Pubdate: Tue, 01 Aug 2000 Source: Reader's Digest Australia (Australia) Copyright: 2000 Reader's Digest (Australia) Pty. Limited Contact: GPO Box 5030, Sydney, NSW 2001, Australia Fax: +61 2 9690 6211 Website: http://www.readersdigest.com.au Author: Paul Raffaele INJECTING ROOMS: THE TRUTH Here's Why They Won't Work A destructive heroin wave is sweeping Australia. Our cities and towns are awash in the illegal drug. Authorities estimate that 2300 kilograms of heroin, worth $3.4 billion on the street, are smuggled into the country each year. According to the Alcohol and Other Drugs Council, more than 330,000 Australians have tried heroin at least once. To combat the scourge, scores of the nation's most powerful people -- politicians, academics and drug experts -- have lined up in favour of government-funded heroin injecting rooms. Under the plan, addicts would bring their illegal narcotics to these rooms and shoot up under medical supervision, free from police interference. Injecting rooms would get heroin off the streets, out of the laneways and prevent the continuing degradation of neighbourhoods, proponents argue. In May last year, the New South Wales Government proposed an 18-month trial of a heroin injecting room in the heart of King's Cross, one of Australia's most crime-ridden suburbes. The experiment will be supervised by the Uniting Church. Victoria and the Australian Capital Territory have announced similar plans. Beginning in Sydney later this year, with Canberra and Melbourne to follow, the trials are going ahead, despite the prime minister's call for state governments to shelve the controversial plans. Support for supervised heroin injecting rooms may be well-meant, but critics of the plan argue that it will increase rather than lessen the dangers to drug users and society. Here are some of the myths and half truths the heroin injecting room lobby has spread through the media over the past year to sustain a determined campaign to legitimise the use of one of the world's most dangerous drugs. Myth 1: Supervised injecting rooms will save lives Injecting-room staff who are trained in resuscitation techniques and have on hand drugs such as Narcan -- which counteracts heroin's effects - -- will save addicts who overdose, say the plan's supporters. "Going by Europe's experience, the injecting room is likely to save approximately 30 lives a year," argues Dr Alex Wodak, director of Sydney's St Vincent's Alcohol and Drug Service, and a major proponent of the plan. Peter*, who was an addict and heroin dealer for 14 years, scoffs at such arguments. "How can anyone predict that?" he says. "Heroin sold on the streets can be tainted or stronger in purity than the addict can tolerate, irrespective of where they're shooting up." Major Brian Watters, former commander of, and now addiction consultant to, the Salvation Army's drug rehabilitation programme who has worked with addicts for two decades and is chairman of the prime minister's drug advisory body, agrees. "If someone could prove to me that having supervised injecting rooms saves lives, I'd be the first to support them, but the evidence shows otherwise." Watters points out that some 800 addicts die nationwide from overdoses each year. As limited facilities will mean that only a small percentage of addicts will use injecting rooms, only a handful of deaths by overdose would occur among these users each year if they injected in their homes or the streets. And there's no guarantee that injecting rooms will save addicts from ultimately dying as a result of their drug use. "Heroin can cause overdose and sudden death, despite the presence of Narcan," he says. Last year, the Reverend Ray Richmond, pastor of the Wayside Chapel in Sydney's Kings Cross, defied the state government and opened the doors of his church to addicts, providing them with a place where they could inject "safely". The room was opened for just over a week before a decision was made to close it, but soon afterwards an addict died of an overdose in a toilet at the chapel. Of concern to experts like Athol Moffitt, Q.C., the former New South Wales Supreme Court judge who headed a Royal Commission examining organised crime -- central to which is the illegal narcotics trade -- is the long-term harmful effect of sponsored injecting rooms. When governments publicise the "safe" nature of these premises, Moffitt says, they encourage nonusers who might otherwise be frightened by the danger to try heroin. "If you take away the fear, more people will begin to use it, and addicts will use it more frequently," he says. "And more people are likely to die." Says Mick Palmer, head of the Australian Federal Police and deputy head of the National Council on Drugs, the prime minister's advistory body on illegal narcotics: "Sooner or later someone will die in a 'safe' room, and that will create public pressure on governments to provide safe heroin," he says. "That's bad policy." Myth 2: Supervised heroin injecting rooms will cut drug-related crime Wrong. Even with the government sponsoring injecting rooms, addicts who use them will still have to bring in their own heroin, an illegal substance, which they buy off dealers at street prices. It takes several hundred dollars a day to feed a hard-core heroin addict's habit. To pay for it, users often thrust themselves into a life of crime or prostitution, robbing and bashing innocent victims. As a result, rates of violent crime and burglary in Australia have zoomed in recent years. According to a recent study by the Australian Institute of Criminology, almost three-quarters of people detained by the police test positive for illegal drugs. Seventy per cent of males held for a violent crime test positive, as did 86 per cent of men held for property offences -- half of them for opiates. Even in less-populated states, the rapid increase in violent crime is directly related to heroin addiction. According to the Australian Bureau of Statistics, in a three-year period, the number of victims of armed robbery rose by 77 per cent in South Australia and by 99 per cent in Tasmania. Total victims of armed robberies for Australia last year were 10,850, with another 12,928 victims of unarmed robberies. The cost of illicit drug-related crime to the community is a staggering $1.7 billion yearly, says Neil Comrie, chairman of the Australian Bureau of Criminal Intelligence Board of Control. I recently visited a government-financed and supervised injecting room in Frankfurt am Main, Germany, praised as a model by supporters of trial injecting rooms in Australia. Frankfurt's facility has been operating for five years and has not reduced the area's serious crime rate, among the highest in Germany. As with Australia, heroin is illegal in Germany and many addicts there commit crimes to pay for their habit. "Mostly the men rob stores or passers-by with knives or steal bicycles and car radios," says Josch Steinmetz, who runs the injecting room I visited. "The women sell their bodies." We can expect the same criminal activity by users of the Australian injecting rooms, says Moffitt. "In setting up the rooms to be used by people who rob and bash to get their illegal heroin, the governments involved will themselves be aiding and abetting the breaking of hte law, facilitating and condoning the committing of criminal offences," he says. Myth 3: At heroin injecting rooms, addicts will respond to treatment and rehabilitation Unlikely. The four social workers staffing the Frankfurt injecting room I visited were always ready to counsel the 600 addicts using the facility each week and steer them toward rehabilitation courses. Though at some point most addicts talk to social workers about available programmes, their reason for using the facility is shooting heroin. "When users come in, they're so eager to get their fix they find it hard to concentrate on anything else, and afterwards they're so euphoric that what you say doesn't register," says Steinmetz. Myth 4: Establishing injecting rooms shows compassion for addicts The Reverend Gordon Moyes, superintendent of the Wesley Mission, the Uniting Church's welfare body, observes that such compassion, though well-meant, is misdirected. "Supporters of injection rooms have opted for a path of foolish compassion," says Moyes, who disagrees with his church's role in administering the NSW trial. "How can you claim you care for addicts when you signal you condone the injecting that's devastating them?" says Watters. "Actively assisting a heroin addict to inject his drug in the hope of weaning him off it is like the government steering alcoholics towards pubs to wean them off drink." Myth 5: Injecting rooms are cost-effective and in the long run save the community money Wrong. It costs Frankfurt and the German state of Hesse more than $1.6 million yearly to run four injecting rooms that cater to about 1000 heroin addicts, or just 10 per cent of the city's estimated users. One injecting room in Sydney is expected to cost around $1 million a year. It will only cater for some 200 addicts currently injecting in public around Kings Cross - a small percentage of the estimated 56,000 injecting drug users in Sydney. So running, say, a dozen heroin injecting rooms in Sydney, Melbourne and Canberra would cost millions of dollars of public funds for a questionable purpose, says Moyes. "No-one can guarantee that addicts would ever abandon their habit," he adds. Myth 6: Injecting rooms will allow addicts some dignity Anyone who has visited a government-sponsored injecting room in Europe knows that there's no dignity in shooting heroin, wherever it takes place. Media reports here have largely masked the horror, presenting the injecting rooms as akin to coffee shops, where addicts effortlessly inject their drugs and then sit back to enjoy the euphoria. Watters calls this "the Disneyland fantasy." At Frankfurt, the injecting room was bordered on three sides by a stainless steel bench, waist-high, where nine addicts crouched facing the wall. All were visibly suffering from malnutrition, stick-thin with pasty skin, eyes deep-set and haunted. I watched one man drop his trousers to reveal both legs swathed in bandages to hide hideous sores caused by his addiction. For half an hour he repeated plunged the syringe into his groin, because the veins on his arms, neck and legs were unable to take any more puncturing. By him a ravaged blonde in her thirties had another addict hold up a mirror so she could guide the syringe into her neck. Angrily stabbing her neck with the syringe again and again, she took 45 minutes to find a section of vein healthy enough for the injection. "When almost all the veins are too badly damaged to inject into, long- term users must resort to injecting into their groins or necks," Steinmetz told me. Myth 7: Law enforcement authorities will stop dealers from operating near injecting rooms That's like expecting bees to cease swarming around a honey pot. As I approached the Frankfurt injecting room, I saw eight men and women clad in baggy, dirty clothes, milling nervously in the street outside, waiting their turn to enter. A dealer in a leather jacket openly moved among them murmuring, "H, H, does anyone need any H?" Kings Cross police have vowed to pursue dealers to the very doors of the injecting rooms. But judging by their lack of success to date in clearing the suburb's streets of dealers, a question mark hangs over their ability to do so. At Springfield Mall, an open-air heroin shooting gallery in Kings Cross, I recently watched a dozen glazed-eyed addicts hunched over, syringes in hand as they sought veins for their hit. Bloodstained syringes that may harbour HIV and hepatitis microbes littered the mall's fringes. When I asked if it was difficult to buy heroin in the area, one addict laughed at my naivety. It's the same in other cities and towns. In Melbourne, addicts haunt inner-city Smith Street, close by the location of one of Victoria's five planned injection rooms. Myth 8: Overseas experience shows that having injecting rooms and tolerant policies towards narcotics does not increase drug use. Wrong again. The Uniting Kingdom had always allowed doctors to prescribe heroin to those who could not cope without it, but in the 1960s there was an explosion of use. Even though most specialists where subsequently prevented from prescribing heroin, the damage was done. By the early 1990s, known addiction rates were still increasing rapidly every year. On the other hand, Sweden has taken the opposite route, achieving astonishing success with a zero-tolerance policy on drugs. Swedish drug legislation makes no discrimination between "soft" and "hard" drugs and police come down hard on dealers and users who are found to be dealing. In contrast to Australia, Sweden also rejects the policy of "harm minimisation," which was adopted here at a premiers' summit in 1985. Under that policy the government accepts that drug use is a reality and that money used for halting the spread of drugs is better spent on improving addicts' health and welfare. The concept has mushroomed to take in virtually all drug and alcohol treatment in Australia, even in schools. In its Drug Education Strategic Plan 1994-99, for instance, Victoria's Department of Education, Employment and Training states: "Students should acquire knowledge and skills to make informed decisions about their drug use, and so minimise any harmful effects associated with it." The implementation of the harm-reduction policy has resulted in a dramatic increase in the number of drug users here and also in Great Britain where it is in force. In Australia, it's meant that heroin use has spread through our cities and even into hundreds of country towns. Amber Stewart, of Armidale, in New South Wales, had her first heroin hit when she was 13. Her mother, Gwen, blamed the government for providing Amber with the financial means to live away from home. "She turned into a thief and a liar, but that wasn't Amber, that was the heroin," says Gwen. In March, Amber died from heroin at age 14. In contrast, the Swedish government was spent some $195 million over the past two decades stressing to its citizens through media campaigns and school education programmes that even soft drugs like marijuana can cause serious harm. As a result, Sweden has one of the lowest rates of illicit drug usage in the world. IF INJECTING ROOMS are doomed to failure, as many Australian experts now suggest, how can we fight and win the war against heroin? Australia should be following the example of Sweden, says Craig Thompson, a senior New South Wales magistrate who has dealt with thousands of drug addicts in his court. "With their nontolerant approach to drug use, sound educational programmes for children and parents, and innovative rehabilitation schemes, Sweden has had remarkable success in reducing demand for illegal drugs," he says. The prime minister has committed $500 million to his government's Tough on Drugs strategy. But our five dud Collins Class submarines cost more than $5 billion and now need modifications to the tune of $266 million. As the Reverend Moyes points out: "The cost of just one of the submarines would finance a highly effective Swedish-style strategy against heroin addiction and save a large number of lives." Experts like Watters and Thompson insist that federal and state enforcement agencies must receive enough funding to provide more sophisticated means of detecting drugs entering Australia. This must be coupled with strong policing of street sellers. Harm-minimisation policies must be replaced with harm prevention policies aimed at reducing supply and demand. Most importantly, we must provide increased funding to enlarge rehabilitation programmes that prove they can wean addicts off drugs. We should also be concerned about what injecting rooms will do to Australia's image. This is the Olympics year and thousands of overseas journalists will soon descend on us, many eager to report back on life in Australia. It won't be an easy fight to rid the country of heroin, but it's a fight Australia must tackle with all the resources it can muster. Most urgently we must stop injecting rooms from becoming established in our cities and towns. As Moffitt says: "There's a grim consequential reality about injecting rooms that must be recognised. There's a very real risk, indeed a strong likelihood, that heroin and the number of users and addicts will increase substantially as a result of their operation." - --- MAP posted-by: John Chase