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7pmproject.com.au, June 07, 2011

Project Primer: Safe injecting rooms

Victorian Premier Ted Baillieu recently blocked plans by the Yarra Council to open a supervised injecting centre in the inner-city suburb of Richmond. Meanwhile, Sydney’s Medically Supervised Injecting Centre in Kings Cross has just celebrated its tenth anniversary amid massive controversy over its effectiveness.

So what are the major arguments for and against safe injecting rooms? The 7PM Project is here to help with an equally-ill-informed summary of both sides of the debate.

OVERVIEW

Safe injecting sites are part of a range of policies known as harm reduction or harm minimisation, designed to reduce the negative consequences of drug use.  This public health approach to the drug problem is often seen as an alternative to the prohibitionist or law enforcement model, which attempts to eradicate drug use altogether through criminalisation.

THE CASE FOR

Law enforcement alone doesn’t work


Prohibition has failed to eradicate demand for illicit drugs. Since we can’t stop people from using them, it’s better to try to reduce the harm they do to themselves and the community in the process. By treating drug addiction as a health issue rather than a criminal one, we give users a chance to get clean without getting arrested or swept under the rug.

Improved health for users

By providing supervision and sterile equipment proponents claim they can encourage safer using practices (eg by reducing needle sharing) and reduce injuries and fatalities (eg from overdose).  This in turn reduces the burden on our health system, with fewer users requiring emergency room care.

Decreased demand

By referring users to medical treatment, incidence of addiction is reduced, resulting in a decrease in demand for illicit drugs.

Increased public health and amenity

Safer injecting practices reduce the incidence of blood-borne viruses in users and hence the wider community. By reducing public injecting, the public is less at risk from discarded needles and paraphernalia. Public safety is improved by reducing the incidence of crime in the area.

THE CASE AGAINST

“Safe” is a misnomer


Drug use is inherently dangerous, and providing medical supervision gives users the message that injecting is OK and can be safe.

Sending the wrong message

Heroin is a prohibited substance, and by establishing injecting rooms authorities are sanctioning illegal activity. Allowing drug use even in a controlled environment sends the message to drug users – and potential future users, including children – that sometimes drugs are OK.

Attracting crime

The “honeypot” effect: Once users have an official place to congregate, opponents say drug-related crime will increase in the area. According to this theory, dealing, violence and drug-acquisition crimes (eg stealing to pay for drugs) will intensify due to the ready supply of clients.

Encouraging ongoing drug use

The existence of a safe injecting facility encourages ongoing drug use rather than reduction or cessation.  If users have a safe environment to use drugs, they have no incentive to stop doing so.

THE EVIDENCE

None of the arguments above are new. They’re basically the same talking points that were heard over a decade ago when Sydney’s MSIC was being proposed. The difference is that now there’s a decade’s worth of research to either back up or refute each claim.
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