Pubdate: Mon, 04 Jul 2016
Source: Sydney Morning Herald (Australia)
Copyright: 2016 The Sydney Morning Herald
Authors: Matt Noffs, Alex Wodak
Note: Matt Noffs is chief executive of the Ted Noffs Foundation. Dr 
Alex Wodak is president of the Australian Drug Law Reform Foundation.
Bookmark: (Supervised Injection Sites)


Sydney needs to operate safe rooms for users, write Matt Noffs and Alex Wodak.

It is an indictment of our failed approach to drugs that the 
injecting centre in Kings Cross is, after 15 years, the only one in 
the country.

Australia's once bold drug policy is now stuck. Our law enforcement 
leaders tell us that Australia cannot arrest and imprison our way out 
of our drug problems. Yet as Australia struggles with increasing 
problems from ice use, we haven't been prepared to try innovative 
approaches that appear to have worked overseas.

Thirty years ago, authorities in Bern, Switzerland's capital, became 
the first to approve a drug consumption room where drugs could be 
injected under supervision and without the threat of police action.

As inhalation of vapour from the combination of heroin and cocaine 
became popular in the city, health officials asked for permission to 
modify the drug consumption room to be able to also accommodate 
people who wanted to inhale their drugs. When authorities rejected 
this, the police told the authorities they had to approve the request.

Now a facility operates in Bern across the road from a police station 
which is supported by the community, the police, the tourist 
industry, people who use drugs and healthcare staff who work with 
people who use drugs.

There is a hierarchy of risky ways of using ice. The most dangerous 
way is to inject the drug alone, followed by inhaling it alone. 
Injecting in a drug consumption room is more risky than inhaling in 
such a facility.

The safest way to use ice is never to touch it. What drug consumption 
rooms add to our approach to ice users is engaging with them where 
they are now. Some will be talked into accepting health or social 
interventions, with the aim of reintegrating people who have used ice 
back into the community. It's usually a long process, often 
accompanied by setbacks.

There is now compelling evidence that drug consumption rooms are 
effective, have no serious downsides and save more money than they cost.

In a recent paper by Australia's Drug Policy Modelling Program, 
researchers outlined that there are are nearly 100 supervised 
injecting facilities, sometimes more broadly called drug consumption 
rooms, across the globe. They exist in about 10 countries in more 
than 60 cities.

Many are focused on injecting drug users and some also have 
"inhalation rooms" for smoking drugs like methamphetamine  ice. There 
have been more than 130 papers and reports on the efficacy of drug 
consumption rooms consisting of at least 29 evaluations, 15 policy 
and legal papers, 12 qualitative studies, eight literature reviews 
and seven cost-benefit analysis.

Of the cost-benefit analysis, all seven clearly show the savings 
outweigh the associated costs.

There are also a variety of positive outcomes including a reduction 
in overdoses, they reduce risky injecting practices, they improve 
access to drug treatment, health and welfare services and they 
improve public amenity: one evaluation showed 50 per cent fewer 
discarded dirty needles around inner Sydney. They also reduce crime.

Where to put one? The answer at this stage is, any community that has 
a need and asks for one. There are calls for one in western Sydney 
but the community needs to go through a detailed conversation first. 
The fear needs to drop from the debate and the conversation needs to begin.

Premier Bob Carr initially opposed the medically supervised injecting 
centre in Kings Cross but was persuaded by the arguments. Upon his 
retirement, Carr identified the centre as one of his 10 proudest achievements.

It is a staggering indictment of Australia's failed approach to drugs 
that the injecting centre in Kings Cross is, after 15 years, the only 
one in the country. We need more - urgently.

Future drug consumption rooms in Australia should be able to 
accommodate people inhaling ice and other drugs.

Advocates of these rooms have said they are prepared, as a last 
resort, to commit civil disobedience to establish such a facility if 
official approval is not forthcoming.

Establishing Australia's first needle syringe program to prevent an 
HIV epidemic among people who inject drugs required civil 
disobedience in 1986. So too did the injecting centre in Kings Cross in 1999.

Surely our drug policy processes should be more flexible than to 
require health workers to commit civil disobedience in order to 
achieve much-needed reforms.

Drug policy hardly figured in the federal election campaigns. No 
doubt there are more urgent issues, but important issues that get 
ignored later become urgent issues.

It's time to trial drug consumption rooms with inhalation facilities 
where these are needed and where communities will accept them. A 
country that can waste $160 million on a useless plebiscite can afford it.
- ---
MAP posted-by: Jay Bergstrom