Drugs strategy review finds staff shortages and disruption as charity urges Government not to abandon alcohol labelling
Meanwhile, the review found that annual funding arrangements and restrictive hiring policies have contributed to staff shortages and disruptions in service delivery.
The National Drug Strategy (NDS) is set out as a national framework for addressing substance use through a "whole-of-government, person-centred, and health-led" approach that primarily frames substance use as a public health issue.
An independent review of the strategy, published on Monday, found that several stakeholders also believe prevention efforts are underdeveloped, inconsistent and lacking national ownership.
The report compiled by Grant Thornton notes some progress and achievements but makes 10 recommendations for the future direction of the strategy.
The authors consulted with the Health Service Executive (HSE), the Health Research Board (HRB), members of the National Oversight Committee (NOC) and Strategic Implementation Groups (SIG) for the NDS, as well as service users and family members with lived experience of drug use.
Based on those engagements, it found that equity of access continues to be a concern, particularly for marginalised groups.
Prevention and early intervention efforts were found to be fragmented and inconsistently delivered, while recovery and service user involvement requires further formalisation and resourcing.
Additionally, the limited integration of alcohol policy and the "gradual implementation of legal reforms", such as alternative sanctions, were identified as areas requiring strategic refinement.
Meanwhile, governance structures were found to lack clearly defined roles, mandates, and accountability mechanisms.
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Stakeholders highlighted the need for strong national leadership, enhanced co-ordination across departments, and more inclusive decision-making processes that incorporate lived experience of service users.
There were also calls for enhanced data integration and the establishment of a national research and evaluation centre.
The report also details claims of inconsistent reporting from all treatment providers which is further constraining the ability to assess the strategy's effectiveness.
Stakeholders reported that high attrition rates have been observed in different regions due to factors including limited funding.
There were repeated calls by some stakeholders for multi-annual funding commitments and targeted workforce investment to support more consistent and sustainable service provision.
Prevention efforts were widely viewed as "under-resourced and lacking strategic focus".
There was an emphasis on the need for early, community-based interventions that address root causes, such as trauma, poverty, and social disadvantage.
Evidence shows that early life experiences significantly influence later substance use.
The SPHE programme in schools was repeatedly cited for its inconsistent delivery.
Many stakeholders also felt that the NDS lacked clarity and strategic direction regarding alcohol addiction.
The Minister for Health, Jennifer Carroll MacNeill said it is "essential" to assess how the more than 300 million euro in annual public expenditure on drugs delivers impact.
She said: "The establishment of new HSE health regions presents a valuable opportunity to tailor drug treatment services to population needs and to ensure that both existing and new funding is allocated effectively and transparently."
Meanwhile, Minister of State with responsibility for the National Drugs Strategy, Jennifer Murnane O'Connor, said: "We have made significant progress in implementing the national drugs strategy, and I'm pleased that the independent evaluation documents the many achievements over the last eight years."
She added: "The recommendations from the independent evaluation will inform the development of the successor National Drugs Strategy. We need to move forward with new policies and better services to address the ever-changing drugs situation."
Alcohol Action Ireland welcomed the publication of the independent evaluation.
Data included in the report shows that alcohol remains Ireland's largest drug problem by far.
73pc of the population currently consume alcohol compared with 7.3pc using any illegal drugs.
While there has been some reduction in the level of alcohol use by children, the report also points to high levels of hazardous and binge drinking by international standards particularly among men, the charity said.
The report also notes the high level of Alcohol Use Disorder (AUD) in the population with 20pc of drinkers having an AUD – approximately 600,000 people in Ireland.
AAI's CEO, Dr Sheila Gilheany said: "Alcohol is Ireland's largest drug problem with health impacts on individuals including cancer, heart disease and liver disease as well serious mental problems such as depression, anxiety, addiction and tragically also suicide.
"There are also many issues for families, particularly for the hundreds of thousands of children growing up with alcohol harm in the home – a trauma which can last a lifetime.
"Alcohol also places a heavy burden on the State with costs of at least €12 billion annually arising from health, justice and loss of workplace productivity.
"Despite these well recognised issues, alcohol policy in Ireland remains disjointed and often contradictory with some government departments seeking to enhance alcohol consumption through supports for the alcohol industry and pushing back against the well-evidenced measures from the Department of Health.
"Never has this been clearer than in the past few weeks with some cabinet ministers putting extreme pressure on the Minister for Health to delay the long-planned for introduction of alcohol health information labelling.
"Often using spurious arguments from the alcohol industry while pointing to the modest improvements in some aspects of alcohol consumption as a reason to abandon the well-evidenced policies rather than strengthening these policies.
"Abandoning labelling at this point would be particularly shocking and foolish, given the labels are already appearing on multiple products in shops across Ireland. Multiple health organisations, clinicians and advocates across Ireland and internationally have contacted the Minister and the Taoiseach in recent weeks to express their alarm at any such derailment of what is long settled policy.'
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