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IT TAKES TWO-
SHOULD THERE BE A SECOND
MEDICALLY SUPERVISED INJECTING ROOM
IN MELBOURNE?

AN OBSERVATIONAL ESSAY BY AMITY BROWN, AGED 17

Ever since the opening of Victoria’s first injecting room in July 2018, controversy has been raised over whether or not this approach to our 'drug problem' is working for the better of our community or not. 


But what does this mean exactly?

Who comes to mind when I say community? Your friends? Colleagues? The family next door? Those in circles of high privilege tend to forget that their 'community' consists of many vulnerable and deeply disadvantaged groups. A large proportion of these groups are made up of people who inject drugs. People that are just like us, with differing life circumstances. 


The Victorian government recently acquired a large building in the Melbourne CBD and are indicating towards possibly using this space to open a second injecting room. We need to make this happen, or our communities will suffer.


Heroin and other opioids seems to have a history of detrimental side effects to its users, families and communities. However, many drug users, harm reduction activists and medical professionals would argue that the drug itself, and the route in which it is most commonly taken (Via intravenous injection) is of no real threat if taken with proper precautions. 


The long-term health consequences of heavy opioid use seem undeniable, but these drugs alone are no more harmful than the socially acceptable, readily available ones that we choose to take. Research shows that heroin and alcohol do equal amounts of damage to the body, with alcohol causing more deaths and illness worldwide.

So why do we squirm or other ourselves from those that inject? Heroin use- especially injecting- is extremely stigmatised. This stigma derives from a lack knowledge and of understanding of the innumerable reasons behind drug use. 


Many see drug use as simply a 'poor life choice', instead of looking further into any possible underlying issues, where they may find that for some people, this "choice” isn’t much of a choice at all. Some who use drugs may be suffering from emotional pain, trauma, usually poverty or sometimes even homelessness. People living on the streets that also use heroin, may continue to use to keep warm in winter, or may use meth to stay awake at night, just so they can feel safe and alert in the case of a dangerous situation.


This stigma makes it most unsafe, meaning death and injury from taking the drug is more likely to occur.

The demonising and criminalising attitudes (and laws) towards those who use drugs are responsible for these deaths. 
Heroin that is used 'in the streets' is usually used in isolation, done quickly and done out of the way of prying eyes. But where no one is around to see you use, there is also no one able to respond if an emergency occurs. 
In an opioid overdose,  breathing slows followed by loss of consciousness. 3-5 minutes without oxygen, brain damage starts to occur, soon followed by death. With opioid overdoses, surviving or dying wholly depends on breathing and oxygen.


Death from overdose is easily preventable.

In a Safe Injecting Facility or Medically Supervised Injecting Room(MSIR), a person can take the time to look at their substance, calculate a dose that seems safe for them, prepare it in a clean & safe environment with new sterile equipment, and inject carefully and slowly in a way that causes the least amount of harm to their veins.
MSIRs were first created to be safe, non-judgemental environments that anyone over the age of 18 who injects drugs could come to, with the assurance of sterile equipment and supervision by medically trained staff in case of an overdose.

These health centres also provide access to doctors, nurses, counsellors, dentists, lawyers, housing workers, as well as outreach to any additional health or 'life'  support services needed by their clients.
 

The government’s reasoning for the opening of a new injecting room is heavily based on the success of Victoria’s first MSIR in Richmond. 

Within the first year of it’s opening, there were over 61823 injection related visits, and 2908 registered clients using the service. During this time there were 1232 overdoses safely managed by staff, all of which without supervision could have resulted in death. There are over 120 other MSIRs or SIFs running successfully worldwide. Despite these evident results, there has been public outcry over the location of the Victorian MSIR, as it is near a primary school and in a residential area. Residents report "finding needles in the streets" and "overdoses occurring near school grounds". 

What a lot of people don’t understand is that the placement of the Richmond facility on Lennox street was not random. This exact spot, near this school, near these residents, near the Victoria St businesses, whether you’d like to admit it or not, has always been a drug hotspot, with overdoses occurring only steps away from the placement of the site-daily. The MSIR opening has since made a clear positive impact on not only those who use the facility, but the entirety of the Richmond community. This has been done by getting people to inject off the streets, in a safe, supervised setting, therefore reducing overdose rates- publicly and otherwise. Not to mention they have staff patrolling the area, picking up and disposing of any used needles and responding to overdoses outside the health centre if need be.


Unfortunately, this is not enough.

One room will never be enough to manage the whole of Victoria’s overdoses.

Our drug-using community extends far past Richmond, requiring people to travel all over our city just to use the service or to get the services they need. 

 

Another common criticism from Richmond residents is that the MSIR is turning their suburb into Melbourne’s ideal spot for drug activity. The answer to this would not be to take away the one and only harm reduction assistance we have, but to open as many facilities as we can, in as many places as we can, therefore taking the load off any one suburb. The opening of the Flinders street site (or other CBD location) would do this, as well as reducing the load on ambulance and emergency hospital services.

 

The current proposed location of the new injecting room has long been suffering from high overdose rates. Ambulance Victoria data shows there has been an average of almost one heroin-related overdose per week in the vicinity of just four CBD intersections since 2015. That’s over 300 deaths. We have the chance to stop these deaths from occurring through the opening of a CBD facility.

Medically Supervised Injecting Rooms have had a deeply positive impact on the community, reducing ambulance call outs, the financial strain on health facilities, and most importantly, they’re saving people’s lives. Following the huge success of Richmond’s facility, the federal government should not only agree to the construction of a second site in the CBD’s centre, but support the expansion of more MSIRs throughout Melbourne, because they are the only one’s caring for our drug community as of now. 


But that can also change. We are battling a health crisis that the large majority don’t care about, and it is only us who can change that. We need to get over our fear of the unknown and start putting the responsibility of these deaths onto ourselves, so we can then expand on our personal knowledge of how to respond to an overdose. 


Because these deaths are on us. 


All of us.

NOTE FROM THE EDITORS:
WHACK would like to thank, acknowledge and support the voice of our next generations by including this last minute submission by one of our youngest authors this year-Amity Brown- 17yrs of age. Their observations on the MSIR and their compassion and passion for treating our community with care, respect and dignity comes shining through in this essay. A lot of readers will know what Amity is writing about but we love to hear from our community about the issues that are important to us. 
Thanks Amity!


We'd like to encourage other young readers/members to share their observations/opinions/artwork and stories with WHACK. 
Email: whack@hrvic.org.au

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