Advertisement

‘I’m living proof’: how Melbourne’s drug-injecting room has changed – and saved – lives

At the lowest point of her 25-year addiction, Lisa Townsend had nothing left. Not her children, whom she had had to give up, nor a roof over her head. For three and a half years, she slept rough in the streets of the Melbourne CBD, scraping together whatever money she could to score heroin in the city, or along Victoria Street and Lennox Street in the nearby suburb of North Richmond.

“My depression and mental health was extremely bad,” she says. “I didn’t know how to deal with it all, and using was a way for me to escape all of that.”

She wanted to get clean, but didn’t know how she would manage to. “Nobody sits there and says, ‘I want to use heroin for the rest of my life.’

“When you’re withdrawing from heroin, there’s nothing more painful,” she says. For a few years, she moved interstate and managed to stop using, but relapsed in 2018 after moving back to Melbourne and dealing with the grief of a miscarriage.

Townsend is now in her 40s and her life is the polar opposite of what it was a few short years ago. She is in recovery, living independently and working. She is part of a team that provides Covid-related support to people in high-risk accommodation, and is passionate about her advocacy work for the Council to Homeless Persons.

Townsend credits Melbourne’s medically supervised injecting room, which opened as a trial facility in June 2018, with turning her life around. “Had I not been able to access the support there, I’d either be dead or still in the throes of my addiction,” she says.

Townsend used both the injecting room in North Richmond and programs its community health centre offers, including housing support and oral and mental health services. The facility’s non-judgmental staff motivated her to recover, she says.

“I’m living proof that the whole injecting room set-up, with all the wraparound services, do work to help people on their recovery and aren’t just there to make drug use an easy thing.”

Established benefits, fierce opposition

The benefits of supervised injecting facilities are well established by numerous reports and peer-reviewed research studies, which have found that injecting rooms save people’s lives, take public injecting off the streets, alleviate the burden on frontline health workers, reduce needle litter and provide an avenue for support services. In more than 120 injecting facilities operating around the world, to date there has not been a single overdose death.

But injecting rooms face fierce opposition from certain quarters, often driven by fears of a so-called “honeypot effect”, in which a facility purportedly attracts drug users to an area who would not otherwise be there. An independent review last year into the North Richmond facility’s first 18 months found no evidence of such an effect.

The same goes for Australia’s first injecting facility, in Sydney’s Kings Cross, which has been used by 16,500 people since it opened 20 years ago, and has led to no increase in local drug-related crime.

Recently, a proposal for a second injecting facility in the Melbourne CBD was met with alarmist media coverage. Last month, the Herald Sun emblazoned “Nightmare on Flinders Street” and “Junkie Town” on its front page.

The new Melbourne injecting site, likely to be located opposite Flinders Street station in the former Yooralla building, has been opposed by some Melbourne city councillors and businesses.

The Victorian government has confirmed that it has bought the building but says: “No decision has been made regarding the final location for the medically supervised injecting room.”

A drug harm reduction worker, who wishes to remain anonymous, tells Guardian Australia that concerns about the proposed facility ignore the reality of drug use in the Melbourne CBD.

“It seems to me that the obvious thing to do would be to open more [facilities] in different areas,” she says. “You would end up with a number of smaller, more discreet places.”

The level of trauma in this population is astounding – the stories of horrific sexual abuse, physical abuse

Dr Nico Clark

Overdoses are a growing problem in the centre of Melbourne: opioid-related ambulance attendances have doubled between 2015 and 2020, according to Ambulance Victoria.

Since 2015, on average there has been nearly one heroin-related overdose a week in the vicinity of just four intersections in the CBD. One in four overdoses occur within 250 metres of the intersection of Flinders and Elizabeth streets.

Brett Adie, the secretary of the Ambulance Employees Australia union in Victoria, says paramedics are routinely called out to attend to unconscious patients who develop respiratory depression as a result of drug overdoses.

“The safety of ambulance officers attending overdose patients is a key and constant consideration,” Adie says.

“Medically supervised injecting centres assist in reducing the unnecessary discarding of needles and syringes, which are often located in close proximity to the patient being treated by paramedics, emergency crews and bystanders.”

Townsend, who believes the proposed CBD facility will provide accessible and much-needed assistance, says some opposition is inevitable regardless of the location. “The majority of the population don’t understand addiction. Of course there are going to be naysayers and there’s going to be that judgment,” she says.

Dr Nico Clark, the medical director of the North Richmond injecting room, says despite some media reports, data from the facility’s trial shows largely beneficial results.

In its first 18 months, the North Richmond injecting room was used 119,000 times, treated 217 serious overdoses and saved at least 21 lives. Following the 2020 review’s recommendations, the Victorian government has extended the trial for another three years.

“There’s no reason to think that an injecting room in the CBD wouldn’t also have a positive impact,” Clark says.

‘Numerous overdoses in that car park’

Recent research by the Burnet Institute points to the success of the North Richmond trial in reducing public injecting in the area and supporting drug users at highest risk of harm.

“A lot of the injections in the facility would have taken place in public had the facility not existed,” says Prof Paul Dietze of Burnet. “We would expect the same kind of impact in relation to any new facility in the CBD.”

The North Richmond facility, located beside a primary school and near the busy restaurant precinct of Victoria Street, has remained controversial. Some parents and residents have campaigned for it to be moved away from the school, most recently after a body was found outside the school grounds in March.

Last year’s independent review found that support for the injecting room among nearby residents had dropped from 61% to 44% a year after the trial began. It also noted no reduction in public sightings of discarded needles.

Related: Drugs are a health and social issue. Why do we make it a law enforcement battle? | Alex Wodak

“I know it must be horrible for some of the families with young children to walk out and see people who are stoned,” says Townsend, “[but] when you compare that to those kids walking out and seeing people shoot up in the car park or shoot up in the gutter.”

Recalling the days before the safe injecting room, Clark often saw people injecting themselves in the car park by the community health centre – along the route many children walk to school.

“There were numerous overdoses in that car park, many of them fatal, that had been going on for years,” says Clark. “Somebody would go out and revive the person in advance of the ambulance getting there. The frequency with which we’ve had to do that has dropped substantially.”

In the injecting room’s first 18 months, ambulance callouts for heroin overdoses requiring treatment with naloxone dropped by 25% in the 1km area surrounding the facility. In Victoria overall, those figures increased in the same period.

“The level of trauma in this population is astounding – the stories of horrific sexual abuse, physical abuse,” says Clark. “One of the people started using heroin at the age of six.

“I think we’ve completely forgotten this population as a society, and then we blame them when they start using drugs.”

The harm reduction worker, who is familiar with the support services provided at the North Richmond facility, says the injecting room has helped turn around the lives of some of society’s most vulnerable people. “With a lot of drug use it’s circumstantial,” she says. “If you can sort out other things in people’s life, then quite often you see a reduction in drug use.”

That was the case for Townsend. “They allowed me to unpack and realise what was at the core of my addiction and why I kept going back,” she says.

“They saw me, not just the addict. They saw the mum desperate to get back with her kids; they saw the daughter that missed her parents.

“For the first time in my life, I’ve got a lease of my own. I’ve got a good relationship with my mother. Seeing them go above and beyond for me gave me the feeling [that] I’m not a lost cause.”