More than 70 people with heroin dependence attend a methadone clinic in Galway, a meeting of the HSE West’s regional health forum was told recently. Methadone, an opioid substitute, is used to help treat people who are addicted to heroin.
The service, which is run by the HSE West’s Community Healthcare department, operates in the city and is staffed by four sessional GPs and 1.5 nurses.
The local health authority also finances 20 treatment beds in Hope House Drug and Alcohol treatment centre in Foxford, Co Mayo. Funding is allocated as well to individuals on a case-by-case basis for referral to specialist treatment centres when this cannot be provided locally. In addition, counsellors throughout the region work individually with clients and their GPs to enable clients access appropriate treatment pathways.
Tony Canavan, the chief officer of the HSE’s Community Healthcare West, outlined that there has been a “significant increase” in drug related deaths nationally. He said the reason why there was not a correlated increase locally was due to the fact that clients are not only receiving stabilisation by opioid replacement treatment but they are also availaing of the psychosocial support associated with clinic attendance, and by extension access to other required services.
“In general, the increase in drug related deaths from overdose is undoubtedly associated with poly substance misuse. When drugs are mixed there is an interaction known as synergistic potentiation where there is an additional chemical impact (more than the simple addition of the effects of the two drugs ). This actually increases the chemical effect of both drugs and so their effect is magnified creating greater overdose risk. Added into this problem is the fact that a lot of the drugs taken are bought on the street and so their pharmacological components are variable and uncontrolled, further increasing risk. Alcohol and drug use is also a significant problem.”
He pointed out that the use of benzodiazepine has been on a “sharp increase” for a number of years. He said unfortunately most of these are bought on the street or online and have been found to contain other properties, for example, codeine.
“These drugs are not alone becoming more addictive but they are becoming more available and in greater demand among illicit drug using populations. The greatest portion of the deaths referred to would appear to relate to those who are not actively engaged with services and providing treatment for those that are not ready to engage, tends to be modest in its return.”
Mr Canavan added that the formal medical prescribing of painkilling and benzosiazepine medications needs to be continually monitored and international guidelines around these practices need to be followed as this can be the beginning of the journey to chronic addiction.
He concluded that in terms of addressing the problem a community detoxification programme is in operation to address benzodiazapine misuse.