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Drug dealing happens in mental health facilities across the country, doctor says

Injection centres, medicinal cannabis and investment were on the agenda at the IMO’s annual conference.

DOCTORS AT THE Irish Medical Organisation (IMO) AGM have spoken about the difficulties they face when treating people who are using illegal substances.

Dr Matthew Sadlier proposed a motion at the conference which would have seen the IMO call on the justice and health ministers, along with the Medical Council, to clarify doctors’ legal responsibilities in relation to reporting the use and sale of illegal substances.

Screenshot 2017-04-21 at 17.10.50 Dr Mathew Sadlier IMO / Twitter IMO / Twitter / Twitter

Sadlier stressed he wasn’t necessarily on either side of the argument but felt the issue needed to be debated as many medical professionals are unsure of what to do when such a situation arises.

The consultant psychiatrist noted that drug dealing happens in mental health facilities throughout the country, a somewhat inevitable offshoot of treating people with substance abuse issues.

A number of contributors opposed the motion, saying they understood why it was being proposed, but, if enacted, could put vulnerable people off seeking help.

shutterstock_515560582 Shutterstock / Syda Productions Shutterstock / Syda Productions / Syda Productions

One doctor said patients in mental health or drug detox facilities sometimes make up information about other patients in a bid to get them in trouble, so not everything could or should be reported.

He said doctors should decide themselves if they need to report something, namely if they believe someone is genuinely at risk.

Ultimately, the motion was rejected.

Injection centres and medicinal cannabis 

Dr Garrett McGovern proposed a motion calling for the IMO to endorse supervised injection centres, due to the evidence they reduce overdose deaths, drug paraphernalia litter and the number of ambulance call-outs.

Some concerns were raised about the issue from the floor but most people agreed that international research highlights the positive benefits of such centres, and the motion was passed.

Medicinal cannabis was also on the agenda, with Dr Cathal Ó Súilleabháin proposing that the IMO urge the government to “not limit the availability of medicinal cannabis products in any future legislation by restricting their prescription to consultants and the indications for which they can be prescribed”.

Ó Súilleabháin, a GP in addiction services, took issue with the fact chronic pain is not one of the conditions for which medicinal cannabis could be prescribed under legislation currently being debated in the Oireachtas.

“One of the biggest things medicinal cannabis works for is chronic pain,” he noted.

download Health Minister Simon Harris Sam Boal / RollingNews.ie Sam Boal / RollingNews.ie / RollingNews.ie

Ó Súilleabháin said he believes the government does not want the bill to pass and will put too many restrictions on the use of medicinal cannabis.

A number of doctors contributed to the debate saying the approach to medicinal cannabis must be evidence-based and have some restrictions, noting it can be a potent drug.

A Health Products Regulatory Authority (HPRA) report recommended in February that medicinal cannabis be made available to people with certain medical conditions, namely:

  • spasticity associated with multiple sclerosis (MS)
  • nausea and vomiting associated with chemotherapy
  • severe, treatment-resistant epilepsy

Chronic pain was not included on the list.

Speaking about the HPRA report in the Dáil recently, Health Minister Simon Harris said: “Patients accessing cannabis through the programme will be under the care of a medical consultant.

“The HPRA report did not recommend the inclusion of chronic pain and spasticity from cerebral palsy conditions for cannabis-based treatments in the access programme.

“However, this position will be kept under review, and if better clinical evidence becomes available in future, the inclusion of these conditions can be reconsidered.”

Drink driving

Delegates also backed a motion calling for the government to legislate for an automatic ban from driving, “of appropriate duration”, for anyone convicted of drink driving offences, including first time offenders.

Proposing the motion on behalf of the IMO Council, Dr Patrick O’Sullivan said: “There should be a zero tolerance nationally on drink driving and an automatic ban on those caught.”

The motion was passed unanimously.

The discussion was timely given the fact legislation proposed by Transport Minister Shane Ross would mean anyone caught driving over the legal alcohol limit would get a minimum three-month ban.

‘Dying for investment’

The overall theme of the conference was ’Dying for investment’, with a number of speakers highlighting the need for extra resources and staff.

Dr Brian Turner, a health economist based at University College Cork, told delegates Ireland needs 2,800 extra doctors and 9,000 additional hospital beds to match OECD average figures.

He said the Irish health system has not fully recovered from cutbacks made in the 1980s and ’90s.

Screenshot 2017-04-21 at 18.14.14 Dr John Duddy and Dr Ann Hogan Twitter Twitter

Speaking to TheJournal.ie at the AGM, incoming IMO President Dr Ann Hogan said: “We need a massive investment in our health service.

We see how the health service has suffered after all the years of austerity … we have hospitals that just can’t cope, you go into an A&E and you could be there for days on a trolley waiting. We see long, long waiting lists for necessary surgical procedures like scoliosis procedures.

“I suppose our problem in some cases in this country is that we have had trouble recruiting people into critical posts because so many of our young health professionals are planning to go away and stay away … because work and conditions here are so poor and people can earn a lot more in other countries in settings that are an awful lot more conducive to their work and development.”

Hogan said we urgently need to invest in services and improve working conditions in order to get more doctors to stay in Ireland.

When asked about a possible restructuring of how money is spent in the HSE, Hogan said: “There’s a lot of sweeping statements made about some things, but obviously the health service does need to have managers and administrators.

“People will say, ‘Oh there’s too many people working in there’, but at the same time, when they ring up with their query, they want someone to answer the phone and be able to deal with their query.

We need to try and achieve a happy balance where we have enough people in management and administration, behind the scenes stuff. For every new consultant you employ, you do need someone to type up their letters, to make sure their appointments get sorted, all those kind of things.

‘An explosion in theatre capacity’

Speaking at the conference, Hogan’s predecessor Dr John Duddy expressed concerns over the work of the Oireachtas Committee on the Future of Healthcare.

He said the committee made a fundamental error by deciding to not cost its recommendations.

“While the notion of mapping out a 10-year strategy for healthcare is admirable, doing so without paying any attention to the resource issue is just meaningless and has significantly undermined the value of the exercise.”

Duddy said the IMO is concerned at recent leaks of the committee’s likely recommendations, stating: “While we will have to await the final publication of the report, what we are hearing so far is far from encouraging.”

He cited in particular the risk with rumoured proposals to legislate in order to oblige hospitals to perform within set times, saying this was impractical.

You can’t even begin to deliver on this proposal without an explosion in theatre capacity in this country. Even if all operating theatres were opened and fully staffed next week, it could not happen.

“There simply isn’t the physical space in operating theatres or surgical wards to cater for all the patients who would require surgery in this timeframe.

“If hospitals are fined or punished for failing to meet this target, it will have a negative impact on the whole hospital. This kind of target-driven culture will not help patients, and could ultimately harm them,” Duddy said.

Read: Doctor: People end up in foster care and jail because of drinking during pregnancy

Read: Should drink drivers get an automatic ban? Doctors will be debating that today

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5 Comments
    Install the app to use these features.
    Mute TechBuzz Ireland
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    Apr 25th 2019, 8:53 AM

    An average day so

    202
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    Mute Vocal Outrage
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    Apr 25th 2019, 9:29 AM

    @TechBuzz Ireland: no, because we don’t get storms every day

    105
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    Mute David Stapleton
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    Apr 25th 2019, 10:47 AM

    @TechBuzz Ireland: someone once said that Met Eireann may be being a tad over zealous with their weather warnings. Here in Grenoble, we have had rain and winds averaging between 30 and 70 km per hour, with gusts exceeding 80km for the last two days. No weather warnings because, well it’s the weather. So I think they may have a point.

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    Mute joe
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    Apr 25th 2019, 10:58 AM

    @David Stapleton: I think of you actually look on meteoalarm.eu that most of France is currently under a yellow warning! The warning standards are EU standard as far as I know.

    50
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    Mute joe
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    Apr 25th 2019, 11:00 AM

    @David Stapleton: status orange by the way!

    20
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    Mute Paul
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    Apr 25th 2019, 11:02 AM

    @joe: yup it’s EU regulation, standard across the EU. When a storm is discovered the country that it first makes landfall with is require to name it.

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    Mute James Padden
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    Apr 25th 2019, 11:29 AM

    @David Stapleton: 90 – 110 is higher than 80

    19
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    Mute David Stapleton
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    Apr 25th 2019, 1:21 PM

    @James Padden: really, thanks for that salient point. A wind that exceeds 80 is also higher than 80 but that wasn’t the point I was making. Also for those other posts about a status orange warning in France, point taken. However it still doesn’t change the fact that it is not plastered all over the newspapers here. Though, on reflection, the issue may be with the friggin’ newspapers sensationalising everything.

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    Mute joe
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    Apr 25th 2019, 1:25 PM

    @David Stapleton: good point. They gave to get clicks somehow, pretty low bar for what constitutes news these days!

    5
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    Mute Paul A Whelan
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    Apr 25th 2019, 3:43 PM

    @TechBuzz Ireland: the alarmist approach is from rte, not meteirann.

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    Mute liam ward60
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    Apr 25th 2019, 10:05 AM

    Yippie bring it on lest we can enjoy a good nights sleep again that weather we had was too warm not used to it and we ll b able to enjoy a pint down d local without the sweat pouring out of us

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    Mute Deirdre O'Byrne
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    Apr 25th 2019, 4:39 PM

    @liam ward60: yeah, because being able to have a pint in comfort is the most important thing. :/ sheesh

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    Mute This Guy
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    Apr 25th 2019, 7:28 PM

    @liam ward60: Sounds like you may have a problem with your sweat glands. Or your local pub needs air conditioning. One or the other.

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    Mute Ó Donnabháin Ccian
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    Apr 25th 2019, 9:41 AM

    Is there ever any good bit of news to start off the day? Anyone? Nah?

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    Mute Patabake Kennedy
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    Apr 25th 2019, 9:50 AM

    @Ó Donnabháin Ccian: Well, the missus said that she was going away for a few day’s. Does that count at all?

    154
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    Mute The Great Unwashed
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    Apr 25th 2019, 10:27 AM

    @Patabake Kennedy:
    Not if she’s going away for a few days with the new boyfriend.

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    Mute Celia Murphy
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    Apr 25th 2019, 10:30 AM

    @Ó Donnabháin Ccian: ofc theres good news…you’re alive and breathing..isnt that some great news?

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    Mute Ó Donnabháin Ccian
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    Apr 25th 2019, 10:41 AM

    @Celia Murphy: You’re spot on!

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    Mute Joan Smith
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    Apr 25th 2019, 11:36 AM

    @Ó Donnabháin Ccian: i have good news, i am in Portugal

    13
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    Mute Joan Smith
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    Apr 25th 2019, 11:38 AM

    @Ó Donnabháin Ccian: my good news is, i am in Portugal

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    Mute Josh Hanners
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    Apr 25th 2019, 12:28 PM

    Storm Hannah sounds rather benign, how about Storm Ghengis Khan.

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    Mute Mike Conway
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    Apr 25th 2019, 10:53 AM

    More Met Eireann scaremongering. The PC age tries to have us afraid of rain these days.

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    Mute Bilbo Baggins
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    Apr 25th 2019, 12:03 PM

    @Mike Conway: It’s the information age and its just information, don’t be afraid of it.

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    Mute Football in the Groin
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    Apr 25th 2019, 12:32 PM

    @Mike Conway: Asking people to be careful is scaremongering? To what end?

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    Mute Deirdre O'Byrne
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    Apr 25th 2019, 4:42 PM

    @Mike Conway: funny thing is that there are people who have been repeatedly flooded out who are, in fact, afraid of rain. And if some of the predictions are to be believed, many more will be in future, especially those around the coasts who will have to deal with elevated sea levels.

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    Mute Sean Bradley
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    Apr 25th 2019, 10:16 AM

    Was the name Hannah not used already in the last few years?

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    Mute David Kangley
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    Apr 25th 2019, 1:05 PM

    Hopefully they won’t take the roads in

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    Mute Mike Hawkins
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    Apr 25th 2019, 1:44 PM

    Wet Eireann

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    Mute BreadBasketCase
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    Apr 25th 2019, 2:30 PM

    East Coast completely fine. Business as usual for the hardy Wesht

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    Mute Candace
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    Apr 25th 2019, 12:21 PM

    ..

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    Mute Chewey Bacca
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    Apr 25th 2019, 2:23 PM

    I press the play button on the pic but nothing happens :-(

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    Mute David Stapleton
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    Apr 25th 2019, 3:21 PM

    @Chewey Bacca: they do it that way to be in sync with the actual weather warnings…

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    Mute Duncan Paul
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    Apr 25th 2019, 9:53 PM

    Y

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