They save lives and keep the public safe. Should there be more of these rooms in Australia?

The Victorian government is facing renewed pressure to "save lives" by creating more safe injecting rooms, but experts explain stigma could be leading to "cold feet".

A medical room with small desks, chairs and a couch

Australia's second supervised injecting site opened in North Richmond, Melbourne, in 2018. Source: AAP / James Ross

Key Points
  • 18 peak medical bodies and unions have pushed for a second supervised injecting facility in Victoria.
  • Advocates claim they save lives and keep the public safe.
  • But some businesses have claimed there are concerns over safety for people in the area.
On average one person dies a month in Melbourne's CBD from a drug overdose.

This has prompted 18 peak medical bodies and unions to push for a second supervised injecting facility in Victoria, promised in 2020 by then premier Daniel Andrews.

An open letter released on Tuesday urged the Victorian government to deliver a facility in the heart of Melbourne, where people can use drugs of dependence in a medically supervised setting, to combat a surge in overdoses and ambulance call outs.

It states that more than 40 Victorians have lost their lives to overdose in Melbourne's CBD since the promise was made.
The Victorian Alcohol and Drug Association (VAADA) aims to reduce drug-related harms and advocates to save lives by creating safe spaces with access to sterile equipment and various forms of health care.

VAADA acting executive officer Scott Drummond said the organisations issued the plea because the second site was "overdue and needed".

"We hold some concerns that the government may be hesitating on this important lifesaving initiative, and we are encouraging them to do what's best and save lives of Victorians who choose to use drugs," he told SBS News.

The Alcohol and Drug Foundation (ADF) said overdose prevention centres were needed to stop further deaths and combat a 28 per cent increase in heroin-related ambulance callouts.
Rear view of a room with a long metal desk separated by dividers. There are blue chairs at the desk.
Medically supervised injecting rooms like the one located in North Richmond are supposed to provide safe spaces and Melbourne's site alone has reportedly prevented more than 7,000 overdoses. Source: AAP / James Ross
"These heartbreaking deaths have a ripple effect on the community, with friends and families suffering," ADF CEO Erin Lalor said.

"A medically supervised injecting room in Melbourne’s CBD would play a key role in preventing overdose deaths, reducing drug-related harm and connecting people with vital health and social support services."

Earlier this year, the Victorian government received a report from former Victoria Police Chief Commissioner Ken Lay on the establishment of a medically supervised safe injecting room in the Melbourne CBD. The report is yet to be released.

Three decades of safe-injecting in Europe

The Netherlands and Switzerland lead a pragmatic approach to reducing drug harm, with the latter opening its first unofficial supervised injecting facility in 1986 during a heroin crisis.

Since then more than 120 safe injecting facilities have launched across Europe - including in Germany, Spain, Denmark, Norway and Portugal - as well as dozens in Canada.

A 2019 report by Harm Reduction International concluded that safe injecting facilities "reduce morbidity and mortality by providing a safe environment and training people on safer drug use".
Drummond told SBS News that overseas experience shows these "facilities work".

"I think the thing that we could take in particular from success overseas is that there's a long history of overdose prevention services having been established for many years," he said.

"It's not as if the evidence is equivocal on this topic."

Australia's first site opened 22 years ago

The first Australian medically supervised injecting facility opened in Sydney's Kings Cross in 2001.

Since its launch, it has reversed nearly 11,000 overdoses and provided more than 20,420 referrals to treatment and services, according to the ADF.

Melbourne's North Richmond site has had over 300,000 visits, preventing at least 63 deaths and managing over 7,000 overdoses since 2018.
VAADA and the ADF said the benefits of the facilities extend beyond safe drug use as they reduce demand on public hospitals, the spread of blood-borne viruses and the presence of public injecting and discarded equipment in streets.

"I think when they're well established, well structured, well implemented, they reduce street-based drug use and that's clear," Drummond told SBS News.

"And by reducing street-based drug use, which can be confronting, it improves the visual amenity of an area. It makes it safer for communities and of course, it saves lives."

While that these sites have a positive impact on local residents and businesses, some locals are concerned about the congregation of drug users around facilities and have a perception of reduced safety.

In July, 40 Melbourne restaurateurs signed an open letter to Andrews asking a second Melbourne injecting room not be opened in a Salvation Army building in Bourke St reportedly being considered for a site, citing concerns over safety for people in the area.

Earlier that month Victorian Opposition leader John Pesutto called on the government to reveal if the building was being considered as a site for the injecting room and said it was not the right place for the facility.

So why don't we have more sites?

Both Lalor and Drummond pointed to stigma as a key obstacle to setting up sites like the one in Melbourne's CBD.

"For people who are dependent on drugs, stigma is a common and complex problem," Lalor said.

"Having dedicated spaces for people to attend where they can be free from judgement and discrimination, can help them build trust, and connect with other health and support services that they may not have otherwise accessed."

Drummond said drug use needed to be tackled like other health initiatives and urged the Victorian government not to get "cold feet".
A close up of a person in a small room holding a tray holding medical supplies in packaging
Sterile equipment ensures safety and prevents the spreading of bloodborne virus transmission. Source: AAP / James Ross
"If I presented government with any other lifesaving health intervention or any other chronic condition, it would be embraced," he said.

"But due to the stigma of drug use and those who use drugs and the minority of wealthy well-connected voices, we are concerned that this proposed supervised injecting facility won't go ahead."

Asked about a potential timeline for the second site and the public release of recommendations by Ken Lay, a Victorian government spokesperson said:

"The findings in Ken Lay's report highlight the complexity of this matter - it must be dealt with sensitively and comprehensively, and we're taking the time to get it right.

"We are considering Mr Lay's recommendations and will release the report, and a government response, in due course."

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6 min read
Published 28 September 2023 7:07pm
Updated 28 September 2023 9:08pm
By Ewa Staszewska
Source: SBS News



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