Injecting room turns twenty

9 September 2021 | Posted In: #140 Spring 2021,

Australia’s first medically supervised injecting centre is still going strong despite the pressures of gentrification, reports John Moyle.

Twenty years ago, Australia’s first medically- supervised injecting centre (MSIC) opened in Kings Cross. At the time, it was one of around 40 worldwide — and the first in the English-speaking world. Today, as the centre celebrates 20 years of continued operations without losing a single client, there are calls by some in the rapidly gentrifying community of Kings Cross/Potts Point to see it either closed or relocated.

That is unlikely to happen as the centre’s operators, Uniting, own the building in Darlinghurst Road, and a 2016 NSW Health and the Department of Justice report concluded that “based on the evidence of significant ongoing need in Kings Cross, the current location of the service is appropriate”.

Speaking to the Sydney Sentinel, Dr Marianne Jauncey, medical director, Uniting Medically Supervised Injecting Centre, says the fact the centre still exists is a significant achievement in itself. “The most obvious success is that we are still here after 20 years of service, and it’s not like we haven’t had a few things thrown at us, whether it was the media, politics or the pandemic,” Dr Jauncey said.

After many years of lacklustre debate by NSW politicians, police and religious leaders on how to address the growing heroin epidemic in Sydney, and particularly in Kings Cross, it took a personal drug tragedy in the life of former NSW Labor premier Bob Carr — whose younger brother Greg died after a heroin overdose — to force the issue. Carr oversaw the 1999 Drug Summit, which paved the way for the centre to open for trials in 2001.

For Kings Cross, this happened against the background of ambulance calls for overdoses every 12 hours and gutters blocked with spent syringes at the height of the AIDS epidemic. The centre then went through a series of three trial extensions over nearly a decade until the Keneally Labor government legislated to overturn the trial status and grant the centre permanent status.

Justine Muller grew up in Woolloomooloo and recalls her schooldays. “I used to walk up to the Cross every day to go to school and I would see needles,” she said. “I also remember the controversy when the injecting centre first came about and I remember clearly the huge difference that it made not seeing those needles around anymore.”

The Kings Cross centre is not a drain on the public purse, as some claim, being funded from the Confiscated Proceeds of Crime and, after an initial set up cost of $1.3 million, its current operational costs stands at around $2.5 million a year — or an average of $34 per injection.

Kevin Street is one of those clients who, after a long struggle, has used the centre to break his link with heroin. Growing up in a dysfunctional family, he spent many formative years in state training schools for boys where he suffered under a brutal and sexually abusive regime. On the outside, he quickly went back to the inside. While incarcerated in Long Bay Correctional Complex, he had his first shot of heroin, which gave rise to an addiction that lasted from 1981 all the way through to 2019. “My periods of abstinence would never last more than six months and it wasn’t about the actual drug, it was what the drug offered me in the way of medicating a painful upbringing,” Street, who is now a former drug user, said.

The average drug user will use for around 13 years and will have a number of attempts at quitting before getting clean. Though his period of use was longer than the average, Street’s pathway to breaking the addiction came about in a familiar way. After he started using the MSIC’s facilities, he became comfortable enough to ask for help.
“Even though I had an addiction, I was being treated as a human being, and I got referred to the Kirketon Road Centre where they had methadone maintenance and I got onto the subcutaneous patches, which were monthly,” Street said. “This freed me up from that daily reminder, kept me out of the Cross, and in my case it allowed me to volunteer with Uniting.”

Local historian and musician Warren Fahey supports the idea of the MSIC but does not agree with its location on Darlinghurst Road. “It’s the right service in the wrong place,” Mr Fahey said. “It has an economic impact that people refuse to consider because they get emotional about it because of the service the clinic provides.”

Brandon Martignago is the new chairman of the Potts Point Partnership, representing businesses in the area. He is also the owner-operator of Dulcie’s small bar located in the vicinity of the centre. He has a different opinion. “It’s really amazing that we still have the injecting centre and that after 20 years it still has a place in the community, and it is one of the things that we need to move forward with,” Martignago said. “Part of the issue of doing business in the community is the injecting centre and some of the outreach programs that do a world of good for us.”

While the centre’s Darlinghurst Road location will continue to be debated across various local social media pages and groups, those arguing against it need to know that Uniting has no plans of going anywhere. “To suggest that all the behavioural issues that happen up and down Darlinghurst Road is our fault is fanciful,” Jauncey said. “Unfortunately, the stigma in our society about the centre feeds into the fact that anything in any way that is undesirable and unpleasant, we are to blame.”

In June 2018, the Victorian government opened a medically supervised injecting centre in North Richmond, originally with 3,000 registrations. It did this based on research and practical assistance from the Kings Cross centre. The Victorian government is now looking at a location for a second MSIC, which begs the question as to why, after 20 successful years of operation, are there not MSICs being rolled out across NSW, which has a growing problem with intravenous drug use? “It doesn’t make sense that there are not more centres,” Fahey said. “People in Liverpool are not going to come into the city and back, so they don’t benefit.” For Dr Jauncey, it is one of the few regrets she has had since taking over in 2008. “I am saddened that we are the only one [in Sydney],” she said.

Despite the support of Brad Hazzard, the NSW minster for health, few other politicians will offer more than token support for the centre and will not enter into a debate about rolling them out across the state, where they are desperately needed. As with so many other issues in our society, it is time to drop the stigmas and move forward.