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Does Sydney Need Another Supervised Injecting Room?

15 years after Sydney opened the first medically supervised injecting centre in the English-speaking world, its founders think it's time to establish a second one.
July 16, 2014, 12:20am

In 1999, the streets of Sydney were awash with heroin, with an escalating number of drug overdoses. At this time, a group of community leaders set up the Tolerance Room at the Wayside Chapel in Kings Cross, which was the epicentre of the epidemic.  It was a room where users could inject drugs in a supervised environment. Considered by some as an act of civil disobedience, the project aimed to get supervised injecting on the agenda of that year's New South Wales Drug Summit. The result was the trial and then establishment of Sydney’s Medically Supervised Injecting Centre (MSIC), the first such centre in the English-speaking world.

Fifteen years on, Unharm, a newly formed drug harm reduction group, held a meeting on June 26, at the Wayside Chapel calling for the establishment of a second supervised injecting room and southwest Sydney was flagged as a suitable area for one.


Will Tregoning, a director of Unharm, said with the success Sydney’s MSIC, it’s time to look at establishing another centre. “People who are disadvantaged or marginalised are over represented among injecting drug users,” he said. “In pockets of southwest Sydney there is a high risk rate of disadvantage that we know to be correlated with injecting drug use and that's the reason why we are saying that's an example of the kind of area that we want to be looking at.”

Dr Alex Wodak, president of the Australian Drug Law Reform Foundation, said there is a need for “at least one” more MSIC and southwest Sydney would be a fitting area for it. “Overdose deaths have been increasing in Australia in recent years,” Wodak told VICE. “Where you need them, is where you've got a huge drug market that spills over into the rest of the community. If there's not a medically supervised injecting facility available, they'll inject in the streets, lanes, parks and supermarkets, where other members of the community have to see somebody shoving a needle into their arm.”

In 2009, an NDARC report into accidental opioid-induced deaths in Australia found that overdose rates were on the rise with 645 that year compared with 551 in the previous year. The report projected that these rates would continue to increase with an estimated 723 for 2011. It also outlined that in 2009 among Australians aged between 15 to 54 just under a third (31 percent) of the opioid deaths occurred in NSW.


In 2013, a survey of NSW drug trends conducted by IDRS found that among people who inject drugs heroin is still the drug of choice, with 62 percent using the drug, while participants stated it was "very easy" to obtain.

Dr Marianne Jauncey is the medical director of Sydney’s MSIC, which began running on a trial basis in 2001. It’s run by Uniting Care, the social services arm of the Uniting Church, who report to the Director General of NSW Health and the NSW Police Commissioner. Jauncey said: “The aim primarily was to stop people dying and suffering injuries related to drug overdose, and also make contact with a really marginalised, often homeless, mentally ill population.” She points out that there’s never been a death from drug overdose in any of the 92 supervised injecting facilities around the world and the centres cut down on discarded equipment in the streets of local areas.

Jauncey said: “It's all about engagement with people that generally are quite mistrusting and have little contact with other health and welfare services. It’s getting to know them, getting them to trust you, to such that, then you're in a position that they're much more likely to accept referrals and offers of assistance.”

The centre ran on a trial basis for its first ten years, every four years the legislation had to be passed again and the local community were consulted each time. Jauncey said, of the repeated surveying of the local community: “not only has it always consistently shown that the majority are supportive, the support has actually increased overtime. Now 78 percent of local residents actively support the centre and about just over two thirds of local businesses actively support it.”


In 2010 the Drug Misuse and Trafficking Amendment (Medically Supervised Injecting Centre) Bill  was passed allowing the MSIC to run permanently, like any other health service. However, this amendment only allows for one MSIC to operate within the state.

Wodak, along with the members of Unharm, are calling for a change to the legislation. “I think there should be a discussion about it. There was a lot of support on June 26 about having another medically supervised injecting centre in southwest Sydney,” Wodak said.

But some members of the community in southwest Sydney have spoken out against the proposal. Cabramatta was known as a hotbed for heroin in the late 1990s and it is one area of the southwest that has been suggested as a possible site. Labor MP Nick Lalich said, that Cabramatta no longer needed such a facility. “Cabramatta doesn’t need an injecting room in the area. We may have needed it a couple of decades ago, when drugs were openly sold and used on our streets, but not anymore,” he said. “Opening an injecting room here might bring the problem back with people outside the area coming here to use it, and I won’t support that.”

A spokesperson for Fairfield Council, which includes Cabramatta in its local government area, stated that drugs and crime are a matter for the state government. “As southwest Sydney is a very large and diverse region further work by the state government agencies would be required to determine the need and/or location of an additional safe injecting room,” she said.

Peter Carter, director of the Mental Health and Drug and Alcohol programs at the NSW Ministry of Health, said that a number of evaluations of the MSIC have shown that the centre meets the objectives set out by the NSW government under the 1985 Drugs Misuse and Trafficking Act and cited an independent evaluation by KPMG (2007-11). In regards to a second room for Sydney he said: “The NSW government is committed to maintaining one supervised injecting room at Kings Cross.”

Tony Trimingham, chief executive of Family Drug Support, was instrumental in establishing the Tolerance room at the Wayside Chapel in 1999, as two years earlier his own son had tragically died of a heroin overdose in Kings Cross.

Trimingham would like the legislation changed, so it allowed for more than one supervised injecting room.  “I think there's probably room for a least one in Sydney and in other places as well. I think they are most effective where drug users congregate and we know that southwest Sydney is one area where it is probably appropriate to reduce the risk of death.”

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