Compassion, not judgement, needed on illicit drug use


cartoon syringe and hand saying stop

Stakeholders have reiterated support for Richmond’s supervised injecting facility, following a Herald Sun article which reported the facility was attracting poor behaviour

Writing in the Herald Sun on Tuesday, Monique Hore reported on “lurid behaviour” in a Richmond laneway between February and May 2019, including “at least six separate incidents of public drug use”.

Further alleged incidents include a man threatening a woman and strip searching her, what was described as “an apparent ‘drug deal involving four people” and a couple engaging in sex acts in the laneway.

According to one property owner whose home backed onto the laneway, the supervised injecting facility was attracting illicit drug users “from far and wide”.

“We are not being holy, or not-in-our-backyard type of people,” the resident told Ms Hore.

“We were for the injecting room because we were hopeful that it would ease the strain on ambulance services.

“But it’s a Band-Aid, it’s not a solution.”

Another Richmond resident described finding packets of needles in a drain in his front yard, as well as bloodied needles in his driveway.

Richmond residents are reportedly calling to have the injecting facility shut down or moved – or for potentially opening more such facilities around Melbourne in an attempt to have drug users attend different facilities, rather than only one in Richmond.

A community meeting was held to discuss the issue.

The article is accompanied by images of alleged drug users in the laneway and a nearby car park, and pictures of an allegedly “drug-affected” man walking on a road in the suburb.

Victoria Police told the Herald Sun that the organisation was committed to reducing drug-related harm in the vicinity.

Meanwhile Victorian premier Daniel Andrews said that the facility was saving lives, and that while the trial was not providing a perfect solution, it should be permitted to run its course in order to make informed decisions about whether the facility should continue to remain open.

Brunswick pharmacist and harm minimisation Angelo Pricolo told the AJP that the supervised injecting facility in Richmond was never going to be a complete solution to harms arising from illicit drug use, but had already done a great deal of good.

“Allowing a trial to take place in Richmond, a hot spot for drug use and overdose deaths, was a courageous move by the premier Daniel Andrews in the face of some vigorous opposition,” he told the AJP.

“It needs to be stated that there was also lots of support from many and varied camps including residents, traders, drug and alcohol workers, the police, AMA, RACGP, Pharmacy Guild and the PSA. 

“The safe injecting facility was never going to ‘fix’ the situation in Richmond but what is not in dispute is that thousands of injecting events have taken place in this room.

“These are episodes that otherwise would have usually occurred in the very streets that have so graphically been photographed. They would have resulted in more activity being openly viewed, more injecting equipment being dumped in public places and probably more overdose deaths.

“This facility has provided an opportunity to treat our most vulnerable, many whom have horrific stories of abuse to deal with and a large percentage struggling with other mental health issues,” Mr Pricolo said.

“How we treat our most vulnerable reflects on the type of society we are. Finally in Victoria we have a government willing to listen to the evidence and stand up for these people and the community.

“Let’s continue with the trial and continue to face the problem with compassion not judgement.”

Anthony Tassone, the Pharmacy Guild’s Victorian branch president, told the AJP that the Guild is committed to reducing the social, health and economic costs of drug misuse in Australia, and believes that a nationally coordinated approach to the management and treatment of drug addiction is required given the magnitude of the issue. 

“The Guild supports a harm-reduction approach, including the trial of the medically supervised drug injecting room in Richmond, which recognises that an individual’s engagement in drug misuse, illegal drug supply or illegal drug manufacture has other flow-on social, economic and other health consequences for the community,” Mr Tassone said.

“The medically supervised drug injecting facility in Richmond is part of a two-year trial, and the views of the community are an important consideration for the next steps following the trial’s evaluation. 

“Figures released from the Victorian government show that more than 2,200 clients have used the service, and staff have safely managed more than 650 overdoses that may have otherwise been fatal.

“The facility is literally saving lives, and this must be at the forefront of all of our conversations about this particular site and any other facility’s future.”

Other pharmacists criticised the way the issue was reported by the Herald Sun, saying it reinforced stigma and was unhelpful.

 

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24 Comments

  1. I believe the sentiment of the community is not against the supervised injecting facility and the aims to be achieved but actually the physical location of it. It’s within a few kilometers of a primary school and evidently near some residential homes. Is it fair for us to be claiming that “this is for the greater good” when we do not live in the house that is adjacent to the injecting facility?

    • Jarrod McMaugh
      23/05/2019

      The community health centre that the facility exists within is close to a school and close to residence – this is correct.

      It also happens to be in the place where people were (and are) already consuming various subtances.

      The location is based on where the service is needed. This has indeed placed in a position where people may find it distasteful or outrageous, but this is a measure of the stigmatising point of view of these people, rather than the appropriateness of the service. The one thing that critics are calling for that is valid is more facilities…. this is desperately needed.

      The fact is that this facility has reduced overdose deaths and ambulance callouts to the area. It hasn’t eliminated antisocial behaviours or even removed all drug consumption from the surrounding neighobourhood, but it has dramatically reduced it.

      When measuring the success or not of such a facility, you need to look at the impact it has had, not just at the “lack of impact” that newspapers want to report on.

      • I don’t believe anyone is arguing against the impact or aims of the facility. You have further accused a whole community of having a stigmatising point of view.

        They simply just want it relocated. I believe this is a worthy consideration.

        • Jarrod McMaugh
          23/05/2019

          Not a whole community, a small portion of it.

          Those who have attended the meetings seeking to have it relocated are much smaller than the number of people who attended the community meetings to call for it’s creation, and the people who signed the petition for the same.

          The difference is, media outlets like the one shown in the article above sell newspapers through controversy, so they give a lot more coverage and attention to those who are outraged… which in this instance is the minority.

          BTW as an example of the kinds of stigmatising things that have been said about this life-saving facility; a local real estate agent suggested that they should form community groups that patrol the streets at night with machine guns to “clean up” the streets. Seems like the response far outweighs the existing issue.

          • 23/05/2019

            Whether it is a small community or a large community there are genuine valid concerns and not just media fear-mongering. This facility has been open for some time now as a trial, and things have not improved.

            If this IS the only location that is feasible then it is fair game, however as you have mentioned further facilities may be warranted, so other locations should be possible.

          • Jarrod McMaugh
            23/05/2019

            “Things” have absolutely improved Alexander.

            Can I recommend that you visit the facility. They are very amenable to discussing the pilot, the impact that it has had, and the number of deaths that have not occurred since the facility became available.

            Yes there are still instances of drug use outside of the facility, but these are fewer than they were previously. No intervention, no matter how well funded or well intentions, will have a 100% “success” rate.

          • 23/05/2019

            Again, I am not referring to the actual outcomes of harm minimization, I believe this is indisputable and also a worthy cause.

            The reality is that there are valid, genuine concerns about crime and anti-social behavior from the local community surrounding the facility. I do not believe that because that they are a “minority” that their concerns are not worth hearing and that a solution should not be explored to resolve such concerns.

            How about other locations? Is this a possibility at all?

          • Jarrod McMaugh
            23/05/2019

            Alexander – the issues that are being raised as issues associated with the presence of the centre were already there prior to the establishment of the facility.

            In fact, this is the reason the facility was established where it is.

            The location of the facility was nor arbitrary. It was chosen based on the need to address the need to reduce the impact of drug use occurring in the area already.

            The issues of crime, antisocial behaviour, deaths, ambulance call-outs, and people not from Richmond coming to the area to purchase and use drugs, were already happening, and have been reduced since the implementation of the service.

            The complaints that are being raised now are from people who are demanding that the service be moved because it failed to eliminate these issues… which is a standard that no service could ever meet, regardless of the intended outcomes or target health issues.

            As for other locations….. yes. Yes there is a need for other locations. Roughly 20 of them. The issues in achieving this are manifold, but include issues of funding, and ALSO other communities seeing the current complaints and assuming that life is worse after implementation, rather than better.

          • 23/05/2019

            I don’t believe this is entirely correct. The issues that the local community are concerned about have been exacerbated by the facility as it has become a congregation for IVDU from all over the city.

            Perhaps the answer is to fund other centres in perhaps St Kilda and Fitzroy to spread the demand for the service.

          • Jarrod McMaugh
            24/05/2019

            Alexander – what is your familiarity with Richmond’s history with people who use drugs?

            I’m going to start on a different tak this time and say “yes” (again) to the need for more facilities. This is definitely something thst everyone acknowledges

            As to the facility drawing people in…. Richmond has *always* drawn people in from other suburbs, as it has always been relatively easy to purchase here.

            The facility was put here for this very reason.

            The characteristics of Richmond that lead to the facility being placed where it is…. are those very characteristics that people are now blaming the facility for. This is called circular logic.

          • 24/05/2019

            Hi Jarrod, I lived in Richmond for over 5 years and also worked with the staff at the North Richmond Community Health. But this was before this pilot started.

            I’m simply echoing the sentiments of the local community which has been widely published – by all media, not just the Murdoch media.

            I’m not the right person to convince that their concerns of increased social problems are not valid. This should probably be aimed at them – the ones living adjacent to the facility.

          • Jarrod McMaugh
            24/05/2019

            The sentiments of the local community lead to the creation of the pilot.

            More people attended those public meetings than the recent ones protesting its ongoing presence.

            Those meetings did not receive the same level of press that this smaller group of people are now receiving.

          • 24/05/2019

            And current concerns about increased social issues? Or is this false and invalid?

          • Jarrod McMaugh
            24/05/2019

            They are not false or invalid.

            But they are reported out of context, since they have reduced since the implementation of the service.

            The criticisms being leveled at the facility are that they have not eliminated these issues, which no service of any kind could every achieve.

          • 24/05/2019

            How can they not be false and invalid and then claim the opposite? It’s either one or the other

          • Jarrod McMaugh
            24/05/2019

            The concerns are valid because people are concerned about antisocial behaviour, and syringes being left in public.

            The way this is being reported is that these issues have been **caused** by the presence of the facility, and also that the facility was supposed to **eliminate** these issues.

            The reality is that these issues existed in the area already, that the facility has had an impact on reducing them.

            In summary:
            The facility has had a positive impact on the antisocial behaviour in the area, including public intoxication, overdoses in public, ambulance call outs, deaths, and syringes left in public.

            The facility has NOT eliminated all of these issues, despite reducing them.

            A segment of the local population is calling on the facility to be closed based on the fact that some of these issues persist.

            A larger segment of the community called on the facility to be implemented based on the high level of these events occurring in the first place.

            EVERYONE would like to see more of these facilities open

          • 24/05/2019

            The issue of contention here is whether or not social issues has increased or decreased. The local community seems to think it has however you claim it has not. This is the actual debate. And as I mentioned, I am not the one that needs convincing

          • Jarrod McMaugh
            27/05/2019

            The observational data seems to suggest that the social issues have decreased, but the analysis is in the hands of DHHS, so until that is released, it’s hard to comment definitively….and it depends on who you speak to.

            There are some concerning developments recently though – since these (small) public meetings have occured, the dispensing machine that provides free clean syringes has been “switched off” for a few weeks.

            The impact of such a decision – against evidence for harm reduction – is a very large concern

          • 28/05/2019

            It’s great that we have made some progress with a change of tone from “they have definitely decreased” to “it’s hard to comment definitively”. A large proportion of the front-line police even agreed that there is an issue.

            I cannot comment on the switching off of the vending machine, but if this was in response to community concerns, then it further shows how significant the issue is and that a solution / compromise is readily needed.

            Harm minimisation albeit important does not need to come as a cost to community safety and harmony.

          • Jarrod McMaugh
            31/05/2019

            Alexander, I will quote myself to keep it in context.

            “The observational data seems to suggest that the social issues have decreased, but the analysis is in the hands of DHHS, so until that is released, it’s hard to comment definitively”

            It is hard to comment definitively because the data is owned by DHHS….

            By definition, harm minimisation is about reducing harm! Not just to individuals, but also to communities.

          • 31/05/2019

            Jarrod you had been commenting definitively for the whole thread right up until your last post where you softened your view. That was the whole reason of the discussion, was it not? My point was that the local community had valid concerns about increased issues, you were claiming that issues had decreased.

          • Jarrod McMaugh
            03/06/2019

            Alexander, the issues have decreased. Dramatically.

            The definitive data that shows this – is owned by DHHS – so I cannot comment on it until they release it for public comment.

            The people who live in the area have had two separate and distinct sets of public meetings: those *before* the implementation of the facility, which included a very large number of people, and lead to the implementation of the service – and those after, that involve a much smaller number of people.

            The public meetings that have occurred most recently are calling for a closure of the facility, because they feel that the facility should have *eliminated* all social and health issues related to drug use in the area.

            Unfortunately, eradication isn’t a realistic outcome. The impacts have been positive, with reduced overdose deaths, reduced ambulance callouts, and reduced antisocial behaviours, but since these aren’t reduced to nil, a small portion of the community is saying it is a failure.

            The total number of people attending the latter meetings is smaller than those who drove the public call to create the service in the area. The reason they called for the service to be created in the area where it is, is due to the existing issue with drug use in the area already.

          • 03/06/2019

            I don’t know Jarrod, everything you claim just seems contrary to what is reported…

            Note: Fairfax media

            “Chief Commisioner Graham Ashton says more police may be needed around the facility.”

            “Honey-pot”

            https://www.theage.com.au/national/victoria/police-powerless-to-stop-dealers-exploiting-drug-loophole-around-injecting-room-20190411-p51dba.html

            “Almost 80 per cent of those surveyed – about 40 officers – said they believed crime had increased since the injecting room first opened.”

            “I don’t discount the experience that local police are having and we will take account of that in this review process,” Ms Neville said.”

            “It comes after about 150 Richmond residents met last week to discuss the injecting room, and suggested moving it, opening more across Melbourne to neutralise a “honey-pot” affect, or extending the opening hours.”

            https://www.theage.com.au/national/victoria/police-say-richmond-crime-has-risen-since-safe-injecting-room-opened-20190522-p51pxb.html

            ABC Media

            “I think people support the safe injecting centre but they want more drug reform to deal with the extra impacts of the drug industry that no-one expected.”

            “We know this facility saves lives but we also know there have been some unintended consequences of that, particularly as it relates to demand for the facility, but also the need for more intensive needle and syringe pickup programs”

            “We’re serious about saving lives but we’re equally serious about improving the amenity of the North Richmond community.”

            https://www.abc.net.au/news/2019-04-20/extended-hours-for-richmond-safe-injecting-room/11033350

  2. Andrew
    23/05/2019

    As drug experts we’ve got the insight, why not advocate for evidence-based solutions?

    PBS-listed diacyclmorphine for opioid dependence would quickly resolve all the secondary problems we’re seeing from drug dependence.

    The public doesn’t like “free heroin for junkies” – maybe as the experts we could argue the benefit and cost-effectiveness.

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