INJECTING ROOM SET TO OPEN

COMPERE: Australia's first legalised heroin injecting centre, in Sydney's
Kings Cross area, is all but ready to open its doors. But the opening date
is still under question because of legal action taken by business interests
in the area, who say the centre will bring disrepute on the neighbourhood.
The case is scheduled to go to court next month.

The New South Wales Government last year held a drug summit, which you may
recall resolved to establish the centre for a trial basis. The State
Government awarded the licence to operate the heroin injection room to the
Uniting Church, after a battle with the Catholic Church, and it was dropped.

The Church's rationale is that heroin does happen, and that users need a
clean and safe area to inject and should be supervised by health care
professionals to reduce the risks of death by overdose. When Rachel Mealey
took a tour through the new heroin injecting centre, with the executive
director Dr Ingrid van Beek, she began by asking Dr van Beek to describe
what the injecting centre looks like from the outside.

INGRID VAN BEEK: It's like a shopfront on the main street of Kings Cross,
it's very subtly designed with frosted glass. We haven't yet got the
signage but we're also planning on very subtle signage and a name that
doesn't give much away. We're relying purely on world of mouth advertising.

We are trying to avoid the full name of Medically Supervised Injecting
Centre, because that seems like such a mouthful.

RACHEL MEALEY: What will an injecting drug user see as they walk through
the door?

INGRID VAN BEEK: The first they'll see is a waiting room with reception
counter, and there'll be two staff stationed behind the reception counter.
And off to the side there's the doorway which leads to the assessment room,
which is where new clients will be assessed.

It's also very integral to our evaluation. We want to find out what type of
person we're seeing, whether or not we're seeing a more marginalised drug
user who hasn't yet come into contact with services.

It is the hope and expectation that a service like this will appeal to
people earlier in their drug using than other services. And in this way we
hope to widen the net and increase the access into health services, and
particularly into rehabilitation.

Particularly because we know that early interventions in this regard are
much more successful than later on. When a person's entrenched in their
drug use, it's very much more difficult to effect rehabilitation. We're
also going to be asking people what drugs they've used on the day, when the
last time was that they used. And we'll be assessing people for their
levels of intoxication because people who are intoxicated won't be allowed
to proceed to the injecting room part.

RACHEL MEALEY: As we move into the next stage of the centre, which is the
injecting room, what does a client see?

INGRID VAN BEEK: First of all, they'll walk up the stairs. And they'll be
asked to come in, in order of entry. Then they'll move to the wash basins
and be asked to wash hands, that's an important part of infection control.

They'll then proceed to see one of the nurses, where they'll obtain sterile
injecting equipment. And that will include needle syringe and a spoon and
sterile water, and a swab to swab the arm. They'll then proceed to one of
the injecting booths which they'll be allocated to. And each injecting
booth can accommodate up to two people.

RACHEL MEALEY: This section of the centre is divided into eight injecting
booths. Can you just describe, we're looking at a silver, stainless steel
bench top with two plastic chairs, it's a very sort of sterile setting?

INGRID VAN BEEK: That's correct. We deliberately wanted this part of the
injecting centre to have a clinical feel to it, and to be designed so that
it would be easily decontaminated in the event of blood spills. So we have,
as you say, a stainless steel table that can accommodate up to two people.
And there's also a disposal unit there so that after a person's injected
they can immediately dispose of the equipment.

RACHEL MEALEY: What were the principles employed to do with the overall
decor of the place? You've got a little bit of bright colour, but mostly it
looks like a hospital.

INGRID VAN BEEK: We wanted the place, I suppose, to be warm and inviting.
But at the same time clinical because we do ... we are a health service,
and we do want to approach the matter from that perspective. We also, I
suppose, heard the community when they said that they didn't want this
place to look like a place that was like a nightclub or something like
that, that might appeal to young people who might not otherwise use drugs.

This area here is just for the purposes of injecting, and once a person has
injected once they'll then proceed to the after care area. It'll vary as to
how long it will take for a person to inject. But somebody who's
experienced injecting, and has good veins - they may only be here for five
minutes.

On the other hand a person who has veins that have been damaged previously,
who has difficulty gaining access, that sort of a person may be for up to
half an hour. We don't envisage that people would stay for longer than that.

RACHEL MEALEY: How many injecting episodes do you hope to house here in one
day?

INGRID VAN BEEK: We're expecting to accommodate between 150 and 200
injecting episodes that we otherwise expect would have occurred in unsafe
circumstances. And from our research, we understand that that number, 150
to 200, is approximately the number of occasions that that's occurring in
this area.

RACHEL MEALEY: Isn't there a risk though that you're going to attract ...
you're going to have a greater demand because people will be attracted to
the service that the centre offers, and it won't be able to keep up with
demand?

INGRID VAN BEEK: I suppose to some extent we're hoping to attract more
users than we need. I think that it would be more of a concern to us if we
didn't attract many users. I guess those are the things that we're going to
have to play by ear.

A lot of this has been decided on on a lot of assumptions, we haven't run
this sort of facility in Australia. And we certainly haven't run this type
of thing here in Kings Cross. But we will be specifically targeting those
sub populations, and there are ways of doing that effectively.

RACHEL MEALEY: What about the location of the centre? We heard before that
it's situated on a very busy road in the heart of Kings Cross, which is
Sydney's redlight district. It's surrounded by strip clubs, 24 hour
establishments. What is the impact that you think the location is going to
have on the service?

INGRID VAN BEEK: Well this is also the heart of where the highest number of
drug overdose deaths occur in Australia. So what we're hoping the impact
will be is that we'll prevent those deaths by supervising those injections.

We're also hoping that we improve the local amenity, which as you suggest
is currently at very low levels, by moving those people - drug affected
people who currently move through this main street - into a service like
that and hopefully not only accommodate them off the streets for the
duration of the drug use event, but also refer those people into treatment,
addressing the cause of the problem.

RACHEL MEALEY: We're moving now from the injecting room up a ramp into the
after care area, as you've named it. What's the purpose of the room that
we're entering now?

INGRID VAN BEEK: This area here will be the area where people will chill
out after they've injected. People who are very drug dependent, who arrive
with withdrawal symptoms, they may well have some heroin and then want to
leave immediately. That won't be a problem for them because those people
will be using heroin just to stay normal, and they'll be completely able to
leave.

Other people that may take a little bit more time, and that's the sort of
person that we're also intending to refer to other drop in services so that
they don't end up being drug affected on the street. Even though, at the
moment, if you walk down Kings Cross within a minute you'll probably pass
about 20 drug affected people slumped in doorways and so on, we do
appreciate that once we open this service we'll probably be held
responsible for every drug affected person in Kings Cross.

And so we own that, we take responsibility and we are rallying around those
other services to accept such clients.

RACHEL MEALEY: And if we keep moving through this area, we come to the
exit. We'll go through that door now, it brings us out into Kellett Street
in Kings Cross. What we can see is the back of a pub, on the opposite side
of the road. It's a street that's lined with businesses and the odd passer
by. What else can you tell me about the back entrance here?

INGRID VAN BEEK: Well I think as you just pointed out, the odd passer by,
then the last two people that just passed by were both drug affected drug
users. So already that sort of person is using this back street to and from
various establishments.

It is generally well lit, and we can get good ambulance access from this
area. We felt it was better to have a one way traffic flow and to avoid
people actually exiting back on to the main street. So to that extent we're
drawing users from the main street and having them exit here where they can
do so a little bit less in the public glare than on the main street.

COMPERE: Dr Ingrid van Beek, speaking to Rachel Mealey.