Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2017

Extracted from Hansard
16 November 2017

Drugs, Poisons and Controlled Substances Amendment (Medically Supervised Injecting Centre) Bill 2017

I rise to speak on this bill, which amends the Drugs, Poisons and Controlled Substances Act 1981 to allow for a trial of a medically supervised injecting centre for certain kinds of drugs of dependence at the North Richmond Community Health Centre. This is a conflicting piece of legislation for me. I understand the reasons behind setting up a trial site, but I also have concerns about the message this sends to the wider community. I understand that the traders and residents in Richmond are concerned and have been confronted by some horrible situations over the past few years, but I am not convinced that the answer is this sort of centre in the format that is being proposed. I do not think it sends the right message to the community at all.

The argument for this trial is based around the facts that there have been 34 deaths in the area surrounding the proposed site in the past 12 months and the number of Victorians overdosing has doubled since 2012. The North Richmond Community Health Centre hands out 60 000 needles a month and has been described as the epicentre of the heroin problem in Victoria. But I fail to see how this proposal addresses why so many people are dying, particularly in the North Richmond area. Why is this the epicentre of the problem, and what does this proposal do to solve that? In my view it simply moves the problem behind closed doors.

I am reluctant to speak again about my experience as a nurse, but in this area I have a great deal of knowledge and experience, because for 15 years I managed an Aboriginal community health centre and worked directly in patient care, and unfortunately dealing with drug and alcohol-addicted clients was a major part of that role. I spent many, many days walking patients through the journey of rehab or looking for rehab beds. One thing I do know is that most of those people felt ashamed of their addiction, and if a facility like this was available, I am not convinced they would want to use it. Evidence shows that 80 per cent of the time injecting drug users injected in all sorts of other locations. This was certainly what my clients told me. Whilst it may stop fatal overdoses while people are in the centre, there is no guarantee that lives will be saved elsewhere when people inject when they are not at the centre. It strikes me as interesting that we think someone will get up, get on a tram and head down to a safe place. What I saw was people just doing it when they had drugs available.

I think what works is when someone a person trusts and who believes in them walks through the journey of withdrawal and rehab with them. A centre can provide that. It is about a service being resourced and the trust and support offered by the people working in that centre and their ability to form that trust with their client.

For me it is about intensive support; that is what I saw more than anything else when I was working. You do not have to look too far to see this type of support and care succeeding. There are people like Les Twentyman, a gentleman I asked to speak to my community one night. People like that, who are committed and really trying hard at a practical level, have a huge rate of success. More support is needed from people who are really committed like that. I doubt this centre would be able to deliver that by being an injecting centre; it is more about having a wraparound centre.

In the Sydney experience my research tells me that only 11 per cent of injecting room clients were referred to maintenance, treatment, detox or rehab: 3.5 per cent of clients were referred to detox; and only 1 per cent were referred to rehab. So there is no evidence yet from the Sydney experience that people have kicked their habit in the long term. It is also reported that none of Sydney’s major rehab services, such as Odyssey House, WHOS or the Salvation Army, have ever sighted one of the referrals. You can make as many referrals as you want, but if the person you are referring does not have the appropriate support and follow-up on the referral, and someone to walk that withdrawal journey with them and help them with the rehab pathway, it simply will not work. I do hold concerns that this bill sends a message that we have given up. Rather than trying to stop people becoming addicted or assisting them through the intensive support to be properly rehabilitated, we are simply enabling people to continue to use drugs, albeit under supervision and behind closed doors.

In my electorate we are not immune to drug problems and we face our own series of issues, mostly around the lack of appropriate rehab places and a withdrawal treatment program which is not fully funded and only operates Monday to Friday and not on school holidays or public holidays. This is a critical failing that must be addressed, because you do not withdraw between 9 and 5, you do not have public holidays off when withdrawing and you do not have school holidays off from withdrawing. It needs a 24-hour service because the demand is clearly there.

There are also no locally based drug and alcohol rehabilitation beds in the South-West Coast electorate. The closest is over 2 hours away. Residential rehabilitation targets people with severe and longstanding alcohol and other drug use problems who have tried other services but with limited success. It involves stays of up to three months, and sometimes longer, at a dedicated facility that provides a structured, work-based program within a supportive environment. Clients undergo detoxification before coming to the service so they are not chemically dependent on alcohol or other drugs. They engage in therapeutic counselling and have group and individual activities to develop personal and social skills that are so critically important in addressing alcohol and other drug use problems for a longer term approach. The wraparound service model facilitates clients’ engagement with other services, with variations according to their individual concerns. Clients may engage with primary and mental health care services and they may utilise employment, education, welfare, family and other services to establish pathways that are integral to their eventual reintegration into the broader community.

As we know, the further people have to travel from their home, the less likely they are to take up treatments. So in the South-West Coast electorate our community has come together to address this gap in services and has set about solving a problem by themselves as a community. The result is the Lookout Project, a planned 20-bed rehab facility in Warrnambool, servicing the entire south-west region. A location has been identified. The community fundraising campaign has been gung-ho in raising the capital costs to get this problem sorted ourselves. Last week we hit the half-million dollar mark in just a matter of weeks. I have spoken with the Minister for Mental Health, who is at the table, and I appreciate and thank him for listening to what I had to say. I hope the far west is considered because we are ready.

In the South-West Coast electorate we have the unique ability to claim an almost full suite of services of drug and alcohol treatment, including centralised hospital-based withdrawal programs. Our community wants this rehab facility. Letters of support are coming from everywhere. A ‘not in my backyard’ attitude has not emerged; there has just been support. We have an incredibly lucky situation, where we have a good team of people with many years experience. In that team we have got doctors like Dr Rodger Brough, with over 30 years experience in the drug and alcohol area, and Geoff Soma, who has run the Western Region Alcohol and Other Drug Centre for, I think, 17 years in the region.

Whilst we have got these experienced people and the team under them, it is an opportunity for their skills and knowledge to be used to make sure we educate the next generation. Learning from experts like this is invaluable for new specialists, but we have a limited window and must act now. The Lookout, fully funding Dr Brough’s withdrawal unit and fixing other issues must become a priority. The Lookout is the community coming up with a solution to a community problem, and I respectfully ask the minister to consider making funding available to cover the operational costs of the centre.

Whilst I know there is support for this injecting room, I cannot help but feel the funding and the focus should be on strengthening other areas of addiction services to stop people becoming addicted in the first place, and supporting those who are on the rehabilitation pathway. The workers in the field need resources to assist, and the families beg us to help them. That was certainly my experience and that is where our focus should be — on supporting families. Residential rehabilitation does this; I do not think injecting rooms do.