AS WE MOVE TOWARD the general election, attention will increasingly be focused on party manifestos.
In 2015, Ireland has made great strides in drug policy under the stewardship of Aodhán O’Ríordáin; the gains we have made in the area are indicative of the importance of having a Minister of State with specific responsibility for the National Drug Strategy.
However, with the current National Drug Strategy only running to the end of 2016 and the process to determine the next strategy already underway, it is important that the positive focus remains and that parties include a comprehensive response to drugs and drug use in their manifestos.
This is critical for a number of reasons.
First, drug policy is not simply about drugs.
The renowned addiction expert Professor Griffith Edwards once noted that dealing with drugs is only partly about dealing with the drugs themselves, but is also to do with what life can offer that is as good as, or better than, intoxication.
This remains true today, and many people see intoxication as their best option.
Drug use, mental health, homelessness, social inclusion, poverty (and this is not an exhaustive list)… these are all interrelated issues. Addressing one doesn’t address the others, but it does help. We need a comprehensive approach across all areas if the state is to provide as much value to the taxpayer as is possible in dealing with these issues.
Second, Ireland has serious issues in these areas to address.
The Health Research Board released the figures for 2013 in relation to drug related death recently – there were 679 deaths, 387 of which were overdoses and 292 were trauma related.
Many more people die by overdose every year than do on the roads. And death related to drug use (as is also the case with road deaths) is only the tip of the iceberg – every death affects many lives; and for every death there is much non-fatal harm suffered.
The most recent population study carried out in 2010/11 showed 27% lifetime use of any illegal substance among Irish people. Surveys like this take place every 4 years, so we await the latest figures, but if we take drug-related deaths as an indicator, we might expect that use in the general population will not have decreased.
Third, there are significant gains to be made from focusing on evidence-based policy.
For many years, drug policy has been expensive and ineffective, partly because its focus has been on unattainable goals. The reality is that no country has a drug policy which results in no drug use and hence no drug related harm. Pursuing goals like that is foolish, not because such goals are not noble – they are – but because having goals which are noble but ultimately unattainable leads to harm elsewhere as we relentlessly pursue an illusion. We have decades’ worth of evidence from around the world to guide us; we need to follow it, as we have been doing in 2015.
And what does this mean for drug policy in Ireland? Well, while drug use within society is complex, we can make a couple of general statements.
First, it is now commonly accepted that drug use is best addressed as a health policy issue and not a criminal justice one. Much of the debate about decriminalisation often misses the point on this, as it assumes that criminalisation serves to deter people from using drugs. It does not. The fact is that how punitive a society is in its approach to drug policy is not really linked to levels of drug use in the population. The reason society criminalises behaviours is surely to discourage those behaviours. However, drug policy really only has a marginal impact on levels of use, both general and problematic.
Given that this is the case, why criminalise? It’s both ineffective and expensive, and has a number of negative consequences such as the impact on employability arising from a criminal conviction. It’s much better to focus on providing healthcare interventions which can have a measurable and positive impact to individuals, families and society. People who want to ‘get tough on drugs’ by criminalising people who use drugs are really just in favour of wasting taxpayers’ money.
Second, there are gaps in the Irish system which need to be addressed.
At Ana Liffey, we’ve been campaigning for the introduction of medically supervised injecting centres, and it’s great that the cabinet recently made a policy decision to implement legislation to permit their operation in Ireland. They are an important intervention that will improve health outcomes and save taxpayers money.
What opposition I have seen in relation to our lobbying in this area has typically taken the form of the argument from personal incredulity (I don’t see how it can work, therefore it won’t work); or a general assertion that we should be doing something else instead. This is a red herring – we should do something because the evidence exists that it is a good intervention. Given the importance of the issue, we should do all such interventions – we shouldn’t settle for either/or arguments.
And there are intervention gaps across the Irish drug services landscape which require to be filled. For people who are actively using we need to ensure adequate access to needle exchange and to opioid substitution. We need to provide services that are shown to increase access to treatment like supervised injecting centres. We need to provide services that meet the needs of people.
Many people we speak to express a wish to live a life without drugs; we should be able to support them in attaining this goal. That means moving away from a model of only providing residential treatment for people who have been successful at stabilising in the community, and towards a model of providing residential support to people who have not been able to stabilise outside a residential setting.
We also need to ensure that aftercare supports are available to people leaving residential treatment and they are supported to develop the social capital which helps prevent a return to drug-using lifestyles.
However, none of these are conflicting goals – these are not either/or situations. We need to do it all. While a drug free lifestyle is a fantastic goal for someone, it is not a realistic goal for everyone at all times.
For people who are actively using, we need to focus on their health. After all, you can’t help someone who is dead. However, if and when people wish to make positive change, they need to be supported in that.
Finally, we need to be pragmatic.
Drug use isn’t going away. We cannot end the harm associated with drug use; thinking we can is arrogant and leads to potentially damaging policy choices. What we can realistically seek to do is to minimise the harm drug use causes in society – in dealing with the individual, this means a focus on health, a focus on the person, and a focus on ensuring that the appropriate services are available for people as and when they need them.
This is the response that will provide the best outcomes to individuals and the most value to the taxpayer.