Chronic shortage of beds for addicts.

The report said there were no dedicated drug or alcohol residential services in nine counties, which have a combined population of more than half a million people. The findings of an expert group called for a huge expansion in the low level of dedicated services for substances users, including a fivefold increase in the number of hospital beds.

In total, it said 365 more beds were needed at hospital, community and rehabilitation levels to meet demand. It said that 79 beds were currently being used in general hospitals and psychiatric hospitals to treat alcoholics and drug addicts, costing about €12m each year. It said dedicated residential facilities would cost less and would free up much-needed beds in hospitals. The report also said these hospitals were not the right place to treat substance users. Overall, there is a poor distribution of services throughout the regions.

There are no dedicated residential stabilisation or detoxification beds [either residential community-based or hospital-based] outside of the Dublin area.

And, there are no dedicated drug or alcohol residential services in Cavan, Laois, Leitrim, Longford, Offaly, Roscommon, Sligo, Tipperary North or Westmeath, which have a combined population of over half a million people.”

The report of the HSE Working Group on Residential Treatment & Rehabilitation (Substance Users) carried out a detailed analysis of the level of provision and what was needed. It recommended:

• The number of dedicated hospital detox and stabilisation beds should increase from 23 to 127.
• An expansion in residential rehabilitation beds, from 634 to 887.
• A rise in step down/halfway house beds from 155 to 296.

The working group noted that in addition to the shortfall of 365 beds, 66 beds currently in use for alcohol and drug problems in the psychiatric hospitals and units will no longer be available as a result of restructuring in the mental health service.

The group recommends that 50 inpatient unit beds for illicit drug users should be provided between the Dublin Mid-Leinster and the Dublin North East HSE areas. The remaining 13 beds should be divided between the HSE South and HSE West areas.

The group recommended that, where there is unused capacity at present in a service or unit because of staffing shortages, such capacity be brought on stream immediately by providing the necessary staff.

A separate government report, published last June, pledged to increase the number of hospital beds from 23 to 48, less than 40% of what the HSE report said was required.