DRUGS, POISONS AND CONTROLLED SUBSTANCES AMENDMENT (PILOT MEDICALLY SUPERVISED INJECTING CENTRE) BILL 2017- Second Reading
Debate resumed from 22 February; motion of Ms PATTEN (Northern Metropolitan).
Ms SYMES (Northern Victoria) — It is a pleasure to rise to make a contribution on the private members bill before the house at this time. Of course every life lost to overdose is an immensely sad tragedy. Drug and alcohol problems, including those that result in overdose, are extremely complex. They affect not just individuals but their families, their friends and their communities. Before us is a private members bill that proposes to amend the Drugs, Poisons and Controlled Substances Act 1981 to provide for the licensing and operation of a medically supervised injecting centre for a trial period of 18 months in the suburb of North Richmond.
It was certainly a very worthwhile experience being involved in the inquiry into the private members bill. We heard from residents, traders, community health experts and police, and we visited the Sydney injecting centre in Kings Cross. We also heard compelling evidence from the Coroners Court, which has now examined three deaths that have led to the recommendation that a safe injecting facility be established. Our committee made 11 findings in relation to this matter, and I think finding 6 is quite a good place to start in relation to my contribution today.
We found that drug use in North Richmond has reached crisis level. It is a major concern for residents, business owners and emergency services. This crisis was certainly evident in North Richmond. Some members of the committee carried out a site visit of the surrounding streets of the intersection of Victoria and Lennox streets. We saw parks, alleyways, the neighbouring streets, schools — just normal streets on the surface. We were accompanied by Mr Greg Denham, the executive director of Yarra Drug and Health Forum, and Judy Ryan, a resident who lives in the area, and she is part of a group called the Residents for Victoria Street Drug Solutions. They were very familiar with locations known for heroin use. However, it was evident to any passer by that this was a centre of drug activity. There were people clearly affected by drugs, there were open drug deals occurring and probably the most obvious evidence of all was the discarded syringes or parts of syringes littering the streets. I clearly remember the little orange safety tips that come off the syringes that were scattered in the gutters of the surrounding streets.
The radiating impact of drug taking was just so evident. Of course it is really easy to empathise with the hurt and pain suffered by those with a drug dependency and their families and even the strain on our health services and emergency services, but it is not until you look closely at the community of North Richmond that you realise that the impact is on so much more than those who are directly affected by drug taking. The community have to look at their feet when they exit their home to ensure they do not stand on a discarded needle. They are constantly worried that they will have to call an ambulance or even resuscitate a person who may have chosen their driveway or their front yard as a semi safe place to inject. We saw evidence of residents having to disable their front water taps because to enable heroin to be injected it has to be dissolved in water, so in terms of access to water in the community people were taking it into their own hands to try to prevent drug users from jumping the fences to access their taps.
We were talking to many residents. We are talking about really regular families going about their everyday business — off to school, off to work, just out for an outing — and these people are living every day having to worry about what they may confront on their front doorstep. Our report has acknowledged the hardships and dangers faced by local residents as a result of the drug activity. State Coroner Sara Hinchey classified these concerns as ‘a health related issue for those who are exposed to the debris associated with injecting drug use’. We did have a close look at lots of the coroner’s submissions and data, and coronial data has shown that overdose deaths have increased over recent years, with 477 overdose deaths in Victoria in 2016, which was up from 379 in 2009. Judge Sara Hinchey told our committee that the figures for heroin overdose deaths in particular had actually remained relatively stable since 2009 until it peaked with increases between 2014 to 2016. She told us that:
Heroin re emerged as a central focus in the Victorian Coroners Court in 2016 when evidence mounted of an unusual increase in heroin related harm. Data from the court’s overdose deaths register showed that 172 overdose deaths occurred in 2015 involving heroin, which was an increase of 26 per cent compared to the 136 deaths which had occurred in 2014. As well, the court received calls from concerned members of the alcohol and drug treatment sector who had noted elevated levels of heroin use and related harm, particularly in public places in the North Richmond area.
It was certainly a frank and compelling discussion that we had at North Richmond Community Health. There were a number of local agencies and service providers, including North Richmond Community Health, the Yarra Drug and Health Forum, the Victorian Alcohol and Drug Association, Victoria Street Drug Solutions, the City of Yarra, the Youth Support and Advocacy Service, St Vincent’s Hospital, the Fitzroy Legal Service, the Neighbourhood Justice Centre and Cohealth Limited. They explained their services, their struggles and their daily interactions helping people with drugs and other health related problems in the area.
We were shown a needle dispensing service. They reported that an average 150 clients per day access this service. That is a staggering 60 000 to 70 000 syringes that are distributed to people in the area each month. The policy rationale for needle and syringe programs is clear. They are given to users to ensure that they are using clean equipment and not sharing needles with other users, so this of course reduces the transmission of bloodborne diseases, such as HIV and hepatitis. The Victorian government certainly supports programs like this. Harm minimisation approaches are certainly something that should be encouraged and promoted.
Of course we consider that this is first and foremost a health issue. We are funding programs that reduce the risk of bloodborne viruses. We invested more than $19 million into the needle and syringe program in the 2017–18 budget. There are other harm reduction activities funded by the government, including outreach workers and other staff, overdose education and a range of locally tailored responses to drug use.
We continue to explore new responses that can further reduce drug related harm. For example, in February this year we announced a $1.3 million package of new harm reduction measures to reduce drug related harm and fatal overdoses across Victoria, including the overdose awareness campaign, six new peer led networks to support those at risk of overdosing and initiatives to expand access to the life saving drug naloxone. Of course these are very worthwhile programs.
As I said, not only are needle exchange programs supported by this government but they are widely accepted across much of the world as an appropriate health measure. However, for many, providing syringes to people with the full knowledge that they will be used to inject potentially dangerous substances creates the logical policy extension that if you provide a safe instrument why would you not follow that with providing a safe venue? The evidence before the committee was overwhelmingly in favour of introducing a safe injecting facility in North Richmond. During our extensive consultation we received about 50 submissions and also held public hearings. This is also an issue that is alive and well in the community.
I want to put on the record all of the people, and in particular agencies, who have come out publicly in support of a trial of a medically supervised safe injecting room. They include UnitingCare; the Australian Medical Association; the Victorian Alcohol and Drug Association; the Youth Support and Advocacy Service; Professor David Cooper from the Kirby Institute; the faculty of medicine at the University of New South Wales; Major Michael Coleman, state social commander, the Salvation Army; Levinia Crooks, the CEO of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine; the Yarra Drug and Health Forum; Phil Dunn, QC; the director of the National Drug and Alcohol Research Centre; Bernie Geary, AO; Odyssey House; Professor Margaret Hamilton, AO; the Centre of Perinatal Excellence; the Victorian Trades Hall Council; Dr Jennie Hutton, emergency physician at St Vincent’s Hospital; Dr Marianne Jauncey, the medical director of the Uniting Medically Supervised Injecting Centre in Sydney; Simon Judkins, clinical director of emergency medicine, Austin Health; Windana Drug and Alcohol Recovery Inc.; North Richmond Community Health; Judy Leitch, the retired former CEO of the Wesley Mission, Melbourne; Professor Simon Lenton, director of the National Drug Research Institute; the Royal Australian College of General Practitioners; the agency Turning Point; addiction studies at Monash University; Anglicare; the United Firefighters Union; addiction medicine, Western Health; Ambulance Employees Australia, Victoria; the World Federation of Public Health Associations; Dr David Morawetz, a psychologist and economist, and founder and director of the Social Justice Fund; Cohealth; the Australian Drug Law Reform Foundation, Victoria; the Drug Policy Modelling Program; the director, National Centre for Education and Training on Addiction; the Alcohol and Drug Foundation; Brian Rolfe, a retired barrister and solicitor; Simon Ruth, the CEO of the Victorian Aids Council; Victoria Street Drug Solutions; Drug and Alcohol Nurses of Australasia; Australian Drug Law Reform Foundation; the mayor of the City of Yarra; the Public Health Association of Australia; the Centre for Social Research in Health; Tony Trimingham, the CEO and founder of Family Drug Support; Matthew Townsend, a barrister; Gino Vumbaca, CEO of Harm Reduction Australia; and Dr Alex Wodak, emeritus consultant, alcohol and drug service, St Vincent’s Hospital, Sydney.
There are some very eminent people and some prominent organisations on that list — people and organisations that have far more expertise in this area than many of us mere politicians. I would like to thank them for the contribution they made to our inquiry in supporting this important issue on the public record.
The committee report does not make a recommendation as to whether a medically supervised injecting centre should be introduced, but it does canvass some of the potential benefits of introducing such a centre. Specifically the committee found that medically supervised injecting centres improve the health of injecting drug users and reduce signs of drug use in surrounding streets. Evaluations of medically supervised injecting centres in Sydney found evidence of public amenity benefits to the local community and reduced demand for ambulance services. The evaluations did not find evidence of the centres having a honey pot effect on crime.
We found clear evidence to support the success of the centres, including improved public amenity, health outcomes and public order. However, we did note that there were relatively few gold standard evaluations of such centres. In relation to service design the government believes it is important to consider the views of the local community when deciding on the location of services. That is not a requirement of the current bill, but it is part of the New South Wales legislation.
The committee report notes the strong support from local North Richmond residents for a medically supervised injecting centre, but the view of local traders was slightly unclear. There seemed to be a lot of support for the centre, but traders were very concerned that it might be on Victoria Street. It is important that we get clarification as to exactly what the traders are saying. The recent campaign has been supportive of a centre, but there was some doubt around the concerns of traders about location. This is something that the government should investigate to make sure that we know what the views of traders are on this matter.
The report notes that the submission from Victoria Police did not support or oppose a centre. It gave a useful summary of policing approaches in the local area but did not provide a yes or no response in terms of the views of police. However, the police effectively said that they considered this predominantly a health issue and that they would respond appropriately to any decision the government made regarding a trial.
The government has six months to respond to the committee’s report in relation to the status of this bill. However, I can confirm that the government takes this matter very seriously and knows that there is immense community pain and concern about it. We intend to respond very quickly on this matter. At this time I cannot provide support for the bill because it is still being considered by the government, and as I said, the government will be providing a response to the Parliament in the very near future.