabilitation: lack of access to day and residential services Rehabilitation of Offender Act: Mechanism for expunging criminal convictions Other Drug Use: Problematic use of prescription medications Poly drug use

© Merchants Quay Ireland 2011 RECOMMENDATIONS Needle exchange services should be expanded to cover all areas affected by problem drug use. Waiting lists for access to drug treatment should be reduced to bring waiting time down to a maximum of four weeks. An immediate increase in the number of dedicated detoxification beds available to those seeking to become drug free. An increase in the number and geographical spread of dedicated detoxification beds. An immediate increase in the number of dedicated rehabilitation places Develop a Rehabilitation of Offenders Act. Develop measures to ensure increased awareness of problematic use of prescription drugs and poly-drug use. © Merchants Quay Ireland 2011