Beyond Addiction

medically supervised injection centres
DEB BENNETT

The Uniting Church in Victoria and Tasmania will consider its position on the establishment of Medically Supervised Injecting Centres (MSICs) when it gathers for the September Synod meeting at Box Hill.

Responding to a recent coroner’s finding on the death of a young woman in Richmond, moderator Rev Sharon Hollis believes it is an important issue for the Church. In the lead up to the Synod meeting, consultation will be held throughout the synod to determine the Church’s response.

“We are both service providers and people engaged in the community,” Ms Hollis said.

“(Uniting agency) ReGen has been working in the AOD (alcohol and other drugs) space for some time and I thought it was the right time to bring it all together in our synod and have a look at it. Also, clearly the prompt is there as the government is looking at it.”

In Victoria last year, nearly 500 people died from drug overdose, a figure greater than the road toll. The City of Yarra recorded the greatest number of deaths. In February of this year, after investigating the overdose death of a young woman in a Hungry Jack’s toilet in Richmond, the Victorian coroner recommended the Andrews government establish a MSIC in the suburb of Richmond – often referred to as ‘ground zero’.

In spite of the recommendation from the coroner, as well as support from the Australian Medical Association and community groups, Victoria’s premier Daniel Andrews said his government does not support the establishment of MSICs.

One of the groups to add its name to a letter of support for a MSIC trial was Uniting ReGen, an organisation with decades of experience in the treatment of addictions to alcohol and other drugs.

ReGen CEO Laurence Alvis said that treating drug addiction is extremely complex. Many addicts will use for up to a decade before they seek treatment. As he explained, people cannot be ‘forced’ to enter treatment. For most programs to be successful, the drug user needs to commit to giving up.

“We recognise that a lot of people are not at the stage where they are saying ‘we want to give up’. We often find that people who are substance abusers feel guilty about it but are nowhere near the point of giving up,” Mr Alvis said.

“It’s about forming relationships and waiting for the opportunity to offer help when it is asked for. As the families say, it is a case of actually making sure we are keeping them alive so they can make the decision at some stage, when they are ready, that they need to stop doing this.”

Mr Alvis is pragmatic in his response when asked why a MSIC needs to be established in Richmond. MSICs keep people alive.

“A couple of months ago I went to a family drug support organisation,” Mr Alvis said.

“Two of the families told me their children were involved in drug use for 10 years and then finally saw the light.

“The third family was not so lucky. Their son died of an overdose about three years after he started using.

“The key message is that we know that people are likely to use heroin for something like 10 years before they consider treatment – you have to keep them alive for that time.

“This has become even more critical now with the introduction of synthetic substances like methamphetamine and ice.  When synthetic products are mixed with normal grade-base heroin, its makes it up to 100 times more powerful. So people who are buying it, when they inject they can go straight into overdose.”

According to Mr Alvis, the statistics should speak for themselves when deciding on the pros and cons of MSICs.

In 2001, Australia’s first MSIC opened in Sydney’s Kings Cross. Operated by Uniting NSW, staff have supervised more than 1 million injections, and managed more than 6000 overdoses without a single death.

More than 80 MSICs are in operation throughout the world; there has never been an overdose death at any of these facilities.

Last year the City of Yarra recorded 96 illegal-drug overdoses, more than three times the metropolitan average.

Figures such as these can polarise views on both sides of the debate around MSICs. Some would say they point to an obvious need for more harm minimisation strategies, others argue for greater law enforcement.

Ms Hollis agrees that the language surrounding this debate is extremely important.

“Some people think it is a medical issue, others think it is a health issue, for others a legal issue,” Ms Hollis said.

“There are polar views on both sides. I think we add to the conversation by taking on a difficult, tricky subject.”

Two decades ago, the prime minister of Australia launched an initiative he hoped would combat Australia’s drug problem. In 1997, John Howard’s government budgeted $516 million for its ‘Tough on Drugs’ policy. Howard’s chief advisor was The Salvation Army’s Major Brian Watters. Major Watters was also chairperson of the Australian National Council on Drugs and took a moralistic view towards drug use.

A few years after the Tough on Drugs policy was announced, social researchers Julian Buchanan and Lee Young suggested the language used when talking about drugs contributed to the social problems drug users faced. The 2000 article titled ‘The war on drugs – a war on drug users’ examined the impact of individualising the complex issue of drug abuse.

“The policy of prevention, prohibition and punishment has resulted in the wholesale

criminalisation of major sections of society (especially those under 25 years) and locked long-term drug users into a process of stigmatisation, marginalisation and social exclusion,” the article stated.

Speaking at a Centre for Independent Studies dinner in 2006, Mr Howard cited his Tough on Drugs policy as an example of the positive influence governments could have on social norms.

“Governments do have a responsibility to articulate a clear cultural message, especially in confronting social pathologies such as crime, domestic violence and drug addiction,” Mr Howard said.

Ms Hollis feels the language used when discussing drug addiction – whether it is a ‘social pathology’ or a health concern – is important. She hopes the church can help to tackle the sense of alienation from mainstream society that drug users often feel.

“We have often seen drug taking as a kind of moral failure. If you were stronger or better or your family wasn’t so dysfunctional – whatever we think causes it. We put a lot of judgement onto families that they don’t deserve,” Ms Hollis said.

“I suppose my own experience of having a partner die of suicide, that’s a really stigmatised area; it alerts you to the other stigmas that exist. Whenever you are battling something like that, the stigma makes it worse.

“If you’re a drug addict or the family member of a drug addict, that’s enough – you don’t need the stigma to deal with as well.”

While MSICs serve a very real function of keeping people alive, Ms Hollis feels they also signal to the person using drugs that they are still valued members of society.

“I don’t imagine anyone finds it much fun shooting up in the back lanes of Richmond, so let’s give them somewhere where they feel like a human being,” Ms Hollis said.

“By and large this is a problem that needs to be dealt with clinically by allied health and welfare supports. I hope it sends the signal that you are a person worthy of respect and dignity. A person worthy to have decent, clean, comfortable facilities.”

For more than 30 years, Carol* supported her youngest daughter as she lived with a heroin addiction. Maddie* first used heroin at the age of 16. Her then-boyfriend later admitted in a counselling session that he had injected Maddie in order to maintain control of his girlfriend, who he thought was going to leave him.

Two years ago, 47-year-old Maddie died of a drug overdose. She was found by her partner in bed when he returned from the pub. He assumed she was asleep, it wasn’t until the next morning that Carol received the phone call she had been dreading for three decades. Her daughter, who had won prizes for dancing and wanted to be a vet when she grew up, had died alone. Estranged from her husband and 12-year-old son, ashamed to attend family functions and living in an abusive relationship.

“Nearly two years later I still can’t help thinking of how alone Maddie must have felt,” Carol said.

“No one should have to deal with something like drug addiction on their own, but often the people who love them the most will actually avoid them.

“Maddie was many things in life. She was incredibly funny, very loyal and she loved her son with all her heart. But, especially in the last few years, she had begun to see herself as little more than an addict. Because that was what she was labelled as.”

Carol said that for many people, giving up drugs was only half the battle. While Maddie successfully completed drug rehabilitation a few times, she often felt excluded from mainstream society and ashamed of her past.

“In her 20s, after her boyfriend died, Maddie made a real effort to regain control of her life,” Carol said.

“She was clean for the first time in 10 years, got married and had her beautiful little boy. But she found it so hard to make real friends. The other mums would sit and chat about things and she said to me that she was terrified they would find out about her past.”

The sense of failure and being judged by others is a common hurdle for people suffering from addiction to overcome. Ms Hollis feels the Church also has a theological role in affirming the inherent worth of a person.

Part of the consultation process with the wider church includes a theological response to the issue of MSICs. Former principal of Pilgrim Theological College Randall Prior is working closely with Rev Dr Sally Douglas, minister at Richmond Uniting Church, to prepare a document for consideration.

According to Mr Prior, the involvement of the church offers a tangible expression of the gospel. He feels the Uniting Church offers a different perspective to those of more conservative faiths, who may view drug abuse as a personal moral failing.

“At the very heart of the Christian faith is that in Jesus Christ, God takes upon God’s self the fullness of our broken humanity,” Mr Prior said.

“All of us, whatever colour, race, creed or human condition, all of us are sisters and brothers of each other. We stand as a community of people embraced by God in Jesus Christ.

“There is no such thing in theological categories of people who are good or evil, right or wrong, people who deserve God’s love and those who don’t deserve God’s love.

“All of us stand equally broken in the presence of God and in need of the graceful healing of God.”

*Not their real names

Uniting invites church members to attend a discussion on medically supervised injecting centres at the Centre for Theology and Ministry in Parkville on Wednesday 28 June from 6-8pm. Click here for more information and to register to attend.

 

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