Estimating the prevalence of opiate use in Ireland and the implications for the criminal justice system
| Author | Julian Pugh,Jamie Saris,Catherine Comiskey |
| Published date | 01 March 2007 |
| Date | 01 March 2007 |
| DOI | http://doi.org/10.1177/0264550507060862 |
| Subject Matter | Articles |
Probation Journal
Article
The Journal of Community and Criminal Justice
Copyright © 2007 NAPO Vol 54(1): 22–35
DOI: 10.1177/0264550507060862
www.napo.org.uk
http://prb.sagepub.com
Estimating the prevalence of opiate use in
Ireland and the implications for the criminal
justice system
Catherine Comiskey, National University of Ireland
Jamie Saris, National University of Ireland
Julian Pugh, Stewarts Hospital, Dublin
Abstract Drawing upon innovative research methods this article provides the first
Irish estimates of opiate use based entirely on non-medical data. These estimates
are based on the report Baseline Findings from the ROSIE Study by Comiskey and
Cox (2005), commissioned in 2002 by the Irish Government’s National Advisory
Committee on Drugs (NACD). In order to place these estimates in context we first
provide a background to the probation and welfare service in Ireland; we then
provide a picture of known opiate use to date; and finally we introduce the methods
we used to provide new results on the prevalence of opiate users in Ireland.
Keywords drugs, Ireland, NACD, opiate use
Since the formation of the European Monitoring Centre for Drugs and Drug
Addiction (EMCDDA) in 1993 in Lisbon as the central source of information
on drugs and drug addiction in Europe, western industrialized nations of the
European Union have gathered together to provide best practice guidelines for
the monitoring, evaluation and prevalence estimation of drug use and in particu-
lar opiate drug use (EMCDDA, 1997b). This is not only a European phenomenon.
The United Nations have formulated an International Drug Control Programme
and have highlighted how research has been held back by the clandestine nature
of the drugs trade on whose hidden population data is inevitably partial and of
poor quality. Given these limitations it is encouraging to note the emergence of
the EMCDDA annual reports, which include tables of treated drug use. One-off
estimates of national and local prevalence have also been produced for a majority
22
Comiskey et al. ● Estimating the prevalence of opiate use 23
of existing member states (EMCDDA, 1997a, 1997c, 1997d). In addition Interpol
within the Drug Sub directorate acts as a centre for the collection, collation,
analysis and dissemination of drug-related information. However, the emphasis
has been on enumerating treated opiate users and estimating possible numbers
who may present for treatment in the future. Little or no prevalence estimates of
general opiate use based on crime data have been produced and no emphasis
has been placed on providing a methodology upon which to base these estimates.
There are some exceptions to this – for example Choi and Comiskey (2003)
recently produced the first opiate prevalence estimates in Western Australia based
on police crime statistics.
Background to the Probation and Welfare Service in
Ireland
The Probation and Welfare Service in Ireland, whilst not a drug treatment agency
per se, plays a major role in relation to addressing drug-related problems in the
criminal justice system. This is undertaken in partnership with agencies from the
voluntary and statutory sector and is underpinned by the National Drug Strategy
2001–2008 (Department of Tourism, Sport and Recreation, 2001). This strategy
is currently subject to a mid-term review. During 1998 the Probation and Welfare
Service undertook a survey of the 2183 offenders subject to supervision and
discovered that 56.39 per cent had a history of drug use (Probation and Welfare
Service, 1999). Only 43.61 per cent of the cohort had no known history of drug
abuse and 82.6 per cent of those with a known history had used drugs in the
previous 10 months.
The Probation and Welfare Service is also part of an inter-departmental initia-
tive, between the departments of health and justice, in supporting a pilot drug
court programme (Butler, 2002). Whilst initial outcome research of the programme
has been undertaken, a full cost benefit analysis of this programme has yet to
determine its efficiency (Farrell, 2002).
The main process by which the Probation and Welfare Service is used by the
courts is via the use of supervision during deferment of sentence rather than the
use of probation orders. There is an argument to suggest that supervision during
deferment of sentence has been an effective way of addressing offenders with drug
use problems over many years. This form of disposal involves the court hearing
the evidence, finding the charges proved and postponing sentencing on the
condition that the offender responds to probation officer supervision. The officer
is required to produce a report on a specified date to inform the court of what
progress has been made. Indeed, an offender may be subject to several adjourn-
ments before a final decision is made by the sentencer. This type of supervision is
used in both the district and circuit courts and an offender can be brought back
to court if they fail to comply with any conditions. This practice, which has no
legislative basis, allows courts to regularly review sentences whilst holding a sword
of Damocles over the offender, in terms of the possibility of a custodial sentence,
for offenders who do not display sufficient co-operation under supervision. This
24 Probation Journal 54(1)
form of supervision, whereby offenders are brought back to court for progress
reports, can also have a motivating influence and promote change. In 2002, there
were around 4100 persons under supervision in the community, compared to a
daily average of around 3200 prisoners in custody. In 2002 there were 11,860
committals to the Irish Prison Service (17 prisons).
Drug use in Ireland is being tackled in a comprehensive and concerted way via
national policy, partnership working and crosscutting initiatives (Boyle, 1999;
Whelan et al., 2003). The establishment of drug task forces in areas of high need
has resulted in integrated working within particular geographical areas to address
problems associated with drug use, social inclusion and homelessness. During
January 2005 the health services in Ireland were re-organized in order to stream-
line overall effective service management and delivery (Department of Health and
Children, 2003). Within prisons an effective co-ordinating structure is being
developed. A multidisciplinary case management system is being piloted using the
concepts of shared care planning and integrated care pathways to ensure the
continuity of transitional care services. In this way needs-based assessments and
continuity of service provision can be delivered. Effective case management is
associated with better treatment outcomes and a reduction in recidivism rates. In
this way problems associated with fragmentation of services, relapse and recidivism
can be minimized (Kothari et al., 2002; Pugh, 2004).
Successful efforts to address drug treatment demand in the community has
allowed the continuity of methadone maintenance between the community and
prison to be achieved, and has resulted in an ever-increasing number of prison-
ers subject to this form of intervention. It is thought that the use of a public health
model of drug treatment has positively impacted upon the prevalence of blood-
borne diseases and reduced offending behaviour in the community and in prison.
It has also resulted in a change in judicial attitudes from that of an abstinence
approach to one that appreciates the chronic relapsing nature of addiction and
the role of substitution. However, there are still major areas of social policy conflict,
between the health and justice departments – for example the latter does not allow
the use of bleach tablets or syringe/needle exchanges within prisons and the
negative impact of this on blood-borne viruses is discussed in detail in Allwright
et al. (2000) and Long et al. (2001).
Background to drug use and estimating prevalence of
opiate use in Ireland
Over the past 10 years there have been considerable advances in the provision
of health care services to drug users. Despite these advances, government policy
and planning continue to be troubled by the...
Article
The Journal of Community and Criminal Justice
Copyright © 2007 NAPO Vol 54(1): 22–35
DOI: 10.1177/0264550507060862
www.napo.org.uk
http://prb.sagepub.com
Estimating the prevalence of opiate use in
Ireland and the implications for the criminal
justice system
Catherine Comiskey, National University of Ireland
Jamie Saris, National University of Ireland
Julian Pugh, Stewarts Hospital, Dublin
Abstract Drawing upon innovative research methods this article provides the first
Irish estimates of opiate use based entirely on non-medical data. These estimates
are based on the report Baseline Findings from the ROSIE Study by Comiskey and
Cox (2005), commissioned in 2002 by the Irish Government’s National Advisory
Committee on Drugs (NACD). In order to place these estimates in context we first
provide a background to the probation and welfare service in Ireland; we then
provide a picture of known opiate use to date; and finally we introduce the methods
we used to provide new results on the prevalence of opiate users in Ireland.
Keywords drugs, Ireland, NACD, opiate use
Since the formation of the European Monitoring Centre for Drugs and Drug
Addiction (EMCDDA) in 1993 in Lisbon as the central source of information
on drugs and drug addiction in Europe, western industrialized nations of the
European Union have gathered together to provide best practice guidelines for
the monitoring, evaluation and prevalence estimation of drug use and in particu-
lar opiate drug use (EMCDDA, 1997b). This is not only a European phenomenon.
The United Nations have formulated an International Drug Control Programme
and have highlighted how research has been held back by the clandestine nature
of the drugs trade on whose hidden population data is inevitably partial and of
poor quality. Given these limitations it is encouraging to note the emergence of
the EMCDDA annual reports, which include tables of treated drug use. One-off
estimates of national and local prevalence have also been produced for a majority
22
Comiskey et al. ● Estimating the prevalence of opiate use 23
of existing member states (EMCDDA, 1997a, 1997c, 1997d). In addition Interpol
within the Drug Sub directorate acts as a centre for the collection, collation,
analysis and dissemination of drug-related information. However, the emphasis
has been on enumerating treated opiate users and estimating possible numbers
who may present for treatment in the future. Little or no prevalence estimates of
general opiate use based on crime data have been produced and no emphasis
has been placed on providing a methodology upon which to base these estimates.
There are some exceptions to this – for example Choi and Comiskey (2003)
recently produced the first opiate prevalence estimates in Western Australia based
on police crime statistics.
Background to the Probation and Welfare Service in
Ireland
The Probation and Welfare Service in Ireland, whilst not a drug treatment agency
per se, plays a major role in relation to addressing drug-related problems in the
criminal justice system. This is undertaken in partnership with agencies from the
voluntary and statutory sector and is underpinned by the National Drug Strategy
2001–2008 (Department of Tourism, Sport and Recreation, 2001). This strategy
is currently subject to a mid-term review. During 1998 the Probation and Welfare
Service undertook a survey of the 2183 offenders subject to supervision and
discovered that 56.39 per cent had a history of drug use (Probation and Welfare
Service, 1999). Only 43.61 per cent of the cohort had no known history of drug
abuse and 82.6 per cent of those with a known history had used drugs in the
previous 10 months.
The Probation and Welfare Service is also part of an inter-departmental initia-
tive, between the departments of health and justice, in supporting a pilot drug
court programme (Butler, 2002). Whilst initial outcome research of the programme
has been undertaken, a full cost benefit analysis of this programme has yet to
determine its efficiency (Farrell, 2002).
The main process by which the Probation and Welfare Service is used by the
courts is via the use of supervision during deferment of sentence rather than the
use of probation orders. There is an argument to suggest that supervision during
deferment of sentence has been an effective way of addressing offenders with drug
use problems over many years. This form of disposal involves the court hearing
the evidence, finding the charges proved and postponing sentencing on the
condition that the offender responds to probation officer supervision. The officer
is required to produce a report on a specified date to inform the court of what
progress has been made. Indeed, an offender may be subject to several adjourn-
ments before a final decision is made by the sentencer. This type of supervision is
used in both the district and circuit courts and an offender can be brought back
to court if they fail to comply with any conditions. This practice, which has no
legislative basis, allows courts to regularly review sentences whilst holding a sword
of Damocles over the offender, in terms of the possibility of a custodial sentence,
for offenders who do not display sufficient co-operation under supervision. This
24 Probation Journal 54(1)
form of supervision, whereby offenders are brought back to court for progress
reports, can also have a motivating influence and promote change. In 2002, there
were around 4100 persons under supervision in the community, compared to a
daily average of around 3200 prisoners in custody. In 2002 there were 11,860
committals to the Irish Prison Service (17 prisons).
Drug use in Ireland is being tackled in a comprehensive and concerted way via
national policy, partnership working and crosscutting initiatives (Boyle, 1999;
Whelan et al., 2003). The establishment of drug task forces in areas of high need
has resulted in integrated working within particular geographical areas to address
problems associated with drug use, social inclusion and homelessness. During
January 2005 the health services in Ireland were re-organized in order to stream-
line overall effective service management and delivery (Department of Health and
Children, 2003). Within prisons an effective co-ordinating structure is being
developed. A multidisciplinary case management system is being piloted using the
concepts of shared care planning and integrated care pathways to ensure the
continuity of transitional care services. In this way needs-based assessments and
continuity of service provision can be delivered. Effective case management is
associated with better treatment outcomes and a reduction in recidivism rates. In
this way problems associated with fragmentation of services, relapse and recidivism
can be minimized (Kothari et al., 2002; Pugh, 2004).
Successful efforts to address drug treatment demand in the community has
allowed the continuity of methadone maintenance between the community and
prison to be achieved, and has resulted in an ever-increasing number of prison-
ers subject to this form of intervention. It is thought that the use of a public health
model of drug treatment has positively impacted upon the prevalence of blood-
borne diseases and reduced offending behaviour in the community and in prison.
It has also resulted in a change in judicial attitudes from that of an abstinence
approach to one that appreciates the chronic relapsing nature of addiction and
the role of substitution. However, there are still major areas of social policy conflict,
between the health and justice departments – for example the latter does not allow
the use of bleach tablets or syringe/needle exchanges within prisons and the
negative impact of this on blood-borne viruses is discussed in detail in Allwright
et al. (2000) and Long et al. (2001).
Background to drug use and estimating prevalence of
opiate use in Ireland
Over the past 10 years there have been considerable advances in the provision
of health care services to drug users. Despite these advances, government policy
and planning continue to be troubled by the...
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