Policy, Strategy and Frameworks

Reducing Harm, Supporting Recovery

“A health-led response to drug and alcohol use in Ireland” – 2017 – 2025

Published in 2017 by the Department of Health, the vision for the strategy is to

"To create a “healthier and safer Ireland, where public health and safety is protected and the harms caused to individuals, families and communities by substance misuse are reduced and every person affected by substance use is empowered to improve their health and wellbeing and quality of life”."

The strategy presents an action plan under the following strategic goals:

1. Promote and protect health and wellbeing

2. Minimise the harms caused by the use and misuse of substances and promote rehabilitation and recovery

3. Address the harms of drug markets and reduce access to drugs for harmful use

4. Support participation of individuals, families and communities

5. Develop sound and comprehensive evidence-informed policies and actions

The HSE are named as the lead agency with responsibility for 24 of the actions in the strategy and are partners in many other actions. The HSE National Social Inclusion Office is represented on the Standing Sub-Committee for the National Drug and Alcohol Strategy, chaired by the Department of Health.

The National Drugs Rehabilitation Framework

Rehabilitation emerged as a key issue during the lifetime of the National Drugs Strategy 2001-2008. Arising from this a working group developed the Report of the Working Group on Drugs Rehabilitation 2007 which mapped out rehabilitation policy and a strategy for integrated drugs rehabilitation services. Following this, the National Drugs Rehabilitation Framework was developed in 2010 to provide “...a framework through which service providers will ensure that individuals affected by drug misuse are offered a range of integrated options tailored to meet their needs and create for them an individual rehabilitation pathway”.

In 2011, 10 sites piloted the rehabilitation framework. They did this so their experience could be used when the national framework was put in place. The pilot schemes used the National Protocols and Common Assessment Guidelines.

In November 2013, the Department of Public Health and Primary Care at Trinity College, Dublin, conducted an Evaluation Report of the National Drugs Rehabilitation Framework Pilot. The evaluation assessed the quality and effects of the Framework and examined how useful people felt the Framework tools were.

The quality of the Framework tested well. The evaluation found that there was near universal enthusiasm for the Framework. People were optimistic that its aims could be achieved if commitments to the Framework were shared by all agencies.

A standard assessment and care plan document has been developed to support the implementation of the National Drugs Rehabilitation Framework:

Hidden Harm

The HSE and TUSLA jointly published the Hidden Harm Strategic Statement and Hidden Harm Practice Guide in January 2019.

These publications set out how the HSE and TUSLA intend to bridge the gap between adult and children’s services, in favour of a more family-focused approach that considers the needs of dependent children and other family members.

A Hidden Harm information leaflet was published and is currently under revision.

More information on Hidden Harm eLearning is available on the Hidden Harm - Impact of Parental Alcohol and Other Drug Use Training webpage.

SAOR Screening and Brief Intervention for Problem Alcohol and Substance Use

SAOR (Support, Ask and Assess, Offer Assistance and Refer) is a brief intervention model developed in response to problem alcohol and other drug use.

Originally developed in 2009 for alcohol in hospital emergency settings, the successful application of the model led to the addition of problem drug use and the promotion and use of the model in a wide variety of settings, including community, statutory, voluntary, justice, sport and education services. SAOR (2017) uses a person-centred approach based on Motivational Interviewing to have a conversation with a person about their drug or alcohol use, supporting workers from their first point of contact with a person to enable them to deliver brief interventions and then, if necessary, to facilitate those presenting with more complex needs with entry into specialist services in line with the National Drugs Rehabilitation Framework (2010).

National Standards for Safer Better Healthcare

The National Standards for Safer Better Healthcare are the quality standards framework developed by Health Information and Quality Authority (HIQA) in 2012. These National Standards apply to all healthcare services (excluding mental health) provided or funded by the HSE including, but not limited to, addiction services.

The National Standards are divided into 8 themes

Person-centred care and support
Effective care and support
Safe care and support
Better health and wellbeing
Leadership, governance and management
Workforce
Use of resources
Use of information

HSE Primary Care developed quality improvement and assessment workbooks for each of the National Standards for Safer Better Healthcare themes. These workbooks have now been adapted for HSE and HSE funded addiction services. The workbooks are intended to support assessment teams in preparing for assessment against each of the eight themes. A matching exercise found that most QuADS standards were embedded in the National Standards SBHC. The suggested evidence listed for each standard includes evidence from the associated QuADS standards as appropriate. The workbooks were amended to include the small number of QuADS standards not included in the National Standards.

Please access the HSE National Quality and Patient Safety for more resources on quality standards.

Services

To find a service in your area, use the National Directory of Drug and Alcohol Services on drugs.ie.