The Eastern Health Board had to abandon its "drug-free" policy at one of its emergency residential units in Dublin because banning all drug use was "not a realistic objective", the report reveals.
The unit was opened for 12- to 17-year-old boys and girls who are used to surviving on the streets and many of whom are involved in crime, drug abuse and prostitution. Since it opened "heroin has continued to be a huge difficulty" in its work, the report says.
Of 28 young people admitted to the unit in the last year, 16 actively abused drugs. Twelve abused heroin, two took a variety of drugs, one abused medicines and one abused cannabis "to a serious extent and within the unit".
Frequently, it says, young people are placed in the unit "who require a much more specialised and therapeutic environment than can be provided within the chaos of a busy emergency unit".
It is pessimistic about the future of those who come to the unit. Of the 28 admitted last year, "13 young people were discharged because of unmanageable behaviour or continued drug use, four young people chose to leave and one was sentenced to prison".
"Positive outcomes in the short term are extremely difficult to achieve for this group of young people," it states.