Latest news with #NationalDrugStrategy
The Journal
3 days ago
- Health
- The Journal
Drugs strategy review finds staff shortages and service disruption
CONCERNS HAVE BEEN raised around access to drug treatment services and prevention efforts, according to an independent evaluation of the Government's drug strategy. Rural areas, young people and marginalised groups are reported as being 'disproportionately affected' by service discrepancies. 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 today, 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. 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. Advertisement 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.'
Irish Independent
3 days ago
- Health
- Irish Independent
Drugs strategy review finds staff shortages and disruption as charity urges Government not to abandon alcohol labelling
Rural areas, young people and marginalised groups are reported as being "disproportionately affected" by service discrepancies. 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. ADVERTISEMENT 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.'
The Guardian
19-03-2025
- Business
- The Guardian
While Australia is aggressively taxing tobacco, the black market flourishes
The black market for tobacco has flourished in the shadow of Australia's aggressive tax policy, creating a lucrative opportunity for organised crime. As legal tobacco prices have soared, criminal networks have profited by undercutting legal products, offering smokers a cheaper alternative that circumvents regulation and taxation. This underground economy has expanded dramatically in recent years, fuelling criminal turf wars and undercutting tax revenues. The sporadic but aggressive increases in tobacco excise are the primary driver of the illicit trade. Australia's policy, implemented with the dual aim of reducing smoking rates and boosting government coffers, has created some of the world's highest cigarette prices. Despite mounting evidence of unintended consequences, and prior knowledge of these risks, government officials remain inflexible, rejecting even temporary pauses in tax hikes. Proponents of ever-increasing tobacco taxes often dismiss industry opposition through what they call the 'scream test' – the notion that the louder tobacco companies protest, the more effective a policy must be. This simplistic reasoning conveniently ignores a troubling reality: while prices have increased due to the excise tax, Big Tobacco's profit margins have also increased considerably. Before taxes are applied, Australia's cigarette prices rank among the highest in the world, suggesting that the 'big three' cigarette manufacturers have opportunistically used tax increases as cover for their own price gouging. While public health advocates continue to recite the World Health Organisation's mantra that taxation represents 'the single most effective and cost-effective measure' to reduce smoking in the population, the evidence supporting this claim in Australia is weak in recent years. Despite the policy's centrality to our tobacco control strategy, no formal evaluation has been published since the major tax increases started in 2010 – an astonishing oversight for such a consequential intervention. Much has changed over the past two decades. Prices are much higher and smoking rates have fallen, becoming increasingly concentrated in disadvantaged groups in the community. The absence of rigorous assessment should raise serious questions about whether assumptions and ideology, rather than evidence, are driving policy decisions. Available data paints a picture at odds with tax advocates' confident assertions. Smoking rates have declined remarkably – but at similar rates during periods with and without significant tax increases. This suggests minimal impact from the tax hikes themselves. The graphs below display two trends from 2000 to 2022-23: the percentage of adults who smoke daily (according to the National Drug Strategy household survey from 2000 to 2022-23 ) and the price breakdown of a common cigarette brand (showing both tax and pre-tax components). The relationship between cigarette pricing and consumption appears far more complex than the simplistic elasticity models upon which policy has been based. The fact that smoking rates fell during periods of price stability indicates that shifting social attitudes and cultural norms around tobacco use, as well as policies such as smoke-free areas, are playing significant roles in reducing smoking prevalence. This nuance has been largely ignored in policy discussions fixated on tax as a silver bullet. Furthermore, the growth of the black market fundamentally undermines the health aims of the tobacco excise. By creating parallel distribution channels offering cigarettes far below retail prices, high taxes have expanded access to cheaper tobacco products. For price-sensitive smokers, the black market provides an alternative to quitting. This diminishes the intended health benefits of tax rises. It also deprives the government of billions in revenue and enriches criminal enterprises. This is particularly troubling when we consider who bears the heaviest burden of these taxes. Those unable to quit are disproportionately and increasingly concentrated among disadvantaged groups who are least able to absorb these financial imposts. The policy effectively functions as a regressive tax, deepening inequality and penalising the poor. This might be justified to the extent that tax increases are saving lives, but it is not clear that the policy is delivering on its public health promise. Smoking remains a vitally important public health issue. A comprehensive, evidence-based review of Australia's tobacco pricing strategy is long overdue. We need an honest accounting of both the benefits and costs of pricing policies, acknowledging the complex interplay between pricing, social factors and illicit markets. Without such analysis, we risk continuing a policy approach that imposes significant economic hardship on disadvantaged smokers and may not deliver proportionate public health gains – and inadvertently strengthening organised crime. The time has come to look beyond ideological commitments and engage with the uncomfortable reality we find ourselves in. Edward Jegasothy PhD is a senior lecturer at the Sydney school of public health at the University of Sydney. Dr Francis Markham is a fellow at POLIS: the centre for social policy research at the Australian National University
