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About time…Sydney’s medically supervised injection centre gets the official nod

As you may have heard, the NSW Government has FINALLY decided to make the medically supervised injecting centre at Kings Cross a permanent fixture. About time, too.

Here is a statement issued today by the Public Health Association of Australia:

“The PHAA has welcomed the NSW Government’s decision to make the medically supervised injecting centre at Kings Cross a permanent fixture.  The centre’s trial status is set to be lifted after almost 10 years of life-saving work and proven community benefits.

“The establishment of the centre by former Premier Bob Carr back in 2001 following the NSW Drug Summit was a ground-breaking and forward-thinking public health policy decision.  In the years that have followed more than 3,500 overdoses have been managed at the centre without a single fatality – a wonderful outcome for both those individuals and their families who may otherwise have lost their loved ones.  The Centre has also referred thousands of people to drug treatment and contributed to a reduction in drug-related problems for the Kings Cross community,” said Michael Moore, PHAA Chief Executive Officer.

“The Kings Cross medically supervised injecting centre caters for around 200 injections a day by intravenous drug users – these would otherwise take place on the streets – placing users at risk of overdose and creating obvious problems for the community and businesses in the area.  Assessments of the centre’s operation have consistently demonstrated that despite some initial reservations, the Kings Cross community has seen demonstrable benefits from the establishment of the centre in terms of amenity and public order, which are over and above the health benefits experienced by users.

“PHAA supports the harm reduction approach to policy in relation to reducing the harms from illicit drug use.  Harm reduction measures, such as the establishment of the medically supervised injecting centre, coupled with complementary demand reduction and supply reduction measures, make up a comprehensive approach to addressing drug-related problems in the Australian community.

“Ultimately, if people are to overcome drug problems, it is vital that they are kept alive long enough to do so.  It is impossible to rehabilitate someone who has already died from a drug overdose, and the Kings Cross medically supervised injecting centre has saved the lives of many sons, daughters, brothers, sisters and parents who would otherwise not be with us today,” said Mr Moore.

****

Update 30 Sept

Dr Marianne Jauncey, the Centre’s medical director, has supplied links to two recent evaluations of its work.

http://www.bocsar.nsw.gov.au/

http://www.health.nsw.gov.au/resources/mhdao/msic_kpmg_pdf.asp

http://www.druginfo.nsw.gov.au/publications/nsw_government_publications/medically_supervised_injecting_centre2

She also supplied this rather impressive list of all the organisations supporting the centre:

ACON

Alcohol and other Drugs Council of Australia (ADCA)

Ambulance Service of New South Wales

Australasian Chapter of Addiction Medicine (AChAM)

Australasian College for Emergency Medicine (ACEM)

Australasian Faculty of Public Health Medicine (AFPHM)

Australasian Professional Society on Alcohol and other Drugs (APSAD)

Australasian Society of HIV Medicine (ASHM)

Australian Drug Foundation (ADF)

Australian Federation of AIDS Organisations (AFAO)

Australian Medical Association NSW

Australian Parliamentary Group for Drug Law Reform

Baptist Inner City Ministries

City of Sydney Council

Come In Youth Resource Centre

Director of Public Prosecutions (NSW) Nicholas Cowdery AM QC

Drug and Alcohol Nurses Australasia (DANA)

Family Drug Support

General Practice NSW

Global Fund to Fight AIDS, Tuberculosis and Malaria

Hepatitis NSW

Inner City Legal Centre

Inner City Youth at Risk Project

International AIDS Society

International Harm Reduction Association

Metropolitan Community Church

Mission Australia

New South Wales Bar Association, Criminal Law Committee Chair

N.S.W. Nurses’ Association

National Centre for Education on Training and Addiction (NCETA)

National Centre in HIV Epidemiology & Clinical Research (NCHECR)

National Centre in HIV Social Research (NCHSR)

National Drug and Alcohol Research Centre (NDARC)

National Drug Research Institute (NDRI)

Network of Alcohol and Other Drug Agencies (NADA)

New South Wales Police Force

NSW Health

NSW Users’ and AIDS Association (NUAA)

Positive Life NSW

Public Health Association Australia – (NSW branch)

Royal Australasian College of Physicians

Royal Australian and New Zealand College of Psychiatrists

Royal Australian College of General Practitioners

Sydney School of Public Health, University of Sydney

Sisters of Charity Health Services

Social Workers in AIDS (SWAIDS)

St Canice’s Church, Kings Cross

St John’s Anglican Church, Darlinghurst

St Vincent’s Hospital Alcohol and Drug Services

Ted Noffs Foundation

UN AIDS

Wayside Chapel

Young Lawyers NSW

Comments 7

  1. Jess Pearson says:

    I disagree with the whole idea of allowing people, teenagers, to do illegal drugs!

    As stated above, “200 people a day inject harmful drugs into themselves,” this should not be allowed, let alone advertised for Australian teenages to be exposed to.

    Even if there are ‘community benifits’ involved in this centre, where are the ethics behind allowing drug addicts a safe place to ‘get a hit’ ?

    The tiny snippet of information indicates that lives are saved through this centre. It touch not touch on any of the other consequences involved.
    As a teenager myself, one of the aspects that stops me and many others from using drugs is the fear and real life danger of dying.
    Taking this fear and unknown area away from drug use will encourage more young Australians to ‘try it’.

    Setting up centres such as the one mentioned is a costly process.
    If this is a NSW government decision, does that mean our tax payers money is being used?

    I can see it from the other view that this centre is saving peoples lives and that is a noteworthy achievment.
    Overall I do see if from both sides of the story but I must put forward the oposing opinion that I am sure many people agree with.

    It is a fine line that is being crossed.

  2. Terry Wright says:

    Now we just have to wait for those looney wingnut opinion writers to start telling us why MSIC is going to degrade the value of mankind and send society into a tailspin of evil and descent.

    Also, be on the watch for Drug Free Australia (DFA) as they try to convince us that the dozens of scientific studies are wrong and they have a report that proves MSIC doesn’t work. Of course they a lot about science because their patron is a TV Evangelist who performs faith healing on stage and their members include links to scientology, The Festival of Light and other fundamentalist organisations who think the earth is 6,000 years old.

    The permanent approval of MSIC is a tick for evidence based policies.

  3. Melissa Sweet says:

    Dr Alex Wodak asked Croakey to post this response to Jess on his behalf:

    Dear Jess,

    The dilemma is distinguishing between what might be desirable from what is actually achievable. Stopping teenagers from taking drugs might be desirable. But half a century of trying to do that has not just failed, but often made a bad problem even worse. We often discover that the unintended negative consequences of failing to achieve what we set out to do and not getting there are horrendous.

    So how would you actually stop young people from using illegal drugs when no-one has managed to achieve that objective?

    And if there are 200 injections a day in the MSIC and you close the centre, how do you feel about those 200 injections now happening in street, lanes, alleys, supermarkets, parks and toliets?

    Especially given the inevitability that some of these young people whose lives would have been saved in the MSIC are now going to die when they instead inject in public places.

    How do you feel about the ethics of this if one of those young people who is now going to die was a loved one?

    During the period that the MSIC has been operating, injecting drug use in Australia has actually been declining.

    It could be that the MSIC is such a potent reminder of the risks of injecting drug use that some young people are put off experimenting?

    We just don’t know.

    You are concerned about the costs of the MSIC – that’s a fair question.

    But the MSIC saves more money than it costs to run.

    The MSIC is in the middle of the most densely populated part of Australia.

    78% of residents support it.

    Don’t they have a right to walk around their neighbourhood without stepping over dead bodies and seeing people shooting up in public places?

    It’s not a fine line – it’s a great big fat line.

    Evidence and compassion on one side.

    Fear and loathing on the other side.

    Dr Alex Wodak.

  4. Melissa Sweet says:

    Michael Moore, CEO of the Public Health Association of Australia, has asked Croakey to post this response to Jess on his behalf:

    Jess Pearson disagrees with the whole idea of allowing people, teenagers, to do illegal drugs!

    Actually, Jess, those of us who advocate for a supervised injecting room and even to trial provision of pharmaceutical heroin and other injecting drugs at the same time would love to see no one using such drugs. The thinking behind all harm minimisation policies is multi-layered.

    Since the prohibition of drugs such as heroin has been pushed from the 1950s onward, particularly by the United States, there has not been a reduction in drug use. There has been a rapid increase.

    As it seems a huge task to challenge the whole concept of prohibition despite its clear abysmal failure to achieve its goals, policy makers in Australia and other places have sought to find alternative solutions.

    As we cannot obtain what we believe is the best solution, we look for the “least worst” solution. There is no evidence that availability of clean needles or an injecting facility increases or encourages drug use any more than availability of condoms encourages young people to have sex.

    In both cases the availability of appropriate devices simply protects those who make these decisions from dire consequences of their actions. Very few people would argue that the poor choice by these people should be ‘punished’ by a shortening of their life or a devastating medical outcome.

    Even for a hardline economic rationalist, as far as our role in spending taxpayers’ money on the provision of devices or facilities goes – it is simply a long term investment. There is no doubt that treating people for HIV/AIDS or Hepatitis for example will be much, much more costly to the taxpayer than the cost of running a supervised injecting facility.

    What is really unfortunate is that in 1997 when the Ministerial Council on Drug Strategy approved a scientific trial of a Medically Supervised Injecting Facility that also provided the heroin it was stopped on the personal whim of John Howard.

    Until such an approach is tried we will not know the extent to which such an approach will improve the health of individuals, reduce the spread of disease in the community and possibly undermine the pyramid sales system that is engendered by prohibition and the black market.

    In spite of the folly of the Howard decision for Australia we do have some knowledge as such facilities are run in about a dozen countries worldwide – including the conservative Switzerland that has been doing so for a decade and a half. A referendum in that country has supported having them continue.

    The people understand that sometimes when our policies cannot achieve everything that we want, we need to have a backup plan that will deliver the really critical things – like saving the lives of individuals and stopping the spread of disease into the broader community.

    Michael Moore
    CEO Public Health Association of Australia

  5. Jess Pearson says:

    “78% of residents support it.” (the MSIC)

    I am representing the 22% of people who do not support it.

    That’s what these public blog sites are for; people to express their opinions and ideas.

    We may not be the majority, but I believe that I have a vaild opinion.
    These centres, although they do have great statistics, have negative side effects.

  6. Terry Wright says:

    “That’s what these public blog sites are for; people to express their opinions and ideas.
    We may not be the majority, but I believe that I have a vaild opinion”

    There’s a big difference between having an opinion (based on some dubious “ethical” assertions and misinformation) and the evidence/facts put forward by medical experts.

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Croakey Conference News Service 2013 – 2019
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