OVER 3,500 PEOPLE were waiting for a drug or alcohol detox bed in Ireland, as of February 2021, with over 2,200 on the waiting list for at least nine months.
Between December 2019 and June 2020, 170 residential beds were closed. A number of these had reopened by November last year but 143 remained closed around the country, according to HSE data released to Noteworthy.
Both the length of the waiting list and the time people are spending on it for residential addiction treatment across the country has increased due to “the necessary Covid-19 safeguards”, according to the Department of Health.
These increases in waiting times range “from an average of 2-6 weeks in some services to an average of 6-9 months in other services”, a DOH spokesperson told Noteworthy.
The HSE response lists reduced capacity in order to comply with public health guidance, restrictions on new entries and closures due to outbreaks as some of the issues that have impacted waiting lists during the pandemic. It added:
In addition, there are difficulties carrying out face to face assessments and validating waiting lists as many of the interactions are telephone only.
The waiting list figures were released by the HSE in response to a parliamentary question by TD and co-leader of the Social Democrats, Róisín Shortall.
Only six of the nine HSE Community Health Organisation (CHO) areas had services listed in the PQ. When asked about the lack of detox beds in some areas, a HSE spokesperson told Noteworthy that “access to all beds is based on need rather than geographical location”.
- Read more here on how to support a major Noteworthy project to investigate why people are waiting up to two years for a drug detox bed.
The HSE area with the largest waiting list for drug and alcohol detox beds of more than 1,800 people is CHO 3 which covers Clare, Limerick and North Tipperary. Over 1,400 were waiting more than nine months.
The next highest is over 1,500 people waiting for services in CHO 7 which covers Kildare, West Wicklow and parts of West and South Dublin, with over half of these again waiting more than nine months.
These were also the CHOs with the highest number of residential bed closures over the past year, with 62 closing in CHO 3 and 60 in CHO 7 between December 2019 and November 2020.
Some people have been waiting up to two years for a detox bed in one particular centre – St Francis Farm in Carlow.
Difficult to keep motivated
There was a limited number of beds before Covid, with people having to wait a number of months for a bed, according to Paula Byrne, chief executive of Merchants Quay Ireland (MQI) who help those caught in addiction through a range of services, including residential detox and rehab treatment.
However, the pandemic has had a number of extra impacts on people with addiction issues. MQI have seen a mixture of people relapsing, an impact on clients’ mental health due to social isolation and exposures of hidden addictions to families during the pandemic. People have to meet strict criteria for detox, explained Byrne.
I don’t think people realise how difficult it is for people to get ready for treatment.
“Speedy access” to these beds is important, added Byrne, as it is hard to keep motivated and prevent relapse if you have to wait a number of months for a bed. “It’s very difficult and takes a lot of work across multi-disciplinary teams, families and ourselves” to do this, she said.
Closure of beds during Covid
Some rehab and detox beds have closed over the past year either due to distancing guidelines or to make way for Covid-19 isolation facilities.
One such facility, Keltoi in Dublin – a residential rehabilitation programme for opiate users, was converted to an isolation centre as part of the pandemic response. Another, Cuan Mhuire in Co Limerick, had 43 beds closed between June and November last year.
The HSE provided Noteworthy with figures for beds in residential, rehab and step down facilities before and during the pandemic. They said that this table highlights how “bed capacity has reduced to operate within public health guidelines”.
To view an searchable version of this table, click here.
A spokesperson for the HSE said that “in order to maintain social distancing and adhere to public health advice, we are aware that the capacity of residential services has been affected”.
MQI’s Byrne said that “there needs to be a plan to reopen [closed] beds or alternative plans to put beds in place somewhere else”.
There was a 10% increase of clients who attended their harm reduction services, including needle exchanges, which Byrne said indicates there will be even more of increasing demand for treatment services in the near future.
The DOH spokesperson stated that “the HSE cannot change the capacity issues that have arisen due to the introduction of social distancing measures to deal with the Covid-19 pandemic”.
More investment needed
Drug use in Ireland increased over the past decade and the number of new people being treated for drug abuse has also grown. Just over 2,200 new treatment cases were reported in 2006 and this had almost doubled to 4,000 in 2019. The number of drug-related deaths is also rising year-on-year.
The Government’s ‘Reducing Harm, Supporting Recovery’ strategy, launched in 2017, is now half way through its eight-year term. It promised the expansion of addiction services, including residential treatment.
Byrne felt that “more investment in both community detox and detox beds is needed” so that people’s needs can be met at the right time. “If people had access to beds a bit quicker, there might be more successful outcomes.”
In 2021, the Department of Health provided an extra €2 million for residential drug and alcohol treatment services, according to the spokesperson. “In addition, over €1.3 million is being provided for the establishment of a 20-bed residential therapeutic community for expectant women and women with children in the mid-west region.”
The Minister of State for the national drugs strategy, Frank Feighan, stated he “is fully committed to the provision of drug and alcohol treatment services” and “will continue to support service providers to fully resume services”.
REHAB WAIT Investigation
Why are people waiting up to two years for a drug detox bed?
Through Noteworthy, we want to do an in-depth investigation into the impact of waiting to detox on people’s recovery as well as the pressure that drug service providers are under due to this bed shortage.
We we will examine why waiting lists are growing when an increased need for treatment was anticipated by the Government in their 2017 drugs strategy.