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Melbourne’s medically supervised injecting centre trial must be open to all injecting drug users

Toby Hall
April 2018

A medically supervised injecting centre has never been attempted in Melbourne.

There’s no getting away from it, it’s a pretty big change. And change can be concerning, confronting and even scary.

But that doesn’t mean it’s not worth trying.

We’ve seen that concern bubble to the surface with the news that drug users at the trial service will be able to inject methamphetamines as well as heroin.

As a result, the Victorian Opposition has now announced it will stop the trial if it wins this year’s election.

In case it’s been forgotten, let’s just re-iterate why the trial is getting off the ground in the first place.

There were 190 heroin-related deaths in Victoria in 2016 – the highest number since the 90s. In the past year, 34 lives have been lost in Richmond alone.

Each of these people left behind brothers, sisters, parents, children and friends. The heartache these deaths cause is real, lifelong, and worst of all, preventable with the right health and treatment services.

St Vincent’s agrees with the Andrews Government that it’s time to try a new approach.

There are around 90 medically supervised injecting centres in operation around the world, including notably, in Sydney’s Kings Cross.

In the 17 years since Sydney opened its medically-supervised injecting centre, more than 6000 people have overdosed without one life lost. Clients of the service say they simply do not know people who die from overdoses anymore.

How many users in Richmond would say the same thing?

Medically supervised injecting centres are far more than simply a place to inject drugs. They provide emergency care in cases of an overdose or other adverse reaction; offer a range of important health services to people who are often disconnected from health care; and provide a critical pathway into treatment.

Let’s be very clear on that final point: all three evaluations of the Sydney MSIC found significant referrals to, and improved access to, treatment services.

Around 40% of clients at Sydney’s MSIC have never previously sought treatment, so it’s having contact with a group who are traditionally outside our reach.

And among frequent clients, 80% accept a referral for drug treatment.

By getting people into treatment, we stand a chance of stopping the cycle of drug abuse, violence, and death perpetuating itself.

And surely that’s the ultimate goal: providing hope to people at the darkest point in their life.

And as for users of the centre injecting methamphetamines?

St Vincent’s Melbourne is a pioneer of addiction medicine and treatment in Australia and all our experience tells us the centre shouldn’t exclude people who inject methamphetamines.

And while I can understand community concerns, on the advice of our clinical experts we think the Victorian Opposition has made the wrong call.

Injecting drug users tend to use many substances – not just heroin. We can’t care for them and connect them to health and treatment services if we turn them away.

Sydney’s medically supervised injecting centre, and others around the world, are open to all injecting drug users.

Around 20% of visits to the Sydney MSIC involve the injection of methamphetamines.

A big part of the Opposition’s concern is around the likelihood of violence and aggression at the centre among methamphetamine users.

But the Sydney injecting centre hasn’t had this problem.

And as in Sydney, Melbourne’s trial centre would also have the necessary staff with the experience and expertise to work with methamphetamine users and de-escalate any agitation.

St Vincent’s has always cared for Melbourne’s most disadvantaged and vulnerable; it’s been our Mission since the hospital was established 125 years ago.

The people who inject drugs in Richmond are our people. We see them when they come through our Emergency Department doors having overdosed, or when their injecting wounds get so bad they need urgent medical treatment.

We support a trial of a medically supervised injecting centre in Richmond and we believe it should be open to all injecting drug users.

Regardless of who wins the election this year, the trial should be given the time to demonstrate results and be robustly evaluated.

And if it’s a success, we will all be the beneficiaries.

 

Paul Andrews | St Vincent’s Health Australia

Level 22, 100 William St

WOOLLOOMOOLOO NSW 2010

E: paul.andrews2@svha.org.au

M: 0409 665 495

T: @paulandrews2043