JUST over two months ago, the governing Council of the AMA (NSW) passed a unanimous resolution calling on the NSW government to make Sydney’s supervised injecting clinic permanent.
The council’s view was that the net public health benefit of the Kings Cross facility was beyond reasonable doubt.
We felt that the government had demonstrated courage and foresight in 2001 in starting a trial of the supervised injecting room. Yesterday’s decision to make the centre a permanent fixture showed similar qualities and should be applauded.
The Australian Medical Assocation supports a harm-reduction approach to all dependencies that cause harm to individuals or society. There are evidence-based public health reasons for this.
Nowhere is this seen more clearly than at the Kings Cross clinic. The government’s move to set it up was a decision that would to test the alleged benefits of a harm-minimisation approach to injecting drug use.
Would the trial result in a reduction of deaths from overdose, public injecting and the numbers of discarded syringes in Kings Cross? Would it mean an increased uptake of drug detoxification and addiction treatment programs?
Or would the clinic act as a honey pot, drawing addicts and dealers to the area? Would it lead to an increase in drug-related crime? Would it be associated with an increased transmission of blood-borne disease?
Although early experiences in Europe pointed to the likelihood of a net public health benefit, no one knew what would happen here. That is why the injecting room was established as a trial, with a rigorous review required every four years.
Two evaluation cycles have now been completed and the results have vindicated the aims set for the injecting clinic on its establishment.
There has been an 80 per cent reduction in ambulance callouts to drug overdoses in the Kings Cross area since the room opened. There has also been a heroin drought, but the Kings Cross figures compare to a corresponding decline of 45 per cent in adjoining suburbs. A recent death associated with the centre generated headlines because it was so unusual.
The count of publicly discarded syringes and the recorded incidence of public injecting have halved during the same period. Nor is there any credible evidence of a honey pot effect on drug-dealing or other related crimes.
These findings have been replicated internationally and there are now more than 80 similar supervised injecting facilities in eight countries.
But the centre’s future has always hung by a thread of opinion, not always informed by fact.
Some argue that the facility should be within a hospital. But it is self-evident that, to be effective, it needs to be where the addicts are.
The NSW Government has acted responsibly. The onus now lies with future governments of NSW to allow the centre to remain for as long as the evidence indicates it is required.
Dr Michael Gliksman was vice-president of the AMA(NSW) when this article was written.