December 18, 2013
Tony Duffin, Director of the Ana Liffey Drug Project (ALDP), has called for residential addiction services which primarily focus on the needs of the client, rather than on organizational ethos or clinical outcomes.
“The simple fact is that it can be difficult for people who are actively using drugs to access treatment, particularly residential treatment providing stabilization and detoxification. Many services require clients to have already achieved a certain level of stability, either in amount or type of drug consumption, before accessing treatment; others charge for their services; others cannot be accessed directly by the client, but use ‘gatekeeper’ services to screen admittance; still others require their clients to subscribe to treatment which includes items like religious instruction, which is not necessary for good practice in residential addiction services. All of these issues are unnecessary barriers to treatment.”
While there are compelling reasons for restricting access to those who have already made progress in the community – residential services are expensive, and treatment outcomes are typically better for those who are more stable on admittance – Duffin argues that this approach further marginalizes those with the most complex needs, and that the evidence supports targeting this group:
“Residential treatment is a good option for those who have had significant difficulties in the community, or for those with multiple and complex needs. It’s not just about ‘getting better’; it’s about ensuring that people have access to the health services they need, regardless of their problematic behaviour or their complex needs. It’s about taking responsibility for the hard cases.”
As it stands, there are no non-hospital residential services in Ireland which will accept people solely based on an objective assessment of need. This means that those who are unwilling or unable to comply with current entry requirements are automatically excluded. As a result they can become further entrenched in their drug using and can see little genuine opportunity or options for change. Duffin hopes that this can change – ALDP’s current strategic plan specifies the development of accessible residential services, which have the capacity to manage complex needs, and where access is needs-based only.
“We definitely think there’s a gap in service provision that needs to be filled. Resources permitting, this is work that the Ana Liffey would be very interested in carrying out. We want to open residential treatment units, where people can refer themselves, and where treatment is evidence based and where access is based solely on need. We will continue to work with all our stakeholders to create innovative, accessible services for our clients.”
ALDP is a national addiction service, which seeks to reduce the harm drug use causes to individuals, families and communities across Ireland. In 2012, the organization provided services to over 3500 individuals nationwide. Services provided by the organization include street outreach, home, prison and hospital visits, drop-in services, one-to-one case management, group work, Needle and Syringe Programmes, and online support. The services are free and people can contact ALDP by calling freephone 1800786828.