Monday, 5 October 2009

Investing in drug services may save the state more in the long-term

Nat O'Connor: Merchants Quay Ireland have highlighted a growing trend of heroin use across Ireland. If this is true, it is something to be taken seriously. An increase in drug misuse is one of the predictable, ugly sides of economic recession and, besides the incalculable human cost, there is a risk here of a downward spiral of long-term costs to the exchequer if this is not handled well by the state.

In the context of public sector cuts, it is likely that drug treatment services (like everything else) will be cut. And no, this is not just another argument to 'protect' a sector from cuts; it simply means that there is a need for the relevant Departments to be very strategic about what they cut and what services they bolster.

For example, at present, many people have to travel to Dublin to avail of drug treatment services. Travel and accommodation increase the cost of the providing these services. Some localisation of services might actually save money. Also, people have a better chance of responding well to treatment where they have a network of social supports. Likewise, early access to detox, rehab and step-down facilities can help tackle addiction at the outset.

British research, cited by MQI, shows that for every £1 spent on drug treatment, at least £3 is saved in terms of social, health and criminal justice related costs. So, there is value for money in continuing to target public spending on drug treatment services, as the state has little control over expenses if someone goes to court or to hospital. (Conversely, 'savings' from cuts may be a false economy, if they result in higher costs in later years).

In the budgetary context, this is an example where one department can save (or cost) another department money. It would be worth the Department of Finance taking more of a holistic approach, and perhaps considering more flexibility about transfers from one Budget Vote to another in order to target resources where they will provide the best impact. In this particular case, if it will save money, funds could be moved from health and justice to pay for drug treatment (and we are talking about expenditure on the same cohort of people). We hear a lot of talk about public service reform. A mechanism for this kind of holistic view, with more flexibility about vote transfers, would be a concrete way of generating efficiencies.

Even when the economy recovers, we may have years of 'jobless growth'. That means years of high unemployment - which is correlated with a higher number of people falling into drug misuse. We already have a problem of over-crowded prisons and waiting lists for hospital beds. Failing to address growing drug misuse now will only result in further pressure in other areas of public spending for years to come.

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