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Safe At Last - But With Conditions.

Melbourne's new safe injecting room is great news - but establishment stigma won't be suppressed.

If you’ve been reading this blog, you may have noticed that I write rather a lot about stigma and discrimination against illicit drug users.

I’m of the strong opinion that these issues are critical in the uptake of Hep C treatment, however, today I’d like to address them (and a few other things) in a different, but related context.

Around this time last year, the number of overdose deaths was upticking and there was a worrying increase in the visibility of drug use on Melbourne’s streets. As a result, in a suddenly quite rational-seeming atmosphere of discussion, there was renewed talk of establishing a safe injecting room.

Two weeks ago, the decision to trial such a space in the City of Yarra was, at last, announced.

Until now, the Victorian State Government has been fundamentally opposed to the notion. However reasonable and progressive they may like to present themselves, they will inevitably serve what they perceive as the current political reality.

But they have been obliged to address a preponderance of positive evidence, the support of all relevant social institutions and a deteriorating situation on the streets.

Unpleasant and difficult to ignore, injecting drug use is now pervasive in the public spaces of North Richmond. The number of drug overdose deaths has exceeded the road toll (for the second year running) and we are only in November.

Add to this the threat of a Greens Party candidate snatching a seat in the most affected area, and the Government was finally inclined to act.

It’s good news, indeed, but predictably, there are conditions. It seems that a positive, life preserving, ethically sound program like this - based on a teetering pile of gold-standard proof– must be salted with punishment. There are few politicians on this planet, after all, who do not believe law and order is the most efficacious recipe for rustling up votes.

So, the Government’s new drug strategy includes a lowering of the quantity threshold for trafficking charges, both for ice and heroin. Just because. Or rather because they do not want to be perceived as being ‘soft on drugs’. In an effort to stymie the sale of synthetics over the counter, they have also announced what seems to be a questionable and scarcely legal ban on ‘any substance that has a psychoactive effect, regardless of (its) chemical makeup.’ I wonder if this includes coffee?

And because injecting drug-users can’t be trusted, there will be special efforts made to eliminate drug-dealing in and around the safe injecting facility. CCTV coverage will be maximized, though an individual here in the HRVic office has expressed doubt as to whether there is even room to fit more cameras in that locality.

To quote The Age: ‘The force will also be monitoring activity around the proposed safe injecting room in North Richmond to ensure it does not become a "honey pot" for heroin trafficking, Assistant Commissioner Rick Nugent told the inquiry.’

Such is the iniquity of drug dealers in this gentleman’s mind. Like vermin, mindlessly obeying their loathsome instincts to infest and destroy.

He’s working on some peculiar premises. After all, the safe injecting room is being situated where it is precisely because the area is already ‘a honey pot for heroin trafficking’. Secondly, there’s no reason why the dealers would leave their patch around Victoria and Lennox to congregate around an official location like North Richmond Community Health (the site of the facility) where a large percentage of their clients already go for injecting equipment. Thirdly, there is no available evidence for such a ‘honey pot’ effect.

Thankfully, the police force have signaled their willingness to cooperate generally and will adopt the peaceful co-existence approach that has been successful in Sydney.

Also, in blind accordance with a receding vision of Judeo-Christian morality, it appears that no client’s children below the age of 18 shall be permitted to enter the premises. Better they be left in the car, or at the nearest playground than in, perhaps, a waiting room? Perhaps it is just too disturbing a thought that they may be present on the same premises in which their parents are engaging in such fearful and nefarious acts? Because we’re talking about drug users here, there must be some chance that, despite any precaution, simple proximity will inevitably expose them to bloody and illicit acts of medical self-abuse.

And what of the customers who are themselves under eighteen? Yes, they are excluded, although - because they do not have cars or, often, homes - they are more likely to use in public spaces. They are also more likely to lack knowledge of precisely those harm reduction techniques which the staff of the safe space will be there to provide.

In Kings Cross, public injecting was the principal driver for establishing their safe injecting room. In Victoria it is the rising overdose toll. This is a possible explanation for the disappointing and dubious decision to exclude ice-users from the facility. Compare this to Sydney, where people can inject any drug they like.

There has also been rumour that only one person will be allowed per booth in the centre – as opposed to Sydney where the number is two. If true, this seems needlessly officious, and likely pointless. In another difference with Sydney, clients will be required to provide their real names and access to their medical records, creating an unnecessary disincentive for attendance.

Obviously, I am highlighting the negatives here to make a point about endemic social stigma. The decision on the safe injecting facility must be hailed for the great thing it is. Already there are positive flow through effects with calls for more injecting rooms in Footscray and the ACT. The government seems also to be leaving at least some decisions up to clinical discretion, which has to be a good thing.

It should also be noted that the Victorian government intends to clamp down on dodgy detox operators, and is including funding for 100 extra rehab beds as part of its drugs package, marginally easing a great insufficiency.

But the stigma runs deep. It is a default community position. In many circumstances, unless an issue is pinned down with logic or an appeal to basic humanity, the prejudiced image of the drug user will prevail. It is the path of least resistance, the social gravity that makes opinion run downstream.

The Golden Phaeton

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