Substance Abuse In Ireland And Portugal: Reasons And Solutions

Introduction

The sustainable development goals (SDGs) 3.5 “Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol”, targets prevention and treatment of substance abuse worldwide. The overall aim of the SDGs is to achieve a better more sustainable future for all and reducing the rate of substance abuse is a major factor for achieving this.

Worldwide substance abuse is a major problem, it was estimated in 2016 that globally 164 million people had an alcohol or drug use disorder, and higher prevalence was seen in men rather than women. the WHO found that millions of deaths each year are a result from harmful alcohol uses and 31 million people worldwide have drug use disorders.

Substance abuse has become a social problem that effects millions of individuals worldwide and also disrupts the lives of their families and friends. Not only does substance abuse have harmful effects on the body of the person involved but also on the wider community, huge expenses for medical and social services. Millions of hours work is lost in the workplace, children who grow up in a house hold were substance abuse occurs are damages and crime rates are elevated in relation to illicit drugs.

Drug and alcohol abuse are defined as an example of drinking or using drugs (both prescription or illicit) that cause harmful effects to a person’s health, livelihood, relationship and productivity. Single dosage of alcohol or drugs it’s the issue its continuous usage and abuse which leads to dependency and addiction. Substance use/ abuse is a hazard for anyone associated, it is a life changing ordeal.

Risk factors:

• Peer pressure
• Considered a way to destress or relieve stress.
• Growing up in a home where substance abuse was considered normal behaviour
• Dealing with loss
• Teenage rebellion
• Unemployment

Irelands situation

Substance abuse in relation to alcohol has always been an issue in Ireland, it has been embedded within the Irish culture for centuries whereas drug abuse is a relatively new issue in Ireland. The great famine can be seen as the time when heavy drinking became the norm, people used this to cope with the devastation they were suffering throughout the famine. In Ireland one is considered too tough/ strong if they can tolerate huge amounts of drink. Drinking until drunk is also a particular concern, as binge drinking, which is a major driver of alcohol harm, is commonplace in Ireland, with the World Health Organisation finding that Ireland has the second highest rate of binge drinking in the world.

Taoiseach Leo Varadkar says that “rates of drug use in Ireland have risen significantly over the past decade, with the greatest increases among younger people”. Adolescence is a time for experimentation and discovery, while peer pressure also is a huge concern. This period is filled with major physical and mental development even minimal changes can place massive impacts on the rest of their lives. It’s known that the younger one starts consuming alcohol or using drugs the higher chance they have of becoming dependent. Irelands 15-24-year-old population represent the largest number of people using drugs.

National Strategy

In July 2017 Ireland launched a nation drug strategy, ‘Reducing harm, supporting recovery: a health-led response to drug and alcohol use in Ireland 2017- 2025’. This is strategy is the first which aims to create an integrated approach to illicit drug and alcohol use. The vision is underpinned by five strategic goals that structure the approach being taken:

• To promote and protect health and well-being;
• To minimise the harms caused by the use and misuse of substances and promote rehabilitation and recovery;
• To address the harms of drug markets and reduce access to drugs for harmful use;
• To support participation of individuals, families and communities; and
• To develop sound and comprehensive evidence-informed policies and actions. Performance indicators are defined for each goal. (Healt.gov.ie, 2017)

The Department of Health has overall responsibility for implementing the strategy, which is supported by a shorter-term action plan (2017-20) that contains 50 actions. In 2016, an external assessment of Ireland’s National Drugs Strategy (Interim) 2009-16 was completed. The new strategy contains a number of performance indicators associated with each goal. More broadly, the strategy aims to operationalise a new performance measurement system by 2020.

Irelands drug use

Cannabis use is Ireland has begun to increase since 2012 and 16.2% of the 15-24-year-old population are using cannabis. Although cannabis isn’t the most harmful drug if taken regularly one can feel demotivated and uninterested in things going on in their lives e.g. education and work. While long term it can affect one’s ability to learn and concentrate. Becoming addicted to cannabis appears low but the earlier one starts using cannabis (e.g. teens) the higher the probability.

Again, cocaine use is the most prevalent among the 15-24-year-old population, with 3.2 % reporting use. Cocaine is highly addictive and dangerous drug. Cocaine and cannabis were the most common drugs used by those who died because of hanging. (Health Research Board, 2019)

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A huge spike can be seen in MDMA use in 2011, and again the age group with the highest use is the 15-24-year-old population. Many believe that MDMA is safe, but its effects can be lethal it can interfere with the body's ability to regulate temperature, and it can raise the heart rate to a dangerous level.

Ireland alcohol use

Alcohol consumption in Ireland almost trebled over four decades between 1960 (4.9 litres) and 2001 (14.3 litres) (http://alcoholireland.ie/facts/how-much-do-we-drink/). More than half, 54% (1.35 million) of 18-75-year-old drinkers were classified as harmful drinkers. 75% of all alcohol consumed in Ireland in 2013 was done so as part of a binge drinking session. One in five drinkers engage in binge drinking at least once a week (Long and Mongan, 2013.). 15% of those drinking at harmful levels felt in the past 12 months that their drinking harmed their health, and 22% felt they should cut down on their drinking. (health.gov.ie, 2015). Drink driving plays a factor in 2 out of every 5 road deaths. Around 7500 people enter treatment for alcohol use every year. Approximately €1.5 billion was spent on alcohol-related hospital discharges in 2012 (€1 for every €10 spent on public health). Alcohol also contributes to more than 60 types of disease and injury.

Ireland scores slightly below in relation to cigarettes, alcohol and heavy drinking but scores higher in relation to cannabis use, use of inhalants and use of new psychoactive substances. Life time alcohol use appears to be declining whereas cannabis lifetime use has plateaued in recent years.

Portugal’s situation

In 2001 Portugal decriminalised the possession of all drugs for personal use. Portugal changed their system so instead of jail time, violations were punishable through fines and community service. Thus, creating an environment which encourages those who may be drug dependent to seek treatment and to do so voluntary. Prior to the law change Portugal’s population health was taken over by drug use and drug problems. The number of drug-related deaths had soared, and rates of HIV, AIDS, Tuberculosis, and Hepatitis B and C among people who inject drugs were rapidly increasing.

Portugal decriminalising drugs wasn’t the only factor at play for reducing the number of drug related deaths and drug users, it’s a total package. The biggest benefit has been around drug addiction stigma, people can now speak clearly and seek professional help without any fear.

Here its clear that death rates in Portugal associated with drug uses were significantly reduced. In 2001 approx. 80 deaths were drug induced and by 2012 less than 20 deaths were drug induced. Both if these figures show that by Portugal decriminalising drugs both drug use and drug induced deaths have been reduced.

Stigma towards substance abuse:

Stigma around substance abuse can actually prevent people from seek help or treatment. Its necessary to understand that addiction doesn’t discriminate people don’t choose to become addicted or dependent. Substance use is stigmatized more than any other health issue,

Stigma is rarely based on facts but rather generalizations, preconceptions and assumptions, stigma results in prejudice, avoidance, rejection and discrimination towards people who have a socially undesirable trait or engage in culturally marginalize behaviours (e.g. substance abuse) (Link, 2001).

In fact, the 2014 National Survey on Drug Use and Health found that 21.5 Americans age 12 and older had a substance use disorder in the previous year; however, sadly only 2.5 million received the specialized treatment they needed.

Solutions/ recommendations

Recovery can’t be individual, within Ireland and globally its necessary to create environment that promotes and facilitates social recovery, the core message must be that you are NOT alone. Those who are seeking recovery must be assisted when attempting to reconnect into society, e.g. job creation. Ireland is of the opinion that alcohol doesn’t cause serious harm when compared to cigarettes and drugs but alcohol is a carcinogen and can act as a gateway for other substance abuse. It’s necessary to look at what Portugal has achieved in the last number of years and take some ideas from them. Decriminalising drugs may not but achievable within Ireland although it is clear that the fear of getting caught isn’t enough to prevent people from using drugs. it is necessary to focus on education about risk factors and safety as well as ensuring people know where to seek help while also feeling comfortable seeking help. Worldwide its necessary to reduce the stigma surrounding substance abuse to ensure the 3.5 SGD can be achieved.

References

1. Alcohol Action Ireland. (2019). How much do we drink? - Alcohol Action Ireland. [online] Available at: http://alcoholireland.ie/facts/how-much-do-we-drink/ [Accessed 13 Apr. 2019].
2. Aleem, Z. (2015). 14 Years After Decriminalizing All Drugs, Here's What Portugal Looks Like. [online] Mic.com. Available at: https://mic.com/articles/110344/14-years-after-portugal-decriminalized-all-drugs-here-s-what-s-happening#.OtUjqaWIw [Accessed 13 Apr. 2019].
3. Health.gov.ie. (2015). [online] Available at: https://health.gov.ie/wp-content/uploads/2015/10/Healthy-Ireland-Survey-2015-Summary-of-Findings.pdf [Accessed 13 Apr. 2019].
4. Health.gov.ie. (2017). Reducing Harm, Supporting Recovery. [online] Available at: https://health.gov.ie/wp-content/uploads/2017/07/Reducing-Harm-Supporting-Recovery-2017-2025.pdf [Accessed 13 Apr. 2019].
5. Health Research Board. (2019) National Drug-Related Deaths Index 2004 to 2016 data. Dublin: Health Research Board.
6. Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual review of Sociology, 363-385.
7. Long, J. and Mongan, D. (2013). Alcohol consumption in Ireland. [online] Alcoholireland.ie. Available at: http://alcoholireland.ie/download/reports/how_much_do_we_drink/Alcohol_Consumption_in_Ireland_2013_web_version.pdf [Accessed 13 Apr. 2019].
8. United Nations Sustainable Development. (2019). About the Sustainable Development Goals - United Nations Sustainable Development. [online] Available at: https://www.un.org/sustainabledevelopment/sustainable-development-goals/ [Accessed 13 Apr. 2019].
9. WHO (2019). Facts and figures. [online] World Health Organization. Available at: https://www.who.int/substance_abuse/facts/en/ [Accessed 13 Apr. 2019].
10. WHO (2019). Global Health Risks. [online] Available at: https://ucc-ie.blackboard.com/bbcswebdav/pid-1803346-dt-content-rid-3063134_1/courses/2019-EH4009/GlobalHealthRisks_report_full%281%29.pdf?target=blank [Accessed 13 Apr. 2019].