SAFE INJECTION SITES: SUBSTANTIVELY AND GEOGRAPHICALLY DISPARATE PERSPECTIVES

Americans can only marvel at the fact that safe injection sites are a reality in other countries – and yet the world keeps spinning. Wow!)

The Daily Telegraph (Sydney, Australia)
Piers Akerman
May 02, 2007 (excerpts from a wider-ranging letter focused mainly on marijuana policies)

The most obscene evidence of the state’s softly-softly approach to drugs remains the NSW Government’s embrace of its Kings Cross shooting gallery despite the absence of any hard evidence that it serves any purpose other than to ensure that addicts will always have a place to legally shoot-up if they so choose when they happen to be in the area and in possession of illicit drugs.

Put simply, the reports produced by the heroically named Medically Supervised Injecting Centre fall apart when examined by competent and genuinely independent experts.

A review of the statistics by Dr Joe Santamaria (former head of community medicine, St Vincent’s Hospital, Melbourne); Dr Stuart Reece (addiction medicine specialist, Brisbane); Dr Lucy Sullivan (social researcher); Dr Greg Pike (director of Southern Cross Bio-Ethics Institute, Adelaide) and Gary Christian (senior manager, welfare industry) demonstrate that despite the claims of the shooting gallery’s advocates, it is unlikely to have saved even one life.

Dr van Beeks letter to Daily Telegraph May 03 (Dr Ingrid van Beek, Medical Director, MSIC)

Mr Akerman cites Drug Free Australia’s “review of the statistics” of the first 18 months’ operation until October 2002, of the Medically Supervised Injecting Centre (MSIC) in Kings Cross, as evidence that it has “failed” (DT 3/5/07) despite a range of health professionals respectfully pointing out the various flaws in its extrapolations over the past several years.

The irrefutable statistics are that in the 6 years the MSIC has now been operating, around 400,000 injecting episodes have occurred in this clinical facility instead of public parks, back alleys and public toilets etc, improving public amenity; more than 2,000 drug overdose cases have been successfully treated undoubtedly saving lives and drug users have been referred to treatment and other relevant services on more than 6,000 occasions. Meanwhile the number of drugs users in the Kings Cross area has decreased 40%, the number of ambulance callouts to overdoses has decreased 86% and drug-related crime has decreased 30 – 40%. These facts perhaps explain why 80% of local residents living in the area over these past 6 years support the MSIC.

Please also note that the MSIC is funded by the confiscated proceeds of crime and not tax payer revenue and that I am employed by the Area Health Service and not the Medical Faculty of the University of NSW, which employs the MSIC’s evaluation team.

Comment May 03 by Ralf Gerlach (Deputy Director, INDRO e.V., Muenster, Germany)

I really wonder why, apparently, there is so much opposition towards medically supervised injecting rooms in Australia. For instance, there are 24 such facilities operating in Germany, all of which have been evaluated comprehensively by the relevant state authorities. Research and practical experience clearly indicate that drug users and local communities benefit substantially from such harm reduction provisions. Not only are they well accepted by the German Government but also by local citizens and residents, political parties, police and shopkeepers. Usually there occurs no congregation of drug users and dealers in front of injecting facilities, no disturbances of the public order in the immediate neighborhood, no honey pot effect as well as hardly ever exceptional police actions. Drug use in public places is considerably reduced. Such positive results and reactions have also been reported from other countries running supervised injecting rooms (SIR), and I have not heard of one single SIR that had to be closed because of ineffectiveness or public protest. SIRs provide shelter to drug using people and facilitate drug use under hygienic and medically controlled conditions, thus increasing dramatically the likelihood of successful life-saving measures. They reach a large group of drug users which never had any contact to the drug-help system before and acute medical care can be provided for the first time (e.g. wound dressings, treatment of abscesses, basic first aid). Also, psychosocial counseling is offered often resulting in referrals to specialized detoxification facilities, GPs prescribing substitute substances (methadone, buprenorphine), primary health careers, agencies advising on in-patient, abstinence-oriented therapies (therapeutic communities) and social welfare services. The statistics published on the effectiveness of the Sydney medically supervised injecting room are very similar to those published in other countries. Therefore, I see no reason to doubt the objectivity of those who evaluated the Sydney injecting facility.

Referring to “shooting galleries” is not only absolutely wrong (since they are operated in private and mostly unhygienic environments without medical supervision and counseling) but simply reveals negative attitudes and beliefs towards harm reduction and life-saving assistance by an abstinence apostle ignoring the fact that only those drug users have a chance to decide for striving at a life abstinent from drugs who survive periods of compulsive and life-threatening using patterns. I strongly believe that professionally operated SIRs offer such a chance, not only in Germany and other countries, but also in Australia.