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Aus - Angry Richmond traders and residents say heroin-shooting gallery is not the ans

poledriver

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Angry Richmond traders and residents say heroin-shooting gallery is not the answer

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PREMIER Daniel Andrews has dismissed calls for a trial of injecting rooms, saying Labor would not break an election commitment by changing drug laws.

But Mr Andrews said there was a need for “new thinking” on rampant drug use in inner-city areas and pledged to investigate alternative answers.

“There are more things you can do, we think there are further supports, further funding, and a greater focus on this and that’s exactly what we will be doing,” he said.

“There are other things you can do without taking that very big step towards providing supervised injecting facilities.”

Mr Andrews said Labor would stand by election commitments.

“We had a position before the election, and unlike other governments, particularly the national government, we are not changing that position,” he said.

“We do not support the introduction of supervised injecting facilities.

“There are other ways in which we can provide support to those IV-drug users — whether it’s needle and syringe exchange services, pharmacotherapy services.”

He said the state was the authority on whether injecting rooms could be legal.

“The Drugs, Poisons and Controlled Substances Act, which is an act of the State Parliament, is very much central to this, and we... will not change it,” he said.

A new push to set up a legal heroin-shooting gallery in one of Melbourne’s most drug-affected suburbs — dubbed “zombie town” — has angered traders and residents.

They are tired of junkies littering Richmond’s streets with discarded syringes.

But Yarra Council, the Yarra Drug and Health Forum, the Greens, the Australian Sex Party, and the Australian Medical Association are keen for the State Government to follow NSW’s lead by sanctioning a six-month trial of a supervised injecting room.

Local police fear the arrival of the state’s first injecting room could attract more dealers to Richmond, keen to feed the habit of desperate addicts, leading to an increase in crime.

They say more than 60 per cent of crooks caught there, including drug dealers, come from outside Richmond.

“They deal, use and steal,” said Inspector Bernie Edwards of the Yarra division.

Richmond Asian Business Association spokesman Meca Ho said Victoria St traders were against the injecting room, saying addicts were already scaring away customers.

“It’s getting worse, not better,” he said. “I liken them to zombies, it’s like zombie town.”

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“People are too scared to walk down Victoria St because they don’t feel safe — we don’t need a shop attracting more,” Mr Ho said. Richmond resident Jackson Ly was also not impressed.

“An injecting room will just encourage more drug use, not less,” he said.

With drug dealing and illicit use rife around the Richmond Housing Estate, one Yarra councillor fears the area is starting to resemble crime- ridden parts of Los Angeles.

The Sunday Herald Sun visited the estate and photographed druggies injecting heroin just metres from kids’ playgrounds and a primary school.

Users in drug-induced states were seen aggressively menacing pedestrians, while two addicts brazenly shot-up in a multi-storey carpark.

Some continue to dump used syringes in streets and laneways, posing a particular health risk to young children.

Cr Stephen Jolly said residents in Richmond and Abbotsford often felt unsafe witnessing drug-related behaviour or stumbling across discarded syringes.

“We need to find a solution because the illegal drug industry is making life intolerable for residents,” he said.

Fitzroy-based police officer Sen-Sgt Kelvin Gale said he had some concerns about supervised injecting rooms.

“One of the big problems is drugs cost money,” he said.

“You’re going to be putting more drug traffickers closer to that facility so potentially it might bring more crime in.

“There might be $100,000 worth of drugs going through that front door every day. I’m tipping that money to buy the drugs didn’t come from Centrelink, it’s coming out of people’s houses — their flat- screen TVs and jewellery.”

Greens Melbourne MP Adam Bandt said one Richmond resident told him they came home to find someone passed out after injecting in their front yard.

“People are finding syringes in sandpits, yards and laneways and they’re sick of it,” he said.

AMA Victoria vice president Dr Gary Speck said heroin contributed to the deaths of 132 Victorians in 2013.

“Access to sterile needles does not result in an increase in the number of people using heroin, rather it reduces the chance of users contracting viruses such as hepatitis C or HIV,” he said.

“It allows drug users to be helped. It is time to bring Victoria’s approach into the 21st century.”

Mental Health Minister Martin Foley said the State Government did not support supervised injecting rooms.

“Harm minimisation and evidence-based responses to drug use like needle and syringe programs, pharmacotherapies, as well as treatment and support services, are our focus,” he said.

Police vow to win war on drugs

A VETERAN police inspector admits containing the drugs scourge in Richmond is an uphill battle, but one police remain determined to win.

Addicts have turned parts of Melbourne’s biggest public housing estate into makeshift shooting galleries.

Inspector Bernie Edwards, due to finish a four-year spell as Yarra Police inspector in coming weeks, said the drug menace was an ongoing fight.

“People talk about adopting a zero-tolerance hardline approach, but that doesn’t work,” Insp Edwards said.

“You can’t win by just putting people in jail. What you have to do is try and break that cycle of use.”

Read the whole article -

http://www.heraldsun.com.au/news/vi...s-not-the-answer/story-fni0fit3-1227219987366
 
Prohibition is pointless, how can we even argue that at this point.
The fact they even argue that this could be helpful is sad.
give them a place to use and discarded there used gear so it's not on the streets... smh..
They make more money locking up these people then helping them.
 
Police vow to win war on drugs

A VETERAN police inspector admits containing the drugs scourge in Richmond is an uphill battle, but one police remain determined to win.

Ya ok buddy..
 
So much ignorance and fear. For starters, you'd think people sick of drug addicts shooting up in public spaces and leaving dirty needles lying around would be exactly the ones to welcome a centralized location where users can inject out of site and safely dispose of needles before leaving.

Calling addicts "druggies" is also a pretty unprofessional move for a supposedly serious publication.
 
The Vancouver supervised shooting gallery did not cause crime to go up and why would it? Its just users shooting up inside instead of in a playground. Heroin habit in Pakistan costs two dollars a day in west it a few hundred. The crime will go down when we change that. Until then supervised injection rooms are a good first step. I used to be opposed out of ignorance but strongly support them now
 
I'm all for supervised injection centres.

Client referral

Evaluators of the Sydney MSIC found that over an 8-year period staff provided 47,396 other occasions of service (94.6 per 1,000 visits) including advice on drug and alcohol treatment on 7,856 occasions, 22,531 occasions where staff had provided vein care and safer injecting advice, with a total of 8,508 referrals to other services where 3,871of referrals were to treatment.[28] Of the 3,871 referrals to treatment 1,292 were to detox and 434 to abstinence-based rehabilitation or therapy.[29] The evaluators asserted that the MSIC was thereby evidenced as a gateway for treatment.[30]

Drug Free Australia has heavily criticized the MSIC referral rates to treatment as abnormally and unjustifiably low. They note that the 2010 MSIC evaluation does not give the percentage of clients referred to drug treatment, but that the 2007 evaluation records just 11% of clients over 6 years referred to treatment. They further cite the 2010 evaluation’s appeal to smoking cessation surveys which demonstrate that 20% of all tobacco smokers, using the most addictive of all commonly used drugs, are currently ready to quit at any point in time. Alternatively, the MSIC has had opportunity to continuously assist their clients over a period of many years and not just at a single point of time.[31]

The Expert Advisory Committee found that Insite had referred clients such that it had contributed to an increased use of detoxification services and increased engagement in treatment. Insite had encouraged users to seek counseling. Funding has been supplied by the Canadian government for detoxification rooms above Insite.[32]

Impact on public nuisance

“The Sydney MSIC client survey conducted in 2005, found that public injecting (defined as injecting in a street, park, public toilet or car), which is a high risk practice with both health and public amenity impacts, was reported as the main alternative to injecting at the MSIC by 78% of clients. 49% of clients indicated resort to public injection if the MSIC was not available on the day of registration with the MSIC. From this, the evaluators calculated a total 191,673 public injections averted by the centre.[33]

Public amenity can be further improved by reduced numbers of publicly disposed needles and syringes. Data from the Sydney MSIC’s 2003 report indicated reductions in needles and syringe counts and resident and business-operator sightings of injections in public places decreased marginally but could not be certain that there was any effect by the MSIC beyond the heroin drought which had commenced some months prior to the opening of the MSIC.[34] The Drug Free Australia analysis pointed to the needle, syringe and public sighting decreases being almost exactly equivalent to the 20% decreases in the number of needles distributed from local pharmacies, needle exchanges and the MSIC, thereby indicating no clear impact by the MSIC.[35]

Observations before and after the opening of Insite indicated a reduction in public injecting.[18]

Impact on blood-borne viruses

The 2003 evaluators of the Sydney MSIC found that it “had not increased blood-borne virus transmission”[18] with the data more specifically showing no improvement re HIV infection incidence, no improvement in Hep B infections,[36] either worse or no improvement (depending on the suburb studied) in new Hep C notifications,[37] no improvement in reuse of others' syringes and injecting equipment, no improvement in tests taken for HIV and Hep C and initial improvement in tests taken for Hep B but worsening again in 2002.[38] The 2010 evaluation found no measurable impact on blood-borne diseases.[39]

The Expert Advisory Committee for Vancouver’s Insite found that journal studies with mathematical modeling by researchers from self-reports of users generated a wide range of estimates for HIV cases averted, but they were not convinced that the assumptions were valid.

Impact on community levels of overdose
Over a nine-year period the Sydney MSIC managed 3,426 overdose-related events with not one fatality[40] while Vancouver’s Insite had managed 336 overdose events in 2007 with not a single fatality.

The 2010 MSIC evaluators found that over 9 years of operation it had made no discernable impact on heroin overdoses at the community level with no improvement in overdose presentations at hospital emergency wards.[41]

Research by injecting room evaluators in 2007 presented statistical evidence that there had been later reductions in ambulance callouts during injecting room hours,[42][43][44] but failed to make any mention of the introduction of sniffer dog policing, introduced to the drug hot-spots around the injecting room a year after it opened.[45]

Site experience of overdose

While overdoses are managed on-site at Vancouver, Sydney and the facility near Madrid, German consumption rooms are forced to call an ambulance due to naloxone being administered only by doctors. A study of German consumption rooms indicated that an ambulance was called in 71% of emergencies and naloxone administered in 59% of cases. The facilities in Sydney and Frankfurt indicate 2.2-8.4% of emergencies resulting in hospitalization.[46]

Vancouver’s Insite yielded 13 overdoses per 10,000 injections shortly after commencement,[47] but in 2009 had more than doubled to 27 per 10,000.[48] The Sydney MSIC recorded 96 overdoses per 10,000 injections for those using heroin.[49] Commenting on the high overdose rates in the Sydney MSIC, the evaluators suggested that,

“In this study of the Sydney injecting room there were 9.2 (sic) heroin overdoses per 1000 heroin injections in the centre. This rate of overdose is higher than amongst heroin injectors generally. The injecting room clients seem to have been a high-risk group with a higher rate of heroin injections than others not using the injection room facilities. They were more often injecting on the streets and they appear to have taken greater risks and used more heroin whilst in the injecting room.[50]
The Drug Free Australia 2010 analysis of the Sydney MSIC evaluations found overdose levels in the MSIC 32 times higher than clients’ own recorded histories of overdose prior to registering to use the facility.[51] The Drug Free Australia calculations compared the registration data for overdose histories published in the MSIC’s 2003 evaluation document, which allowed comparison rates of overdose from a period before a heroin drought reduced overdoses Australia-wide, with rates of overdose drawn from data in the 2010 evaluation. Drug Free Australia has expressed concern that the evaluators, in using injecting room overdose data to calculate quite incorrect 'lives saved' estimates, failed to examine the extent to which overdoses were over-represented in the injecting room against data they had available to them on clients’ prior histories of overdose.

Against other measures the Sydney MSIC’s overdose rate is highly disproportionate. Estimates of the number of dependent heroin users in Australia completed for the year 1997,[52] compared with estimates of the number of total non-fatal and fatal overdoses in Australia for 1997/98[53] yields a rate of 2 overdoses for every 10,000 injections against the MSIC’s rate of 96 overdoses for every 10,000 injections in the 2003 evaluation and rates as high as 146 overdoses per 10,000 injections in the year 2009/10.[54]

A review of the MSIC registration surveys recording each client’s previous overdose histories[55] reveals that MSIC clients’ previous overdose history were less prone to overdose than various other previously studied heroin injector cohorts in Australia.[56]

People living with HIV/AIDS

The results of a research project undertaken at the Dr. Peter Centre (DPC), a 24-bed residential HIV/AIDS care facility located in Vancouver, were published in the Journal of the International AIDS Society in March 2014, stating that the provision of supervised injection services at the facility improved health outcomes for DPC residents. The DPC considers the incorporation of such services as central to a "comprehensive harm reduction strategy" and the research team concluded, through interviews with 13 residents, that "the harm reduction policy altered the structural-environmental context of healthcare services and thus mediated access to palliative and supportive care services", in addition to creating a setting in which drug use could be discussed honestly. Highly active antiretroviral therapy (HAART) medication adherence and survival are cited as two improved health outcomes.[57]

Calculations of lives saved

The European Monitoring Centre (EMCDDA) 2004 Review of Drug Consumption Rooms[3] calculated the number of lives saved for all 25 drug consumption rooms across Germany. It calculated from known overdose mortality rates per 100 dependent heroin users (2%) and the number of injections per 100 person years per dependent heroin user (1,000 injections per year per user). Their calculation indicated that 100 dependent heroin users, cumulatively injecting 100,000 times a year, would statistically have 2 overdose fatalities annually. Thus 500,000 injections results in 10 expected fatalities averted by the entirety of injecting facilities across Germany.

Drug Free Australia has noted that the EMCDDA review’s 2% overdose fatality rate appears excessive in light of mortality studies done by the EMCDDA for 5 European countries, (Germany was not included, but Spain, with the highest heroin overdose mortality, was still well below 2%). The percentages by country were Barcelona, Spain 1.4%; Rome, Italy 0.2%; Sweden 0.7%; Amsterdam, Netherlands unknown; Vienna, Austria 0.2%.[58]

The Canadian Expert Advisory Committee 2008 review of Insite did not declare the method by which it concluded that 1.08 lives are saved by the facility each year,[59] but Drug Free Australia claims that the EMCDDA method, used with Canadian data and assumptions, yields the same result.[60] Canadian heroin mortality in 2002/3 was roughly the same as Australia’s at 1% (958 deaths from more than 80,000 dependent heroin users)[61] and mortality percentages for 2006 or 2007, Drug Free Australia claims, might well be expected to be little changed. Further, the Expert Advisory Committee clearly state their assumption that a typical Canadian heroin user injects 4 times daily.[62]

Consequently 100 Canadian heroin users would cumulatively inject 146,000 times annually, and the 144,000 opiate injections in Vancouver’s Insite would avert the death of the one injection in 146,000 which would likely have been fatal.

The conclusion of the 2003 Sydney MSIC evaluators was that “a small number of opioid overdoses managed at the MSIC might have been fatal had they occurred elsewhere”, calculating that the centre had saved 4 lives per annum during the evaluation period.[63] Estimates were directly calculated from the 329 heroin overdose interventions in the centre. A later SAHA International evaluation of the MSIC calculated 25 lives saved by the facility in a single year.[64]

Drug Free Australia cites two statistics together which demonstrate that the Sydney MSIC cannot statistically claim to save even one life per year. The first is that 1% of dependent heroin users die from fatal overdose each year in Australia. The second is that a dependent heroin user averages ‘at least’ three injections per day according to the MSIC 2003 evaluation’s researchers. Taking these two statistics together, it is clear that the injecting room would need to host 300 injections per day (ie enough heroin injections for 100 heroin addicts injecting 3 times daily) before they could claim they had saved the life of the one (1%) of those 100 who would have died annually. But the injecting room averages just half that number with less than 150 opiate injections per day. Drug Free Australia has shown that the 2003 and 2008 MSIC evaluators indefensibly failed to factor the vastly elevated number of overdoses in the centre into their calculations of lives saved.[65]

Crime

The Sydney MSIC was judged by its evaluators to have caused no increase in crime[18] and not to have caused a ‘honey-pot effect’ of drawing users and drug dealers to the Kings Cross area.[66] The Drug Free Australia analysis pointed to data within the report clearly demonstrating that drug-related loitering and drug dealing worsened at the station entrance 25 metres opposite the MSIC[67] and at the rear door of the centre.[68] A later 2010 evaluation of crime in Kings Cross claimed that drug-related crime had decreased at the same rate as the rest of Sydney after a heroin shortage intervened 6 months before the MSIC opened, but Drug Free Australia has asserted that the evaluators failed to make any mention or assessment of the impact of police sniffer dogs introduced 12 months after the MSIC opened to deter drug dealers and users from the back lanes of Kings Cross, which might well be expected to have decreased drug-related crime more than areas of Sydney not policed by sniffer dogs.[69]

Testimony of ex-clients reported to the NSW Legislative Council[70] alleged that the extremely high overdose rates were due to clients experimenting with poly-drug cocktails and higher doses of heroin in the knowledge that staff were present to ensure their safety. The 2003 evaluation explanation for high overdose rates citing greater amounts of heroin used[71] has been cited by Drug Free Australia as cause for concern. NSW Member of Parliament, Andrew Fraser, made the same allegation regarding the MSIC as a site for experimentation, citing testimony of another ex-client in a Parliamentary speech in 2010.[72]

Observations before and after the opening of Insite indicated no increases in drug dealing or petty crime in the area. There was no evidence that the facility influenced drug use in the community, but concerns that Insite ‘sends the wrong message’ to non-users could not be addressed from existing data.[73] The European experience has been mixed.[74]

Community support

The Sydney MSIC has enjoyed the support of the surrounding Kings Cross community, with the 2010 evaluation indicating 78% of residents supportive of its presence and 70% of business operators.[75] Contesting the reliability of these evaluation surveys is a 2010 petition to the NSW Parliament by 63 business owners immediately surrounding the MSIC to move the facility elsewhere because it has adversely affected their businesses.[76]

The Expert Advisory Committee for Vancouver’s Insite found that health professionals, local police, the local community and the general public have positive or neutral views of the service, with opposition decreasing over time.[73]

Drug Free Australia has expressed concern that supporters, staff and various NSW politicians continually has represented each overdose intervention in the centre to the Australian media as a life saved, when such an equation was clearly false.[77]

Cost effectiveness

The cost of running Insite per annum is $3 million Canadian. Mathematical modeling showed cost to benefit ratios of one dollar spent ranging from 1.5 to 4.02 in benefit. However, the Expert Advisory Committee expressed reservation about the certainty of Insite’s cost effectiveness until proper longitudinal studies had been undertaken. Mathematical models for HIV transmissions foregone had not been locally validated and mathematical modeling from lives saved by the facility had not been validated.[32] The Sydney MSIC cost upwards of $2.7 million Australian per annum in 2007.[78] Drug Free Australia has asserted that in 2003 the cost of running the Sydney MSIC equated to 400 NSW government-funded rehabilitation places[79] while the Health Minister for the Canadian Government, Tony Clements, has stated that the money for Insite would be better spent on treatment for clients.[80]

http://en.wikipedia.org/wiki/Supervised_injection_site
 
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