Poor results for addicts from €140m drugs scheme

An examination into the €140 million spent by State agencies on drug treatment services has found a very small proportion of heroin-users on methadone maintenance ever get off the drug.
About 8,000 people in the greater Dublin area are on methadone maintenance, the main form of treatment for heroin addiction, according to a special report by the Comptroller Auditor General. However, it is estimated annually that about 1.25 per cent progress to detoxification treatment or follow-on rehabilitation.
The report says there are no national targets for treatment progression and calls on health authorities to set objectives to help provide better planning. However, it acknowledges that long-term methadone treatment is likely to be the best outcome that can be achieved for a significant proportion of heroin users.
It is one of a series of often critical findings in a report which raises questions about how effectively the Government’s National Drugs Strategy is being implemented. Other key findings in the report are:
* About 460 people were waiting over a year for methadone treatment in April 2008. The official target is to provide treatment within a month of assessment.
* Cannabis and cocaine use is increasing, but there has not been a proportional increase in the number of cases treated for problem-use of these drugs.
* Non-opiate drug users in the capital are less likely to get treatment than elsewhere in the country, possibly due to the heavy focus on opiate drug treatment services in Dublin.
* Drug treatment courts – where drug use may be a contributory factor in offending – handled just 22 cases a year, rather than about the 100 originally envisaged. The completion rate of this programme is just 17 per cent.
Responding to the report yesterday, Fine Gael’s community affairs spokesman Michael Ring TD described the drug problem as a “national crisis” and said Government spending cutbacks on treatment services would create massive problems in the future.
“We have a drugs time bomb, just when the Government is cutting back on treatment services,” he said. “The budgets for local drugs task forces have been slashed by 20 per cent, while funding for the Government’s own drugs advisory board has been slashed by 23 per cent.”
The report itself raises questions about whether the aims of the National Drugs Strategy – which is aimed at improving and co-ordinating the delivery of treatment of preventative services – are being reached.
The strategy, for example, envisaged that treatment would be based on a “continuum of care” model, which would co-ordinate services and provide for a better transition between different phases of care.
However, it says health authorities have still not put in place a national framework for care planning and management across the State. This would play a key role in providing wider social support – such as accommodation, education and training – to people with drug use problems.
The report also says it is important for local drugs projects to be governed by service level agreements that specify the services to be provided and the standards to be met. In addition, it calls for greater transparency on the cost of treatment and rehabilitation services, and says responsible agencies must provide more information on the effects of their actions or services.
The report says that more research is needed to continue evaluating the effectiveness of drug treatment services. While it says good and informative work has been done in the past, it is important to do follow-up studies to identify long-term outcomes for those in receipt of treatment.
Source:IrishTimes.com 6th June 2009

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