Y/W. It's a tough call, we do know, the almost 50 year war on drugs has been an abject failure except for, as the article said, law enforcement, banks and some crime figures. And as the article stressed, the problem is not solved easily. I remember well the controversy around the first SIF in Sydney's Kings Cross...
Supervised Injecting Facilities
By Ele Morrison
Supervised injecting facilities (SIFs) are services where people who are at risk of drug-related overdose can safely use drugs knowing a trained worker will respond if needed. Thousands and thousands of people have safely used the more than two hundred drug consumption services in the world and the evidence showing the benefits for the community is well-established [1].Yet, because of stigma about drug use, for many people they remain controversial.
On 23 April 2024, the Victorian Premier revealed that plans for Australia’s third SIF, Melbourne’s second, had been abandoned because of their difficulty “finding a location that strikes that balance between supporting people who use drugs with the needs of the broader community”[2].
Australia has a long and proud history of supporting harm reduction services for people who inject drugs. Needle and syringe programs (NSPs) were introduced in 1986 and soon after had been established throughout the country. Many community pharmacies and other health services also provide this essential service. This wide implementation is now rightly recognised and celebrated for preventing an HIV epidemic among the community of people who inject drugs, as well as preventing HIV transmissions in the general community.
SIFs, however, have had far less support. The first SIF in Australia was opened in King’s Cross, Sydney, in 2001. It wasn’t until almost twenty years later, in 2018, that another SIF, the second in Australia, was established in Richmond, Melbourne. There were many similarities between the service in Sydney and the new service in Melbourne. They followed the same medical model and had many of the same rules and regulations about who could access them. There were also some big differences. Sydney’s service operated on a main street surrounded by shops and traders, whereas Melbourne’s service was opened at a community health centre that had a long history of operating a busy needle syringe program. Although both services were opened in areas where the local people lived with a daily reality of public injecting and overdose, the Melbourne facility was in a more gentrified, suburban location, and there was a primary school next door. These factors were highlighted and used by those who were opposed to the service being established.
The planned second SIF for Melbourne was announced in 2020 in response to the backlash that had come from the local homeowners around Richmond. The idea was to take pressure off the busy Richmond location by having an alternative option in the CBD. This area also has documented public injecting, significant numbers of ambulance callouts for drug-related overdose, and high rates of overdose deaths. The people opposing the SIFs aren’t the people who experience these impacts, but they might sometimes see them happen. Having a SIF in the area would make that less likely, but stigma isn’t logical. For the four years following the announcement for a SIF in the CBD, there were coordinated campaigns and protests both for and against opening the service. The government commissioned a review, and the report was released at the same time as the announcement of the new SIF not proceeding. Although this review recommended providing a small facility in the CBD, this evidence-supported plan was not implemented. A more expensive plan including several different programs was announced instead.
What is most disappointing for people who believe an injecting facility in Melbourne’s city centre is needed is the messages this sends: the lives of people who inject drugs don’t matter, the care of people who love people who inject drugs doesn’t matter. The initiatives announced by the government will have far less of an impact on overdose than a small injecting facility would have had. A person who injects drugs dies every month in Melbourne’s CBD. Rates of overdose are rising every year in Australia currently at five deaths a day, and Victoria has some of the highest rates of heroin use in the country. Each day we don’t have somewhere safe for people to go is another day where people’s lives and health are at risk.
The SIF in Sydney, meanwhile, has been very successful...
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