HEALTH MATTERS 65
Addiction ServiceS
needs. The range of interventions available of the country where drug usage has
includes: Stabilisation measures; harm increased significantly in recent years.
reduction; care planning; methadone (With respect to methadone maintenance
maintenance; counselling and detoxification therapy, while there are approximately 600
within specialist clinics, residential clients on waiting lists, over 10,000 clients
settings and within community settings. In received methadone in 2008.) To address
addition, HSE mainstream services such this issue, the HSE has made in excess of
as emergency response, acute hospitals €2 million available to support a range of
and mental health services, address the key service developments. This has been
treatment needs of individuals who misuse augmented by capital funding from the
alcohol and other substances and who avail Dept. of Community Rural and Gaeltacht
discussing and agreeing this programme of these services. Affairs, which will enable the establishment
with the Health Service Executive.” of six new clinics in HSE South.
Demand for addiction services in Ireland examples of service spenDing Last year 274 General Practitioners (GPs)
has been on the rise for several years In 2008, approximately €102 million was and 496 pharmacies participated in the
now. In 2003 there were 11,515 cases spent by the HSE on specific addiction methadone maintenance scheme. An online
in treatment and by the end of 2008 this services, representing an increase of over GP training module is available through
figure rose to 14,743, an increase of 28 €45 million from 2001 funding levels. the Irish College of General Practitioners
per cent. The rise in cases is the result This level of expenditure has enabled the to assist with the recruitment/retention of
of a combination of factors, including HSE to: GPs at community level to facilitate transfer
an increase in numbers presenting for • Exceed the National Drugs Strategy of clients from HSE clinics to community
treatment, an increase in the number target of 6,500 places for the provision of based provision. The HSE also intends to
of treatment places available and an methadone treatment places, with a 75 recruit an additional Liaison Pharmacist to
increase in quality of reporting to the Health per cent increase from 4,963 places in support pharmacies outside the greater
Research Boards, National Drug Treatment 2001 to 8,662 places in 2008; Dublin area to participate effectively in the
Reporting System. Similarly, expenditure • Develop innovative responses to facilitate methadone protocol.
on addiction services provided by the HSE the rollout of needle exchange in order While methadone maintenance is the
and in partnership with the community and to provide countrywide access to these main form of opiate treatment, the HSE
voluntary organisations has increased year services; in collaboration with the Department of
on year. • Develop appropriate responses to Health and Children, is currently conducting
Problematic drugs use is complex in its emerging needs within existing resources, a Suboxone (alternative opiate treatment)
causes, impacts and outcomes. Numerous for example cocaine and polydrug misuse. feasibility study and it is anticipated to have,
social and psychological factors interact There are challenges with respect to by year end, 80 clients in treatment in both
to bring about the emergence of a drug waiting times for treatment in certain parts clinic and community based settings.
problem. Different individuals may use
different drugs, or combinations of drugs,
and depending on the characteristics of organisational structure
the user and the context in which they find
themselves using drugs, very rarely are The HSE has statutory responsibility This structure is flexible and readily
two cases the same. Different drug-users for the provision of an integrated range transferable to the new integrated service
also respond variably to the wide range of preventative and therapeutic drug model currently being developed within
of treatments and supports available to treatment services, including harm the HSE. To complement this, there is a
them, and do so at different times and reduction interventions to meet the dedicated Social Inclusion Unit located
to varying degrees. Drug-users seldom diverse health and social care needs within the Integrated Service Directorate
exist in isolation - they are family, friends of service users. It discharges this which assists the operational wing with
and community members. In turn, each responsibility in conjunction with the regard to the performance and delivery
of these social circles is affected by, and voluntary and community sectors, of these services in compliance with
in turn affects, the drug-user and the where appropriate. relevant legislation, key policy and reports,
consequences of his/her drug use and The HSE addiction services are for example, the National Drug Strategy,
treatment outcomes. fundamentally managed by a network Report of the Working Group on Drugs
For example, individuals in treatment of Area Operation Managers/Regional Rehabilitation and Report of the HSE
for opiate related issues receive a full and Drug Coordinators (10 in number), Working Group on Residential Treatment
comprehensive assessment not only in across clusters of local health offices. & Rehabilitation (Substance Abuse).
terms of medical but also psychosocial
health matters is 4.indd 65 27/11/2009 20:48:04
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