THE DRUGS DEBATE - PART 1
Methadone programmes are not working
In the first of a short series of articles on the drugs crisis and strategies to tackle it, An Phoblacht's MICHAEL PIERSE interviews Dublin Sinn Féin representatives Daithí Doolan and Christy Burke, who argue for new treatment strategies for addicts and greater emphasois on education to prevent addiction.
Sinn Féin needs to ``touch base'' and begin re-engaging with communities on the issue of drug addiction, according to Dublin Sinn Féin chairperson and South East Inner City representative, Daithí Doolan.
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A recent report estimated that almost one in five 15- to 24-year-old males in Dublin's South East Inner City are heroin addicts
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``We need to give ourselves space to see where this whole thing is going. There is no other political organisation in this country with the will or ability to tackle the drugs issue,'' Doolin told An Phoblacht this week. ``With our growing strength comes a responsibility to re-engage.''
Dublin Sinn Féin councillor, Christy Burke, who has long been active on the issues of drug and alcohol abuse, agrees with this analysis. Burke, along with Father Jim Smyth of Dublin's North Inner City, was instrumental in the setting up of Concerned Parents Against Drugs (CPAD) in the early Ô80s, which effectively founded the anti-drugs movement in Dublin.
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The manner in which methadone maintenance is carried out by state treatment centres has had little success in bringing about complete recoveries for addicts
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``From the foundation of the CPAD in 1982, we've come a long way,'' he says, ``both in terms of gaining experience and knowledge ourselves and also in being effective at exposing the inadequate response of the state. Throughout the last 20 years, anti-drugs activists have been successful in exposing the government and the Gardaí for their failure to tackle this issue. Statutory bodies have also failed to provide sufficient programmes of recovery and residential treatment centres. Anti-drugs activists have saved lives, and must be applauded for their perseverance against all the odds.''
Burke believes that some of the approaches taken during the anti-drugs campaigns have been problematic, and in a small number of cases, reprehensible. ``The pressures put on individuals was immense,'' he says. ``Key activists had their energies drained. The time-consuming work of attending meetings upon meetings, pickets and marches and the pressure on communities to watch their own areas left people burnt out. Activists were mostly mothers, trying to rear families at the same time. For many people, frustration then set in.
``While the vast majority of people who got involved in the campaign deserve unstinted gratitude for their efforts, a number of tactics used by a very small element of the anti-drugs movement - of targeting young addicts who dealt heroin to feed their habits - failed and failed miserably. Families and communities were left bewildered as to why these addicts were being made the focus of attention, while main dealers continued their business. This small element didn't subscibe to the banner heading they marched behind: ÔAddicts We Care, Pushers Beware'. I would disassociate myself from that element. When dealing with such a big group of people as the anti-drugs movement was at times, you were bound to get people who were there for the wrong reasons.''
Burke says that there needs to be a realistic, pragmatic approach to the drugs crisis, which takes into consideration the massive attraction the drugs culture has for many young people. ``We have to remember that when young people have no lives and no prospects and they're offered £200 a day to sell drugs, they're very vulnerable to such offers. They're vulnerable targets. While a lot of energies have been focused by activists on tackling drug dealers, to some extent that's taking our eye off the ball. Community groups should put pressure on the Taoiseach and the Garda Commissioner to deal with drug dealers, but the real focus needs to be on rehabilitation and education.''
A number of difficulties, some of them persistent and some the result of a changing social and economic climate, are highlighted by both Sinn Féin representatives. Doolan, who is also employed as a community development worker in Dublin's Ballymun area, says that institutional indifference to the drugs problem in Ireland has been eroded to some extent, due to the resistance of communities at a local level.
``The health boards are coming around to the community's way of thinking,'' he says of some areas throughout the country, including the area he represents himself, Dublin's South East Inner City. Taken as a whole, Dublin's South Inner City area has a rate of heroin addiction a staggering eight times higher than that of the rest of the city. A recent report estimated that almost one in five 15 to 24-year-old males in the area are heroin addicts.
The introduction of more satellite treatment clinics has had a significant impact on the health boards' and governmental attitudes to the drugs problem. ``With the introduction of community-based programmes, the health boards have been forced to engage with local communities,'' says Doolan.
``In my own area, where we now have a monitoring committee including local representatives, there has been a five-year battle.'' Members of the Health Board have had to engage in ongoing consultations with Ringsend and District Response to Drugs (RDRD), of which Doolan is a member. Both bodies have been running programmes alongside one another. Whereas the streamlined Health Board procedures are essentially, based on a medical approach to the drugs problem, the RDRD approach is based on rehabilitation and family and community involvement. The RDRD input has helped change Health Board mindsets and has forced them to recognise that tackling heroin addiction is not just a matter of prescribing methadone, Doolan says.
``The Health Board's is a medical approach, the medicine is methadone. While that could be seen as polemically opposed to the approach of the RDRD, with a lot of work, we can meet in the middle.''
One of the difficulties Doolan identifies is the endless change in trends of abuse, supply and demand.
There is now less public visibility involved in taking and selling heroin - far less open dealing on street corners, far fewer addicts Ôbanging up' in public areas. The danger here, Doolin says, is that people are becoming less and less aware of the sheer scale of the heroin problem, in Dublin in particular.
Changing trends in the variety of drugs being used are a significant threat that communities and the authorities are not prepared for, he warns. Traces of crack cocaine have been found in Dublin. The drug is renowned in the United States for the volatile personality changes it induces in addicts - causing far more violence than heroin. Regular cocaine use is also on the rise. ``Cocaine is more the norm now,'' Doolin says. ``As it becomes cheaper, there is a real fear that we're not up to step.''
However, while not being Ôup to step' is a serious concern, the inability or unwillingness to tackle outstanding issues - issues that have been the focus of years of campaigning - is incredibly frustrating for activists, Christy Burke says.
The manner in which methadone maintenance is, and has for years, been carried out by Ôofficial' state treatment centres, has had little success in bringing about complete recoveries for addicts.
``I see methadone as a further addictive drug, rather than a solution,'' Burke says, pointing to the maintenance of former heroin addicts on methadone for protracted periods, sometimes years. The alternative to this, he says, may be found in a model of residential treatment, rehabilitation and medical facilities available at the DAYTOP treatment centre in New York. The centre, run by Catholic priest Monsignor O'Brien, is set in the notorious Bronx area of the city. Heroin addicts are housed in the centre for two years, after which they enter a three-year long after-care programme that is supported by the private sector, government agencies and statutory bodies. Burke, who himself visited the DAYTOP centre, says that their policy of starting addicts on a 40ml dose of methadone, which is eliminated within five days, is far better than the indefinite 150ml doses that are administered in the 26 Counties.
``Yes, this kind of treatment does cost money,'' says Christy. ``But if we don't spend large sums of money, all we're doing is putting a sticking plaster over a serious fracture.
``People here are left lingering on methadone for five or six years. I know mothers who go to money lenders to buy the £90 bottle of methadone on the black market and addicts who prostitute themselves for methadone. Methadone treatment must be re-evaluated - we still have a serious heroin problem on our streets.''
Burke took part in the setting up of the After-Care Recovery Group (ACRG) on Dublin's North Strand three years ago. He says this project, which has catered for 18 people in non-residential rehabilitation for the last two-and-a-half years, shows that simple community projects of its sort are ahead of government policy. The 18 former heroin addicts are now clean, some are now involved in computers, some have their children back, their own homes and are even seeking counselling positions to help other addicts in recovery. ``If three community representatives could set this up, then what can a properly resourced government do?'' he asks.
Both Burke and Doolan put a strong emphasis on the role of education in preventing drug addiction. They say that while direct education in schools on the effects of drugs is important, programmes must be put in place to encourage marginalised young people to engage more in the formal education process.
``Education has a key role in preventative measures,'' Burke says. ``Twelve and thirteen-year-olds are taking heroin and they have had no education on the effects of that drug. It's the same with alcohol and, taken in the context of most recent statistics regarding under-age drinking, this is a big worry. In the long term, alcohol can be as damaging as heroin.''
``Education, not just in the limited sense, has a key role in stemming alienation,'' Doolan says. ``We must include the community in education, we must build a culture of education. The lack of education leads to a lack of self worth and self confidence.''
Doolan points to the fact that the Department of Education does not sit on any local drugs task force. ``Communities are crying out for better standards of education. The fact that they aren't prepared to shoulder some of the burden on the drugs task forces is indicative of their view of themselves and their relationship with communities.''
With the flourish of low paid jobs fostered by the Celtic Tiger economy, there is a real problem with young people neglecting their studies or leaving formal education to take up employment, Doolan says. So much so that there were rumblings recently in the Irish Congress of Trade Unions for a campaign to expose businesses in Dublin that are encouraging young people to leave school. The recent ASTI annual conference discussed the same issue, with members expressing the view that increasingly schools are playing second fiddle to part-time jobs in young people's lives.
The inclusion of the same young people in the debate on drugs has been abysmal, Doolin says. ``Young people are not consulted. Even where there is consultation at community level, young people are being left out. It is almost as if certain people have an antipathy towards them. Anywhere we're engaged with anything, we need to be asking why they don't include young people.''
Along with the inclusion of young people, there must be a process of wide consultation leading to an agreed strategy for rehabilitation and prevention, Burke says. ``Community and political groups must get together and develop a strategy for change. If it means the saving of one life, I would consider that a job well done.''
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