Injecting Rooms Save Lives

I would like to start by commending the government for deciding to build a second supervised injecting room in Melbourne, this time in the CBD. This matter of public importance goes into some detail about perceived problems around the site of the supervised injecting room.

The following is a speech by Dr Tim Read, in the Legislative Assembly, on the 26th May, 2021. 

"It is important that Melbourne’s second supervised injecting room be at a place where people buy the drugs, because data very clearly show that people use heroin and other injectable drugs within minutes of buying them, so it needs to be very close to the centre where the drug dealing is occurring. It should also be near to or accessible to public transport. And the third criterion that I think is important is that it should be at a site chosen in consultation with local government, with the city council. While the precise location is a decision for the government, it should at least meet that criteria. It certainly meets the first two: it is close to where the drug injecting and drug dealing is occurring, it is close to public transport. Unfortunately there was no consultation with council, but to their credit council have decided to go ahead with this decision.

I have watched most of this debate unfold with interest, and the arguments against this second safe injecting room, when examined carefully, do not seem to apply to the precise address in Flinders Street but rather the opposition would prefer that there was no second safe injecting room at all. And their reasons seem to fall broadly into two groups. One is that it might attract undesirables to wherever this injecting room might be. They put it in terms of amenity, and there is no point arguing with this. There is likely to be some unpleasant behaviour around a supervised injecting room—that probably comes with the territory. There is no point disputing that. However, given that the Richmond injecting room sits right in the heart of the places where naloxone was injected by ambulance officers over the preceding 12 months, it is very clear that the undesirable behaviour predated the Richmond injecting room. Now, whether it has gone up slightly or down is a matter for debate, and it is likely that there is already quite a lot of drug injecting-related behaviour in this site close to the junction of Flinders Street and Elizabeth Street.

But the second argument raised by the opposition against this site, or against supervised injecting rooms generally, is that it perpetuates drug use. And in a way it does, because what it does is it resuscitates drug users who would otherwise die. Certainly failing to resuscitate them is one way of stopping the drug use, but it is far too drastic and Darwinian for my taste. In fact—and I want to break this news gently to the opposition—Melbourne already has 2000 to 3000 supervised injecting rooms. They have got wheels and flashing lights and we call them ambulances, but that is effectively what they are. They are equipped with someone trained in first aid, they are equipped with oxygen and they are equipped with naloxone. The problem with them, though, is that they often arrive just a little bit late.

I would like to tell you a story about a patient of mine who was resuscitated many years ago by an ambulance just a minute too late. If the ambulance had been 2 minutes too late, this person would be dead. But arguably he had a worse outcome: he was left with profound brain damage, damage so severe that he was unable to care for himself properly. Basic activities of daily living were beyond him, and that was because his brain was without oxygen for 4 to 5 minutes before he was resuscitated. It was a disaster, and anything that prevents this degree of preventable disability is worth supporting.

So the argument against this safe injecting room—I think there is a third unspoken argument against it, which is that it somehow nibbles away at or undermines our policies of prohibition towards drugs. I think this is a debate worth having, because the argument sustaining prohibition is that drugs are bad and if you touch them bad things will happen, and that by reducing the complications in some way, by addressing these complications—by reducing the incidence of death and disability relating to heroin use, for example—we are somehow weakening this argument of prohibition. That raises questions of whether we should perhaps be reversing prohibition in other areas—in, for example, cannabis or MDMA, other somewhat safer drugs—and using the benefits of legalisation to provide a regulated, pure supply of a known quantity. That is far too scary an area perhaps for this debate tonight, but it is worth identifying, because there is a lot that goes on in these supervised injecting rooms that relates to care, which is a value completely at odds with the question of whether or not this degrades the surrounding amenity. These supervised injecting rooms provide care to people. The one in Richmond provides dental care. It provides treatment which cures hepatitis C. It provides treatment for drug addiction in the form of opiate replacement therapy. I refer members to the august medical journal the Age, which recently published the results of the first 41 patients treated at the Richmond supervised injecting room—treated with depot buprenorphine. Over half, 59 per cent of them, stopped using and did not return to using heroin while on this monthly injection. So think of this as a long-acting methadone. Overall use of heroin by these 41 patients dropped by more than 90 per cent, so the argument that supervised injecting rooms actually perpetuate drug use is undermined by the fact that in Richmond, and I am pretty sure in the one in the CBD as well, there is treatment for drug addiction, which seems to be remarkably effective and which is turning people away successfully and in large numbers from heroin use. You know, it is just possible that this might improve amenity in the CBD after all."