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 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.

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.”