Australia is set to have its first drug injecting centre following the announcement that a trial facility in Sydney will be made permanent.
The New South Wales Government has announced plans to make a centre in Kings Cross, which opened in 2001, an official part of the state's health system.
But even after its nine-year trial, the injecting centre remains clouded in controversy, with some applauding its work and others accusing it of doing more harm than good.
Police, politicians, health authorities, local business owners and drug users themselves are among those to have welcomed the Government's decision.
The centre's founding director, Dr Ingrid Van Beek, says she cannot believe the news.
It's been so long coming that I was almost in a state of suspended disbelief, she said.
I am very excited and pleased that after all this time, finally this decision has been made.
Others are also in disbelief, but for different reasons.
Drug Free Australia secretary Gary Christian has been evaluating the Kings Cross centre since it opened in May 2001.
Mr Christian, along with his team of researchers, says the centre has no positive effects and that the millions of dollars spent on its development would be better invested in rehab facilities.
He says the centre has failed to achieve its objectives - to save lives, improve public amenity and refer drug users on for treatment.
It has only saved four lives over the $23 million that has been spent since it opened, he said.
If that money is put into rehab, getting people off drugs rather than maintaining people in their drug use, that would be more than 3,000 rehab places in New South Wales.
He says while there are less needles on the streets, less people injecting publicly and less overdoses being reported, this is all attributed to a heroin drought in Australia, not the Kings Cross injecting centre.
There are less needles everywhere in Australia because of the heroin drought, which started six months before the injecting room opened, he said.
The heroin drought reduced drug deaths in Australia by 70 per cent, so of course there was less heroin being used in Kings Cross, of course there was less public injecting, of course there was less needles on the streets.
The injecting room doesn't mention this in its evaluations ... it glosses over the heroin drought ... now that's just being deceptive.
Mr Christian says not only is the centre failing to fulfil its purpose, it is perpetuating drug problems in the community.
He says unprecedented amounts of drug users are overdosing in the centre because they see it as a safe haven for them to experiment.
In 2007 I taped recordings with drug users ... the two users I spoke to were ex-clients in rehab, he said.
They said, 'we go in there to experiment with higher amounts of heroin, we go in there to get the hit of our life, and we know if something goes wrong and we're going to drop, then staff are going to bring us around'.
But Dr Van Beek says Mr Christian is a zero-tolerance advocate who would rather see people dying in the backstreets because of his fundamentalist views".
She says the centre has successfully managed more than 3,000 overdoses and helped 12,000 drug users while receiving about 200 visits a day.
Dr Van Beek says there are too many faults in Mr Christian's calculations to list.
Gary has very successfully confused all of the data that has been produced by the country's top researchers in this area, and I have over the years explained each and every one of those allegations that he has put forward, explaining how he has misinterpreted the data, she said.
While I respect his views, I would hope no right-thinking politician would accept those views and let them inform their decision in this regard. I would find that very scary.
She says she acknowledges the effects of the heroin drought, but insists the injecting centre has still been successful.
Dr Van Beek says the number of ambulance call-outs to overdose deaths in Kings Cross has dropped by 80 per cent since the heroin shortage compared to 45 per cent in the neighbouring suburb of Surry Hills where there is no centre.
The same drug market supplies Surry Hills as Kings Cross, she said.
For there to have been so much more of a dramatic reduction in Kings Cross than Surry Hills, there is no other explanation than the injecting centre.
Moreover, she says the centre is saving lives, and that this was her motive for setting it up in the 1990s.
I worked a lot at St Vincent's [Hospital] during the 1970s and '80s. At the frontline there I saw too many people die, she said.
I think it was that exposure to what was a growing and significant problem, and yet not being armed with the appropriate services to deal with it, that led to me wanting to fill that gap.
Before the injecting centre it was not unusual for someone you were working with to die, so our frustration was that we just weren't getting to people soon enough with our drug treatment - dead drug users don't get into rehabilitation.
As doctors we try to keep people alive regardless of their lifestyle and we just hope that people can be given extra time and be able to address their lifestyles and live a long and more fruitful life.
Dr Van Beek says there is no evidence that drug users abuse the centre as a means of overdosing safely.
Mark is a heroin user who lives in Kings Cross and visits the centre on a regular basis.
He has been injecting almost daily for the past eight years and says some of his friends would still be alive if they had a facility like the one in Kings Cross in their suburb.
I've had friends die since the centre has been opened. They wouldn't have died if they were in the injecting room, he said.
I think there is an idea that it [the centre] enables people - lets them overdose, saves them and then lets them go on their merry way - but when you overdose it's a real wake-up call for people.
It's not a nice feeling and generally it is a time that people can take stock of their lives, and I think if you overdose in a place like that and you live through it there is also an opportunity to talk to someone straight away about what you can do about this.
There are 90 injecting centres around the world.
Dr Van Beek says the New South Wales Government should be proud of its decision to take the lead in Australia.
She says she would support the development of more injecting centres around the country, but that they must be founded from a grassroots level.
It really has to be a local community decision, she said.
In areas where you have a high level of street-based injecting, high levels of overdose, HIV, Hep C, amenity problems, I think it should be one of the things that you would consider, but only if it is acceptable to the local community.
But Mr Christian says more injecting centres would be a waste of money.
Thu Sep 16, 2010