p.50. A health-led approach to drugs misuse

Substance abuse and addiction affects people from all walks of life. By treating the use of substances as a public health issue, rather than solely as a criminal issue we can better help individuals, their families and the communities in which we all live. We are concerned about the increasing prevalence of the illegal drug use over recent decades. 

The National Drugs Strategy, Reducing Harm, Supporting Recovery 2017-2025, provides a roadmap to achieving these aims by promoting a more compassionate approach to people who use drugs, with addiction treated first as a health issue. 

The Drug and Alcohol Task Forces (DATFs) play a key role in implementing this strategy and increasing access at local level to harm reduction initiatives. We will examine how we can continue to support them in identifying local need in communities, and support targeted initiatives addressing drug and alcohol misuse. 

Recognising the link between drugs and mental health, we will ensure a representative of the National Oversight Committee for Reducing Harm, Supporting Recovery is included in the implementation and monitoring arrangements for Sharing the Vision – a Mental Health Policy for Everyone, a new national mental health policy. 

We will implement the recommendations of the Working Group to Consider Alternative Approaches to the Possession of Drugs for Personal Use, as an important step in developing a public health led approach to drug use in this country. This approach will connect people who use drugs with health services and a pathway to recovery, avoiding a criminal conviction, which can have far-reaching consequences for people, particularly younger people. We will undertake a review of this alternative approach to ensure it is meeting all of its aims, following the first full year of implementation, and make any necessary changes. 

In addition, we will:

• Examine the regulations and legislation that apply to cannabis use for medical conditions and palliative care having regard to the experience in Northern Ireland and Great Britain.
• Convene a Citizens’ Assembly to consider matters relating to drugs use.
• Build on recent initiatives at junior and senior cycle and support secondary schools in introducing drug and alcohol awareness programmes, particularly in relation to the hazards of casual drug use.
• Recognising the additional risk faced by people who use drugs, specific actions have been taken to support increased and improved access to opioid substitution services during COVID-19.
• We will seek to retain these measures to reduce waiting times in accessing these services.
• Examine approaches to identifying at risk young people and vulnerable groups to interrupt their potential trajectory into problem drug and alcohol misuse.
• Increase and support drug quality-testing services, particularly at festivals.
• Recognising that women can face barriers to accessing and sustaining addiction treatment, arising from an absence of childcare or the presence of domestic violence, develop targeted interventions aimed at responding to their needs.
• Expand services for pregnant and post-natal women affected by substance use, and their children.
• Examine the potential for an information campaign on the health impacts of steroid use, particularly on young men.
• Create a path for people in rehabilitation from drug addiction to access education and training facilities in their local areas.
• Re-establish the Galway City Community Based Alcohol Treatment Service.
• Progress the National Clinical Programme for Dual Diagnosis and work to develop joint protocols and referral pathways.
• Support the Drug Related Intimidation Reporting Programme, developed by the National Family Support Network, in partnership with An Garda Síochána, to respond to the needs of drug users and families facing the threat of drug related intimidation.
• Establish a 24-hour helpline based on the FRANK helpline in the UK providing advice and assistance to people who use drugs and their family members.
• Develop health and social interventions based on an inclusion-health approach to target people who are homeless and in addiction.
• Ensure in-reach supports and pathways to access to treatment for homeless, traveller and new communities.
• Increase the number of residential treatment beds for those stabilising, detoxing and/or seeking drug-free services.
• Significantly increase support for ‘step-down’ accommodation to prevent high-risk single people and families, exiting treatment into homelessness.
• Reduce the number of lives lost through overdose by opening a pilot medically supervised injecting facility in Dublin City.
• Support roll-out of access to and training in opioid antidotes.
• Ensure a ‘Good Neighbour’ policy for drug treatment centres to address any concerns held by local residents and businesses alike.
• Legislate against the coercion and use of minors in the sale and supply of drugs.
• Continue to resource harm reduction and education campaigns aimed at increasing awareness of the risks of drug use and the contribution of drugs to criminality.

P.48

Tobacco and Nicotine
• Increase the excise duty on tobacco in the years ahead to further discourage smoking.
• Bring in a targeted taxation regime to specifically discourage ‘vaping’ and e-cigarettes.
• Ban the sale of nicotine-inhaling products, including e-cigarettes, to people under 18 years, introduce a licensing system for the retail sale of nicotine-inhaling products and restrict the types of retailers who can sell these products.
• Curb the advertising of nicotine-inhaling products near schools, on public transport and in cinemas.

Alcohol
• Continue to implement the Public Health (Alcohol) Act and honour our longstanding commitment to introduce minimum unit pricing in consultation with Northern Ireland.

p.86

Gambling

We will establish a gambling regulator focused on public safety and wellbeing, covering gambling online and in person and the powers to regulate advertising, gambling websites and apps.