In Australia, the Uniting Medically Supervised Injecting Centre in Kings Cross, Sydney was the first medically supervised injecting centre in the Southern hemisphere. Historically, the first official supervised injecting facility in the world began in Switzerland in 1986. The Centre in Sydney opened in May 2001 and up to last year was Australia’s only supervised injecting facility. In June 2018, a second Australian facility opened in North Richmond, Melbourne. Currently, there are over 120 supervised injecting facilities around the world with more planned to open in the future.
The supervised injecting facilities aim to improve public health and public amenity by reducing drug use in public places. They are established in areas where there is a high concentration of people injecting drugs on the street, often in plain view of the public. This is evident in Kings Cross, where the area was chosen as it had the highest frequency of drug overdose deaths in NSW. Moreover, areas of the suburb had been ‘claimed’ by individuals to use drugs and needles were often found scattered across footpaths. The three main aims of all centres are to:
– Improve health and wellbeing
– Reduce the number of deaths from overdose
– Reduce public drug use
Drug injecting centres focus on the concept of harm minimisation. The notion of harm minimisation aims to address alcohol and other drug issues by reducing the harmful effects of alcohol and other drugs on individuals and society. It considers the health, social and economic consequences of alcohol and drug use on both the individual and the community as a whole. Harm minimisation needs to be the focus of society moving forward. The harm minimisation approach is based on the knowledge that drug use is an inevitable part of society and occurs across a continuum, ranging from occasional use to dependent use. Enforcement agencies across the world over the past few decades have engaged in a ‘war on drugs’, aiming to set strict criminal punishments. This has not worked. The war on drugs has not stopped drug use, it has instead increased the use and prevalence of drugs in society. This is why harm minimisation is the future and must be prioritised by law-making bodies.
We need more drug injecting centres as they prioritise harm minimisation. At the centres, registered nurses and health education officers supervise drug injecting that would otherwise happen elsewhere – often in public and under more dangerous conditions. When an overdose occurs, the supervisors can provide immediate access to emergency medical care. If that same person experienced an overdoes on a small alley, the chance of survival is highly unlikely. The statistics of the injecting centre in Sydney clearly portrays the importance of the centre within the community:
Since 2001, 16,5000 clients have been supported through the centre resulting in more than 1 million injections. During that time, 8,500 overdoses occurred. There have been 0 fatalities.
A client of the injecting centre stated that “Once I overdosed and if I were anywhere else, I would not still be here”. This centre saves lives, and that should be our priority.
A common argument against the centre is that it ‘encourages drug use’. I have two responses to this perspective.
Firstly, have you talked to someone who is suffering from drug addiction? It is a situation where you can walk up to the person and say stop taking the drug and magically their addiction is cured. Drug addiction is incredibly hard to break, and often, the individuals who suffer from addiction do not have the available funds and support network to break free from the addiction. I am guilty of sharing the perspective stated above. When I had a phone call with the owner of a similar drug addiction centre, I said, “Why don’t we just stop them taking the drug”. I thought my statement was logical, but the owner explained to me how judgemental my perspective was. This is not an issue that can be solved through one conversation, nor can it be solved by charging every person who has drugs on them. It can be assisted through harm minimisation through the injecting centres.
Secondly, the team members of the drug injecting centres connect with clients and offer them referrals to a variety of services, including specialist addiction treatment. The Kings Cross centre has provided 14,500 referrals to ongoing care and support that the clients have accepted. Additionally, among the frequently attending clients, 80% of them have accepted a referral for addiction treatment.
Drug injecting centres are essential, and it is the solution to the growing drug problem in our cities. Yes, no one wants people to be using illicit substances, but we must move on from that thought and start to prioritise the health of the drug users. In doing so, we also assist in protecting the families and the community. This is a response of a resident in Kings Cross to the drug injecting centre:
“A totally indispensable service that has cleaned the Cross (Kings Cross) up, reduced street crime and the general sanitation of the neighbourhood streets.”
So should we increase the number of drug injecting centres? For me, the answer is clearly yes. What do you think?