Ireland Citizens’ Assembly on Drugs – time to shift focus from ‘failed policy’ to future solutions?

More than one person dies every day from drugs in Ireland, members of the ongoing Citizens’ Assembly have heard, leading to calls for its focus to shift from symptoms to solutions. 

Members of Ireland’s Citizens’ Assembly on Drug Use have heard how over 400 people died from drug-related deaths in Ireland in 2020.

The third meeting of the Assembly, which took place in Malahide over the weekend of 24-5 June, focused on the role that health and community sectors play in drug policy.

Dr Suzi Lyons of the Health Research Board (HRB) gave a presentation on the latest figures on deaths directly related to drug deaths in Ireland, not including those involving alcohol only. 

“From 2017, there’s been a sustained increase in the number of poisoning deaths reported in Ireland,” said Lyons. 

“They’ve increased from 340 in 2017 to 409 poisoning deaths in 2020. For 2020, this equates to approximately 12,000 potential life years lost to Irish society. We do know also that half of those who died from poisoning had a mental health issue.”

She added: “Six in 10 were men, but for 2020 we also see an increase in the number of women who have died as a result of poisoning deaths, and this is a worrying trend that we need to investigate further.”

Almost all (eight in 10) poisoning deaths involved more than one substance. Opioids were the most common drug involved, followed by benzodiazepines, other prescription drugs including antidepressants and pregabalin, and cocaine. Alcohol was linked to two in 10 deaths, in the presence of other substances. 

The most common cause of ‘non-poisoning’ drug deaths reported was suicide by hanging, with cannabis said to be the most common drug used by this group of people, followed by cocaine. 

Later during the Q&A session, Lyons said: “Internationally we know that cannabis is rarely, or ever, implicated in poisoning deaths, it’s a different type of drug, but where we are seeing cannabis is those people who died as a result of hanging, we know that cannabis was the drug most commonly used by that group. 

“While we may not make a direct connection, it’s very clear in the international research that people who use drugs are a much higher risk of suicide than the general population.”

Hard to reach services 

Chair Paul Reid said the figures were a ‘wake up call’ for the country.

“The HRB statistics show that it is not only heroin that is a key factor in these deaths but also methadone, powder cocaine, crack cocaine, benzodiazepines and other prescription drugs. Poly-drug use is clearly a huge part of the problem, and dual diagnosis seems to feature in half of the deaths,” he said.

“This is all grim news. When the problem is shifting rapidly we need equivalent change in our approach to national policy and delivery of necessary services.”

On Sunday members heard calls for better coordination of drug recovery and treatment services. 

Experts shared how people recovering from drug use require a broad range of healthcare, housing, education and training, financial, justice and support services, all of which are delivered by multiple agencies and bodies.

Members were told that this situation often causes confusion, inconsistencies, and gaps in how these services are delivered that are detrimental to the recovery of the person receiving them. 

The Assembly also heard from health experts from Portugal and Austria on the national policy approaches towards drug use that have been adopted in these countries. Contributors urged members to consider making strong recommendations that address the coordination gap.

Nuno Capaz, general directorate for Intervention on Addictive Behaviours and Dependencies (SICAD) in Portugal, said: “One of the good examples that we [can] give from Portugal is decriminalisation, I think this should be followed everywhere… but I don’t think that is the most important change we made.

“The most important change we made was in 2000, to create a specific structure under the Ministry of Health, to coordinate everything related with drug policy… from prevention campaigns to harm reduction programmes, treatment accessibility and reinsertion programmes, to the decriminalisation system. It’s all coordinated under the same structure.” 

He added: “You need all the pieces together to see the full picture.”

READ MORE: Decriminalisation likely to be ‘key recommendation’ of Ireland Citizens’ Assembly on drugs

Following a number of meetings over the course of the year, the Assembly will be required to submit a report and recommendation(s) to the Houses of the Oireachtas. Experts previously told Cannabis Health that it is already clear that decriminalisation is likely to be a ‘key recommendation’.

Time to start addressing the solutions? 

As the Assembly reaches its halfway point, some following its progress closely say it’s time to move on from discussions around Ireland’s ‘failed drug policy’ and start focusing on strategies and potential solutions.

The majority of the discussion continues to focus on the harms of drug use, with little mention of the 90% of ‘non-problematic’ use. There has also been no discussion around access to medicinal cannabis, which remains an issue for thousands of patients in Ireland. 

Drug reform advocate and chair of the Cannabis Industry Council’s Ireland subgroup, Peter Reynolds, said: “It’s time to move on from talking about the symptoms of Ireland’s failed drugs policy and address the causes.”

In an email to the chair, Reynolds says that while the sessions have been ‘immensely valuable’ in providing an insight into the realities of problematic drug use and the lack of funding and support for services, it’s now time to talk about future drug policy. 

He writes: “Surely, it is this strategic issue that the assembly should be working on? Future drugs policy, which likely depends on the outcome of this assembly, cannot be dominated by a small minority of problematic users. 

“We have heard nothing of the benefits of safer recreational drugs than alcohol, nor about better access to medicinal cannabis.”

Members of the public and stakeholders have until the end of June to make submissions to the Assembly, all of which will be shared with the members throughout the process. Over 400 submissions are said to have been received so far.

These should be based on your opinion, informed by evidence and/or by your own experience, on any issue that falls under the Terms of Reference of the Assembly, with more information on how to submit something here.

The next meeting of the Assembly is scheduled to take place in September. You can catch up on the coverage from previous meetings here. 

Want more stories like this delivered direct to your inbox? Sign up for our free weekly newsletter here.

• ‘Grave concerns’ over handling of Ireland’s Citizens’ Assembly on drugs
• Hundreds submit evidence to Ireland’s Citizens’ Assembly on Drugs – here’s how to make yours
• Decriminalisation likely to be ‘key recommendation’ of Ireland Citizens’ Assembly on drugs
• Ireland former health boss to chair Citizens’ Assembly on drugs
• Ireland Citizens’ Assembly to hear voices of those affected by drugs