Research Therapies — 12 July 2017

AFTER four years researching the dark world of drug addiction in the inner west, Jeremy Aitken believes having a place in the community where users could safely inject drugs would save lives.

Having seen users accessing needle exchange programs, only to overdose through misadventure outside clinic doors, the academic and author is now weighing in on the divisive debate over the need for a second medically supervised injecting room in Sydney.

A review into Australia’s first supervised centre in King Cross has put the conversation back on the agenda with drug and health experts pushing for changes to laws that restrict the number of facilities in NSW to just one.

Among those supporting places where users can access sterile equipment under the eye of medical experts are the State Education Department, the Advocate for Young People and the operator of the Kings Cross drug injecting facility, Uniting.

While the review made no recommendation for another site, submissions called for services to be broadened to address rising use of the drug “ice” outside the Kings Cross strip.

Author Jeremy Aitken has written a book about drug use in the inner west called Crystal Street. Photo: Joel Carrett

Author Jeremy Aitken has written a book about drug use in the inner west called Crystal Street. Photo: Joel Carrett

Australian Drug Law Reform president Alex Wodak named Marrickville, Fairfield and Liverpool as areas that could potentially benefit from a supervised facility.

“The drug market in Kings Cross has become encroached by development, lockout laws and gentrification and that’s led to an increase in other parts of the inner city,” he said.

“We have to adapt and given the proximity to the CBD, Marrickville seems a logical area to put a supervised facility.”

Bureau of Crime Statistics show Marrickville has the highest level of drug-related crime in the inner west and the State’s sixth highest rate of narcotics arrests.

The region’s primary hospital, Royal Prince Alfred, also recorded the state’s second highest unplanned admissions in 2015 — the other factor in scoping the need for a supervised facility.

Uniting has credited the Kings Cross centre for supervising more than one million injections since 2001 without a single overdose.

But the facilities have also proved contentious with the Kings Cross local liquor accord and business groups calling for the centre to be relocated, citing social factors.

The supervised facility is one of two “harm minimisation” approaches — the other being the needle program offered at Marrickville, Concord, Annandale and Camperdown.

The Marrickville Community Health Centre where drug users can pick up sterile syringe kits.

The Marrickville Community Health Centre where drug users can pick up sterile syringe kits.

Data shows “ice” overtook heroin in 2015 as the most commonly reported drug last injected (27 per cent).

The scourge has prompted calls for Australia’s first ice “smoking room” as a third harm reduction strategy.

Law reformers such as Matt Noffs say the facility would offer clean pipes and smoking equipment, as opposed to fresh needles.

“A supervised centre allows you to get to know who the users are and it stops them falling through the cracks,” he said.

Through his research for his book Crystal Street, Mr Aitken believes the approach would “save lives”.

“The kits are effective for people accessing clean syringes but it doesn’t address the problem of users looking for somewhere else to shoot up, mixing drugs or not knowing what they’re taking,” he said.

“That’s when accidental deaths occur.”

The Kings Cross safe injecting room in Darlinghurst Rd.

The Kings Cross safe injecting room in Darlinghurst Rd.

In its submission to the review, Uniting claimed the supervised centres were not politically palatable.

“It is not an exaggeration, there is increased use of ice,” said clinical director of Drug Health Services at the Sydney Local Health District.

“We are seeing behaviour disturbance, we are seeing people coming to the emergency departments, we are seeing psychiatric admissions.

“Any health service like (an injecting facility) has the potential to do some good, but whether it’s the best use of resources, which are scarce, is perhaps a slightly different question,” he said.

STERILE SYRINGES ISSUED AT RATE OF 1.3 MILLION A YEAR

A STAGGERING 1.3 million needles are handed out each year by health authorities to illicit drug users across the inner west.

The Sydney Local Health District (SLHD) said it provides the sterile syringes primarily to halt the spread of HIV/AIDS as well as hepatitis B and C.

People injecting methamphetamine, including ice, or heroin in the areas serviced by Royal Prince Alfred, Concord, Balmain and Canterbury hospitals can pick the “fit packs” up from community health centres, either over the counter or from 24-hour needle vending machines.

Needle dispensing machines at the Marrickville Community Health Centre where drug users can pick up sterile syringe kits.

Needle dispensing machines at the Marrickville Community Health Centre where drug users can pick up sterile syringe kits.

About 3600 needles a day are distributed across the SLHD as part of its Needle and Syringe Program while close to 40 neighbourhood pharmacies sell subsidised needle kits to drug users.

Paul Haber, pictured, the clinical director of Drug Health Services at SLHD, said the number of kits distributed rises between 2 and 3 per cent each year.

Prof Haber said the service aims to reduce the harm and health complications associated with drug use and tries to prevent the misuse of drugs.

He said providing sterile needle kits, which include five syringes, sterile water, swabs and cotton balls, helps prevent drug users sharing needles.

People who inject drugs are 50 times more likely to contract hepatitis C than the general public.

Prof Haber said handing out needles gives health authorities a chance to talk to addicts and encourage them to undergo health checks and counselling.

A discarded used needle and other equipment from a sterile syringe kit, photographed by a member of the public, that was thrown under a public bench just off Marrickville Road, Marrickville.

A discarded used needle and other equipment from a sterile syringe kit, photographed by a member of the public, that was thrown under a public bench just off Marrickville Road, Marrickville.

“In parts of the world where they don’t have this needle-syringe program you are looking at upwards of 50 per cent of people who inject drugs affected by HIV. In Australia, that number is more like 1 per cent.’’

He said it is hard to determine the number of intravenous drug users in the inner west because the use of the needle dispensing machines and using pharmacies is anonymous.

Prof Haber said work is being done to increase medical and nursing support for drug users in the SLHD to help people into medical treatment and assist them get off drugs.

This piece by David Barwell and Jim O’Rourke was originally posted on ‘TheDailyTelegraph’ July 11 2017.

 

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