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Speaker 1: From the newsroom and news still come today.

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Speaker 2: Hey, I'm Emily Waterson filling in for Bucky and we've

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Speaker 2: got an interesting one for you today. Now you've probably

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Speaker 2: heard of the opioid epidemic in the US or the

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Speaker 2: decriminalization of all drugs in Portugal. But what do you

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Speaker 2: know about substance use and management in Australia. Well, news

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Speaker 2: dot com dot a used journalist Rowan Smith went to

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Speaker 2: the epicenter of the country's heroin problem to hear about

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Speaker 2: the impact of medically safe injecting rooms on the community

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Speaker 2: and some of the debate that's happening around them. Then

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Speaker 2: later on we'll also hear from doctor Nico Clark about

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Speaker 2: how and why these facilities are so important. Rowan, thanks

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Speaker 2: so much for joining me. Now, you've written two articles

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Speaker 2: in the last couple of days about the state of

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Speaker 2: a particular area in Melbourne. Where is it and what

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Speaker 2: led you to this story?

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Speaker 3: Yes, so it's an area between North Richmond and West

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Speaker 3: Richmond in Melbourne and it's the site of Melbourne's only

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Speaker 3: safe injecting room. And got in this really small pocket

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Speaker 3: these commission towers, there's kind of like four blocks of them.

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Speaker 3: The injecting room. And then you've got Richmond West Primary School,

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Speaker 3: and I've been there a few times over a number

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Speaker 3: of years to talk to people, talk to parents of

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Speaker 3: the school about kind of what their first hand experiences

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Speaker 3: are like with the drug problem right there.

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Speaker 2: What did you observe there.

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Speaker 3: So there's lots of drug use, and there's lots of

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Speaker 3: drug uses, and I've seen that before kind of just

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Speaker 3: from the outside, but I've never been in. And so

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Speaker 3: I spent some time on Friday inside the towers and

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Speaker 3: there's just this like steady stream of users making their

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Speaker 3: way past security and into the lifts, and they'll wait

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Speaker 3: for somebody in the towers, somebody who lives there, to

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Speaker 3: go in, and then they'll kind of just shadow them

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Speaker 3: in behind. And residents say that they buy drugs from

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Speaker 3: dealers in the towers, and they get their syringes from

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Speaker 3: the safe injecting rooms, and they use them in the

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Speaker 3: stairwells and the car parks and sometimes kind of like

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Speaker 3: out in the open, pretty confronting scene.

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Speaker 2: So I take from what you've said that this isn't

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Speaker 2: a new issue. Does Richmond have a history with drug abuse?

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Speaker 3: Richmond has always had its drug problems.

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Speaker 4: And people who.

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Speaker 3: Support the safe injecting room will tell you that heroin

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Speaker 3: has always been big there and part of the reason

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Speaker 3: they think that there should be a safe injecting room

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Speaker 3: there is that it's saving lives. Critics say that it

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Speaker 3: gives drug users kind of another reason, drug users from

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Speaker 3: elsewhere to come to Richmond, and that's why you see

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Speaker 3: like an explosion in drug use and those antisocial acts

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Speaker 3: that go hand in hands. So it's not a new issue,

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Speaker 3: but I think people who live there say that it's

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Speaker 3: gotten worse since they put the safe injecting room in.

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Speaker 2: And I understand the facility offers clean syringes to minimize

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Speaker 2: the spread of illness. Have the locals at least in

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Speaker 2: improvements there.

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Speaker 3: So the injecting room, it works, and it saved lives

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Speaker 3: and you've got you know, they've safely manage thousands of

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Speaker 3: overdoses inside the facilities since it became At first it

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Speaker 3: was on a trail base and then became permanent. But

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Speaker 3: the problem is that it's not being used for a purpose.

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Speaker 3: It's what I hear is that people go there and

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Speaker 3: you know, they'll get the drug paraphernalia and they'll take

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Speaker 3: it out into the streets, and so on the one hand,

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Speaker 3: you've got you know, yes, it's saving lives and people

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Speaker 3: are going there and using safely there, but not everyone's

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Speaker 3: doing that, and so you'll find the people that live

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Speaker 3: in the towers next door are exposed to drug use

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Speaker 3: kind of on their doorsteps all day every day. And so, like,

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Speaker 3: the funny thing is that I don't think I've spoken

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Speaker 3: to anyone who says that, you know, they don't want

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Speaker 3: or they don't believe that a safety injecting room is

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Speaker 3: a good thing. The problem is that it's just in

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Speaker 3: a bad area, and like you put it next to

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Speaker 3: a primary school, and so you've got kids leaving the

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Speaker 3: school at three thirty every day, and there's a history

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Speaker 3: of incidents there. So it's just kind of it's where

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Speaker 3: it's located that think is the biggest problem.

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Speaker 2: It's interesting because if it's got a if it's got

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Speaker 2: a history in that area, it's sort of like, wouldn't

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Speaker 2: you think that that would be the best place to

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Speaker 2: put it, you know, given that it's already such a

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Speaker 2: such a problem, where do you think the locals would

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Speaker 2: prefer it to be moved to?

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Speaker 3: I think just not next to a school. I think

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Speaker 3: there's a There are huge problems with drugs in Melbourne,

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Speaker 3: and if you look at the stats around heroin in particular,

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Speaker 3: Victoria just carries it's more than it's fash air of

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Speaker 3: the world nationally. The I think they just don't want

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Speaker 3: it right next to the school. Even those who say

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Speaker 3: that it's a good thing, just don't.

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Speaker 2: Want it there.

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Speaker 3: Elizabeth Street in the Cities, there's a huge drug problem

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Speaker 3: there obviously, but you talk to you know, residents who

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Speaker 3: live there, and you talk to business owners who live there,

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Speaker 3: and they don't want it there either. So the reason

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Speaker 3: it's coming for such strong criticism is because you've got

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Speaker 3: kids growing up next door and you've got kids going

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Speaker 3: to school next door. In that mix just isn't right

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Speaker 3: where you put it.

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Speaker 4: I don't know.

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Speaker 2: Yeah. Do you think perhaps if there were more of them,

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Speaker 2: more safe injecting rooms, that then there would be it

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Speaker 2: would be a bit more dispersed and perhaps not so

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Speaker 2: many people would be going to that one area. Do

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Speaker 2: you think if there were more of them that it

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Speaker 2: wouldn't be such localized issue. Yeah.

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Speaker 3: I think that's a really good point. The problem is,

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Speaker 3: you know, getting approval for another one, so this one

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Speaker 3: came in when so the Daniel Andrews Labor government was

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Speaker 3: in power in Victoria and they ran it on a

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Speaker 3: trial base and it was you know, there was kind

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Speaker 3: of a mix of feedback and there was some good

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Speaker 3: results and there was reporting that said that it was

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Speaker 3: saving lives. But it's been just so hugely controversial since

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Speaker 3: they put it in that I think, you know, the

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Speaker 3: Vitorian government now is contemplating whether or not to have

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Speaker 3: a second safe injecting room and where they put that.

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Speaker 3: But it's just kind of how you get that over

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Speaker 3: the line was and where you put it that's the problem.

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Speaker 2: Will we back a moment. Joining me now is doctor

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Speaker 2: Nico Clark, and addiction medicine doctor and the clinical director

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Speaker 2: at First Step Clinic. I am also joined by Patrick Lawrence,

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Speaker 2: the CEO of First Step, a mental health, substance abuse

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Speaker 2: and legal services hub in Sint Kilda. Thank you both

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Speaker 2: so much for joining me. Can you start with telling

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Speaker 2: me how these injection rooms work?

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Speaker 4: In dictor rooms, there are a space where people who

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Speaker 4: inject drugs can do so in a way that they

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Speaker 4: feel safe and that they feel welcome. And I think

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Speaker 4: the first thing to think about is who are the

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Speaker 4: people who might want to use such facilities, it's because

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Speaker 4: they're not necessarily people that many of us would know

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Speaker 4: or come into contact with us in the course of

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Speaker 4: our lives. There is some information that's publicly available about

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Speaker 4: the people who use the facility. We know that they

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Speaker 4: on average started using heroine very young, as teenagers. It

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Speaker 4: was almost always heroin in the Richmond room. And that

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Speaker 4: they are largely almost a third are homeless, that many

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Speaker 4: have them advast majority have spent significant period of time

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Speaker 4: in prison, and they have had kind of largely traumatized lives.

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Speaker 4: Certainly from the personal stories that people told me, they're

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Speaker 4: you know, really gut wrenching stories of kind of personal

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Speaker 4: trauma and tragedy that many people had experienced when they

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Speaker 4: were very young. So and when you had asked them about,

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Speaker 4: you know, their parents experience, their parents had often experienced

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Speaker 4: something too. So we're really looking at the kind of

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Speaker 4: consequences of intergenerational trauma and disadvantage that affects quite a

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Speaker 4: small percentage of people in our society, and then it

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Speaker 4: sets up a series of kind of negative interactions with

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Speaker 4: authority figures in society as a result of that. When

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Speaker 4: people kind of failed to live up to those expectations

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Speaker 4: that society places on people. Instead of stopping to understand

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Speaker 4: what's happened for this person's life, we kind of punish

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Speaker 4: people for not living up to their expectations.

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Speaker 2: And why is Richmond such a hot spot for this

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Speaker 2: type of drug use?

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Speaker 4: People largely buy their heroine in Richmond because Richmond has

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Speaker 4: been the center of Melbourne's drug market really since the

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Speaker 4: Vietnam War and for decades, and there's been a street

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Speaker 4: injecting scene in and around the Housing Estate and Victoria

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Speaker 4: Street for decades and since certainly since it was pushed

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Speaker 4: away from the city when the Comonwealth Games was in

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Speaker 4: the city, where there was an effort of policing effort

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Speaker 4: to move people away from Smith Street and Russell Street,

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Speaker 4: and that led to the congregation in Richmond at that time.

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Speaker 4: And so a location close to that facility means that

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Speaker 4: people then come to the facility and then they can

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Speaker 4: inject there, and the staff there both try and make

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Speaker 4: people feel welcome so that they will want to use

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Speaker 4: the facility and then look after them if they do overdose,

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Speaker 4: and then provide a range of supports if people wanted

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Speaker 4: just talking.

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Speaker 2: On location, you mentioned the facility was placed there to

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Speaker 2: address the pre existing drug issue. Can you talk more

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Speaker 2: and why Richmond and not somewhere else.

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Speaker 4: So the calls for the injecting room to be in

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Speaker 4: Richmond were a direct result of a coronial finding that

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Speaker 4: in a one twelve month period there had been thirty

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Speaker 4: five fatal overdoses linked to the Richmond side. Either people

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Speaker 4: had died in Richmond or they had overdosed and been

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Speaker 4: taken to a nearby hospital and died. There was a

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Speaker 4: lot of support from residents who had seen the impact

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Speaker 4: of public injecting in their area, who knew people who'd overdosed,

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Speaker 4: who had family members who'd overdosed. The police came on board,

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Speaker 4: the media came on board a and that ultimately the

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Speaker 4: politicians agreed and the government agreed to fund a center

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Speaker 4: in Richmond. So it's clear that you have to put

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Speaker 4: an injecting room close by to where people purchased their heroine,

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Speaker 4: and they chose to put it in the community Health

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Speaker 4: center because of the capacity to offer additional support to people.

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Speaker 4: That was I imagine they're thinking. It was also a

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Speaker 4: piece of land that was in government control to a

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Speaker 4: certain extent, and so you know, one can presume that

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Speaker 4: that was the decision making that led to the selection

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Speaker 4: of that location.

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Speaker 1: It was a massive years long campaign, including marches in

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Speaker 1: the street. There were hundreds and thousands of local residents

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Speaker 1: who wanted this to happen, and a great many of

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Speaker 1: those folks that were still in touch with are still

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Speaker 1: campaigning now for the continuation of the medically supervice injecting

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Speaker 1: room and further medically SIPs injectuve rooms or drug consumption

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Speaker 1: rooms in Melbourne.

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Speaker 2: So majority of the public support these spaces. However, some

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Speaker 2: Richmond locals feel quite differently. What do you believe is

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Speaker 2: the cause for these negative opinions?

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Speaker 4: My own observation so that there's been two government independent

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Speaker 4: reports about what's happened in the injectum and the impact

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Speaker 4: on the local area, and the main finding of those

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Speaker 4: reports was really a large reduction in overdoses in the

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Speaker 4: area around the injecting room at the same time that

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Speaker 4: overdoses were increasing in the rest of the state. So

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Speaker 4: really the only logical interpretation of this data is that

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Speaker 4: there was a big reduction in public injecting, and certainly

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Speaker 4: that's what I've seen, But there was also a study

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Speaker 4: done by the Burnett Institute that walked around the hot

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Speaker 4: spots of Richmond counting the number of people who are

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Speaker 4: public publicly injecting. And they did this several years after

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Speaker 4: the injecting room had been up and running, and they

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Speaker 4: had to walk an average of fourteen kilometers through the

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Speaker 4: former kind of hotspots of Richmond to find somebody publicly injecting. Now,

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Speaker 4: obviously you're not going to see, you know, the heroin

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Speaker 4: market is suddenly not going to disappear. The people who

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Speaker 4: are coming and buying heroin are suddenly not going to disappear,

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Speaker 4: and there's a certain visibility and in the immediate area

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Speaker 4: of the injecting room. But so I think there's a

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Speaker 4: combination of some kind of false expectations that suddenly the

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Speaker 4: heroin market would vanish and people would just vanish, and

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Speaker 4: in a way, but the other force of courses that

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Speaker 4: it kind of draws attention to the media to this topic.

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Speaker 4: The government has committed itself to doing something which you know,

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Speaker 4: I'd support them wholeheartedly for doing. In some ways it's

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Speaker 4: a brave thing to do that has enabled there to

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Speaker 4: be criticism in the media. And it's fairly easy to

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Speaker 4: interview somebody who lives in the area who says, well,

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Speaker 4: I think it's been terrible, So why would somebody do that.

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Speaker 4: I mean, the first thing to say is it's actually

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Speaker 4: a very small number of people who do report that experience.

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Speaker 4: I think I went to a rally on the steps

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Speaker 4: of Parliament House that I think had eight people present.

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Speaker 4: And we see many of the same names appearing in

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Speaker 4: the media again and again, and they don't seem to

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Speaker 4: represent the views of people in Richmond. As you say,

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Speaker 4: the support for injecting rooms broadly has increased if you

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Speaker 4: look at local voting people who've stood on a platform

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Speaker 4: of closing the injecting room. There was a council election

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Speaker 4: a few years ago. There was a number of candidates

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Speaker 4: stood on this platform and none of them have gotten

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Speaker 4: became elected. Now, the current mayor of Richmond has kind

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Speaker 4: of it's quite vocal about some of these issues, but

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Speaker 4: there was a whole string of candidates who stood on

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Speaker 4: that and none of them got elected. So it doesn't

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Speaker 4: appear that there is this groundswell of support. The people

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Speaker 4: I talked to in Richmond who live in the area

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Speaker 4: both talk about the long term nature of visible drug

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Speaker 4: use in Richmond, but they talk about the distress that

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Speaker 4: they feel thinking that somebody might be overdosing behind their

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Speaker 4: back fence and what can they do about it. That's

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Speaker 4: the last thing that most people want, is the sense

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Speaker 4: that somebody nearby them is suffering and the lack of

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Speaker 4: certainty about what they could be doing about that, what

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Speaker 4: they should be doing about that. And the vast majority

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Speaker 4: of residents I spoke who felt reassured that there was

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Speaker 4: somewhere that people could go that there weren't at risk

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Speaker 4: of overdosing in their rear lane way that you know,

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Speaker 4: and nothing. That's a common human exp that we feel

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Speaker 4: better that the people around us are being looked after.

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Speaker 2: Correct me if I'm wrong, as I'm not the expert,

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Speaker 2: but I saw that roughly eight thousand overdoses have been

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Speaker 2: managed in the Richmond facility. Is there any evidence to

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Speaker 2: suggest that these numbers are influenced by the existence of

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Speaker 2: a medically safe injecting room.

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Speaker 4: There's no evidence that the presence of a drug consumption

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Speaker 4: rooming increases people's desire to use heroin or other substances.

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Speaker 4: It's just that influences the choice of location for injecting,

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Speaker 4: so that I think it's entirely reasonable to think that

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Speaker 4: had those had those people not injected in the injection room,

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Speaker 4: they would have had those overdoses elsewhere, and not all

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Speaker 4: of those would have been fatal. But there was an

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Speaker 4: estimate as part of the the analysis by their government reports,

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Speaker 4: the two independent reports, that placed that number at I

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Speaker 4: think something like sixty one or sixty three. But we

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Speaker 4: certainly saw about ten percent of the overdoses when I

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Speaker 4: were there required in the lockstone, and a significant percentage

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Speaker 4: of those were people who were not breathing at all

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Speaker 4: and would certainly have had a very serious, if not

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Speaker 4: fatal outcome. So you know, while not all of those

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Speaker 4: nightousand overdoses were in that category, they were all each

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Speaker 4: one of those as somebody who wasn't maintaining the oxygen

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Speaker 4: levels to healthy levels and required some intervention to some extent,

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Speaker 4: and they would certainly have happened somewhere had they not

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Speaker 4: injected in the injecting room.

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Speaker 2: Nico finishes our chat by pointing out that anyone who

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Speaker 2: wants to learn more about the Injecting Center and the

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Speaker 2: work they do, they can get in contact with them

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Speaker 2: through their website with any questions.

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Speaker 4: And there are the inject room offers tours. You can

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Speaker 4: sign up on their website if you'd like to have

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Speaker 4: a tour and they'll explain.

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Speaker 3: To you more.

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Speaker 4: And in my experience, people found that very revealing, that

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Speaker 4: it showed them aside of the facility that they hadn't imagined,

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Speaker 4: and many people went into those tours not really knowing

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Speaker 4: what to expect and came out with a much bigger understanding.

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Speaker 2: Thanks for listening. We'll be back tomorrow.

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Speaker 4: Follow or subscribe to from the Newsroom wherever you get

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Speaker 4: your podcasts.