Tabor Lodge Addiction and Tabor Lodge Addiction and Housing Services LimitedHousing Services Limited

CorkCork

Mick Devine MIAAACMick Devine MIAAAC Clinical Director Tabor Lodge Addiction and Housing Services Clinical Director Tabor Lodge Addiction and Housing Services

LimitedLimited Voluntary Rep on National Drug Rehabilitation Implementation Voluntary Rep on National Drug Rehabilitation Implementation

CommitteeCommittee Secretary Addiction Treatment Centres Ireland (ATCI)Secretary Addiction Treatment Centres Ireland (ATCI) Voluntary Rep on Southern Regional Drugs Task Force Voluntary Rep on Southern Regional Drugs Task Force Finbarr Cassidy MIAAACFinbarr Cassidy MIAAAC Treatment Manager Fellowship HouseTreatment Manager Fellowship House Voluntary Rep on Cork Local Drugs Task ForceVoluntary Rep on Cork Local Drugs Task Force Chair of Southern Voluntary ClusterChair of Southern Voluntary Cluster

Eileen Crosby MIAAACEileen Crosby MIAAAC Treatment Manager RenewalTreatment Manager Renewal

IntroductionIntroduction

Caring for People with Addictions and for their Caring for People with Addictions and for their families since 1989families since 1989

Delivering 28 day Residential Tier 4 Service with Delivering 28 day Residential Tier 4 Service with over 230 admissions annuallyover 230 admissions annually

3 Month Step-Down Facilities for men and 3 Month Step-Down Facilities for men and women with over 50 admissions to each facility women with over 50 admissions to each facility annuallyannually

Delivering Community Based Family Support Delivering Community Based Family Support Services with over 5,000 attendances annuallyServices with over 5,000 attendances annually

52 Week Continuing Care Services with over 52 Week Continuing Care Services with over 5,000 attendances annually5,000 attendances annually

Accredited by CHKSAccredited by CHKS

The main drug of choice of the addicted population The main drug of choice of the addicted population attending services is alcoholattending services is alcohol

REASON FOR REFERRAL

Alcohol

Prescription Painkillers

Cannabis

Opiates

Cocaine

Other stimulants

Benzodiazepines

Others

These 181 patients were all categorised as These 181 patients were all categorised as “chemically dependent to alcohol” according to “chemically dependent to alcohol” according to the Diagnostic and Statistical Manual of the the Diagnostic and Statistical Manual of the American Psychiatric Association, 4th edition American Psychiatric Association, 4th edition DSM IV.DSM IV.

Since the dependence on alcohol indicates an Since the dependence on alcohol indicates an addiction, the issue of minimum pricing is not addiction, the issue of minimum pricing is not relevant. The alcohol will be obtained by fair relevant. The alcohol will be obtained by fair means or foul regardless of the price.means or foul regardless of the price.

Roscommon Child Care CaseRoscommon Child Care Case

Report of the Inquiry Team to the Health Report of the Inquiry Team to the Health Service ExecutiveService Executive

27/10/201027/10/2010

4.9 Alcohol and Drug Dependency4.9 Alcohol and Drug Dependency

There was evidence to suggest that both parents had a There was evidence to suggest that both parents had a considerable dependence on alcohol, upon which much considerable dependence on alcohol, upon which much of the family income was spent. This preoccupation with of the family income was spent. This preoccupation with alcohol clearly affected their parenting capacity. It was alcohol clearly affected their parenting capacity. It was manifested by the children often being left alone when manifested by the children often being left alone when the parents were in the pub and by the older children the parents were in the pub and by the older children having to fulfil adult roles such as minding and feeding having to fulfil adult roles such as minding and feeding younger siblings. younger siblings. The purchase of alcohol was also tolerated by home The purchase of alcohol was also tolerated by home management staff when the mother was brought management staff when the mother was brought shopping.shopping.

Tabor Lodge Annual Report 2010 Table 2Tabor Lodge Annual Report 2010 Table 2

20062006 20072007 20082008 20092009 20102010

SELFSELF 7575 8080 8787 7474 9696

FAMILY/FRIENDFAMILY/FRIEND 7171 6363 4747 5050 4747

COURT/PROBATION COURT/PROBATION SERVICESSERVICES

2727 3232 3232 2424 1111

G.P.G.P. 1818 2020 2525 2020 2121

OTHER TREATMENT OTHER TREATMENT CENTRECENTRE

1616 1616 1818 2121 1717

SOCIAL SERVICESSOCIAL SERVICES 55 66 1515 1919 1818

HOSPITALHOSPITAL 44 1111 88 66 55

EMPLOYEREMPLOYER 99 88 77 77 88

COUNSELLOR COUNSELLOR 44

A & E LIASON WORKERSA & E LIASON WORKERS 22 22

OUTREACH WORKEROUTREACH WORKER 1010

MENTAL HEALTH MENTAL HEALTH INCLUDNIG INCLUDNIG PSYHICATRISTPSYHICATRIST

44

TOTAL TOTAL 229229 236236 241241 233233 239239

National Drugs Strategy (interim) National Drugs Strategy (interim) 2009 - 20162009 - 2016

Action 32Action 32

Develop a comprehensive integrated Develop a comprehensive integrated national treatment service using a 4 –Tier national treatment service using a 4 –Tier Model ApproachModel Approach

MTC Review of Tier 4 HSE Funded MTC Review of Tier 4 HSE Funded Residential Rehabilitation ServicesResidential Rehabilitation Services

Chapter 8 RecommendationsChapter 8 RecommendationsThe key recommendation from this report is that there needs to be The key recommendation from this report is that there needs to be one agency nominated to provide funding for residential treatment to one agency nominated to provide funding for residential treatment to agencies who have reached the mandatory standards of care agencies who have reached the mandatory standards of care required to provide residential treatment (Approved Centres) and required to provide residential treatment (Approved Centres) and that there is criteria agreed to assess the suitability of a person for that there is criteria agreed to assess the suitability of a person for residential treatment. residential treatment.

Where services are required within approved centres, funding Where services are required within approved centres, funding should be provided, based upon agreed outcomes, at a level to should be provided, based upon agreed outcomes, at a level to ensure that the organisation can remain viable.ensure that the organisation can remain viable.

Access and referral to residential services should be standards Access and referral to residential services should be standards based upon best practice.based upon best practice.

Aftercare and relapse prevention should form an essential element Aftercare and relapse prevention should form an essential element of an individual’s treatment package.of an individual’s treatment package.

Roisin Shorthall TD Minister of State at the Dept of Health at Roisin Shorthall TD Minister of State at the Dept of Health at NACD seminar “A Family Affair” October 18NACD seminar “A Family Affair” October 18thth 2011 2011

““I am very focused on ensuring that there I am very focused on ensuring that there is an increased emphasis on moving is an increased emphasis on moving people on from drug treatment to a drug-people on from drug treatment to a drug-free life where that is achievable. free life where that is achievable.

It is my belief that there has been It is my belief that there has been insufficient focus on this ambitious goal in insufficient focus on this ambitious goal in the past”the past”

Recommendations Recommendations to Joint Committeeto Joint Committee

1.1. Tackle Ireland’s National Alcohol problem. Minimum pricing does Tackle Ireland’s National Alcohol problem. Minimum pricing does not do this but rather increases the market share of the more not do this but rather increases the market share of the more established brands.established brands.

2.2. Cultivate nationally a more responsible relationship with alcohol Cultivate nationally a more responsible relationship with alcohol thereby supporting those chemically dependent to alcohol in their thereby supporting those chemically dependent to alcohol in their efforts to establish a sober lifestyle.efforts to establish a sober lifestyle.

3.3. The chief means to achieve this goal is through higher taxation and The chief means to achieve this goal is through higher taxation and controls on advertising.controls on advertising.

4.4. Services providing comprehensive Treatment and Rehabilitation to Services providing comprehensive Treatment and Rehabilitation to the chemically dependent must be funded properly.the chemically dependent must be funded properly.

5.5. Prioritise the implementation of Action 32 of National Substance Prioritise the implementation of Action 32 of National Substance Misuse Strategy (interim) 2009 – 2016.Misuse Strategy (interim) 2009 – 2016.

6.6. Implement the recommendation of the MTC Review of HSE Funded Implement the recommendation of the MTC Review of HSE Funded Tier 4 Residential Rehabilitation ServicesTier 4 Residential Rehabilitation Services

7.7. Endorse Minister Shorthall’s ambition to progress beyond harm Endorse Minister Shorthall’s ambition to progress beyond harm reduction strategies to abstinence-based solutionsreduction strategies to abstinence-based solutions

ConclusionConclusion The main drug of choice in Ireland is alcoholThe main drug of choice in Ireland is alcohol Addiction to alcohol has a devastating impact on Addiction to alcohol has a devastating impact on

those involved and their familythose involved and their family The chemically dependent population should The chemically dependent population should

pursue an abstinence based solutionpursue an abstinence based solution To achieve this comprehensive Treatment and To achieve this comprehensive Treatment and

Rehabilitation Services must be securely Rehabilitation Services must be securely established by the Stateestablished by the State

Tabor Lodge Addiction and Housing Services Tabor Lodge Addiction and Housing Services Limited is a model of excellence in Treatment Limited is a model of excellence in Treatment Provision Provision