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."  
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