LOOKING FOR A QUICK FIX

Overseas Use Of Injecting Rooms Has Yielded Mixed Results

IN 1986, the Zurich drug scene was out of control. Every day, up to
4000 drug users would gather in the Platzspitz "Needle Park" to shoot
up. According to authorities the results of this excess were varied,
but inevitable: a big increase in the spread of HIV among drug users;
rising drug-related crime and a jump in overdoses.

In Frankfurt, the situation was no better. By the mid-80s, the local
drug movement had been transformed from small groups smoking marijuana
in parks to mass public injecting of hard drugs. The epicentre was a
small public park adjacent to a railway station in the city's banking
and business district. Each day, about 450 drug users would gather
there. In summer, the number would double. A further 5000 people would
visit the park to buy drugs. At the same time about 20 ambulances had
to be sent to the park each day to deal with overdoses.

Something had to give. Pressure from business and tourism operators,
combined with community outcry, forced the closure of the Platzspitz
and similar Swiss parks. By 1988 prolonged campaigning by business
groups and local communities led to a major clean-up in Frankfurt.

As one strand in a wider strategy to try to control the heroin
scourge, both cities decided to experiment with supervised injecting
facilities for heroin users.

In Switzerland, the first legal facilities known as Fixerrdumes,
started up in 1986. A year later, injecting rooms opened in the German
cities of Bonn and Bremen. There are now 20 rooms operating throughout
the two countries. In the Netherlands, drug consumption facilities had
been operating since the '70s, but were only officially sanctioned in
1996. Sixteen facilities are now located in nine Dutch cities. Last
year, Spain became the latest European nation to back the program.
Rooms are scheduled to start operating in Barcelona and Madrid this
year.

Supporters of the Bracks Government's bid to establish five injecting
facilities in Melbourne assert this overseas experience provides
evidence that injecting rooms are an effective tool in tackling the
heroin problem. But critics are equally adamant. The Prime Minister,
John Howard, said this week there was "no clear evidence from overseas
experience that they (the facilities) reduce the drug problem".

The difficulty in testing the competing assertions is that there has
been limited evaluation of the European injecting centres since they
opened 14 years ago.

None the less, research shows that no heroin addict has died of an
overdose in a supervised injecting room. Statistics published in the
International Journal of Drug Policy suggest that, combined with
broader "harm-minimisation" policies, the rooms have succeeded in
saving lives and reducing the street crime associated with drug use.

Figures cited by an international drug policy organisation, the
Lindesmith Centre, show a dramatic reduction in street crime in
Frankfurt since the "harm-minimisation" approach was adopted in 1991.
Frankfurt's first injecting centre opened in 1994.

The number of deaths in the city has decreased every year since 1991.
According to the Swiss Federal Office of Public Health, drug-related
deaths in the country have decreased from 419 in 1992 to 209 in 1998.

Alex Wodack, president of the Australian Drug Law Reform Foundation,
said harm minimisation measures, including supprvised injecting rooms,
are no longer controversial in Europe. He criticised John Howard for
closing his mind to the overseas evidence: "It seems this is only
controversial in Kirribilli."

A 1998 New South Wales joint select committee report on injecting
rooms referred to the German experience, where "roughly 1200
injections a day corresponds to a cut in the annual number of overdose
deaths of around 70".

It also concluded, based on overseas evidence, that injecting centres
may reduce public nuisance, such as the number of used syringes, and
the kind of street crime that was a result of users being under the
influence.

The Lindesmith Centre research found Swiss injection centres had
encouraged users to take fewer health risks, and had resulted in fewer
syringes discarded on Swiss city streets. It said fatal overdoses in
Frankfurt had peaked at 147 in 1991, and fallen to 26 in 1997.

The state Health Minister, John Thwaites, who recently visited the
injecting rooms in Frankfurt, said he believed the facilities had
demonstrated two central benefits: reducing the death rate and
encouraging drug-users into methadone programs and
rehabilitation.

The head of the State Government's Drug Policy Expert Committee, David
Penington, who also undertook a fact-finding mission to some of the 42
European facilities, readily acknowledges these countries have
continuing problems with illicit drug use.

But Penington said the facilities have succeeded in saving the lives
of users when they overdose, clearing the streets of public drug use
and crime, and directing users into rehabilitation and counselling
services.

But it seems there are just as many sceptics of the European
facilities as there are advocates. Bob Falconer, a former senior
Victorian police officer, and later WA chief police commissioner, is
one such critic. He believes people such as Thwaites and Penington
have been sold the "party line" by local politicians and facility
managers. When Falconer visited Europe, in the '90s, regional police
gave him a different story. While there were no deaths inside the
facilities, police said the surrounding streets had been hijacked by
criminals. Users heading towards the facilities were preyed upon
because they were known to be carrying heroin. According to Falconer,
police faced enormous difficulties as addicts were threatened and
robbed by local criminals.

This is a theme taken up by the Liberal Party's health spokesman,
Robert Doyle, who has also toured the European rooms. The State
Government requires the support of the Liberals to get the injecting
room legislation passed through the Upper House. Doyle is yet to be
convinced.

"My view is learn from experience, but don't assume we have parallel
societies," he said. "While there have been no deaths in these
facilities, I have yet to see documented scientific evidence that
shows me that lives have been saved overall because of them."

Doyle said he would like to see analysis of the overall take-up rate
of heroin during the life of the facilities; and whether the death
rate, inside and outside the facilities, had risen or decreased.

In advocating the Melbourne trial, Penington's committee warned in its
stage one report that urgent action was required to confront the
illicit drug problem. "It would be regrettable to wait until the
situation in Victoria had reached the state of open trafficking and
use that characterised Berne and Zurich in the early '80s, or
Frankfurt and Hamburg by 1990," the committee said.

An Open Family youth worker, Les Twentyman, agrees. He argues that the
Melbourne situation is now worse than many European cities, Last year,
there were 359 heroin-related deaths in Melbourne, 80 more than the
combined national totals of Switzerland and the Netherlands in 1998.
Last year, the number of drug-related deaths in Frankfurt had dropped
from 35 to 26.

"This is a national crisis," Twentyman says. "It's almost a genocide
of young people in Australia. We just can't keep doing the same things
because it's a total failure."