Injectingadvice.com, May 29, 2011

How will supervised injecting facilities affect you

Although I occasionally have guest articles here on Injecting Advice they do tend to be ones where I've asked the writer if they'll do it for me. But this week I read a great opinion piece by Kathryn Daley about peoples arguments against supervised injecting facilities. This piece deserves to be seen by more people (and more people should read her great blog) so I asked her if she'd let me repost it here. (Please note that Kat is Australian so there are some references to localised politics.)
Nigel Brunsdon 
What will supervised injecting facilities do to people who don't use them? 

But, you probably want a more convincing argument because:
a. you are convinced that a SIF will spread disease and addiction and encourage drug use;
b. you say that a SIF will benefit you as it will prevent you from being exposed to injecting drug users. (I am working from the assumption that if you don't care either way about SIFs then you probably won't be reading this post - at the least, you're probably not going to be offended that I've excluded you.)
So here's why neither of these schools of thought have much nous.
"Supervised injecting facilities encourage drug use"

Premier Baillieu said in parliament today, 'I don't want to be in the business of sending messages to kids ... that it's okay to dabble in drugs'. Baillieu is opposed to SIF 'based on observation and a detailed look at all of these issues'. Now, I'm not sure what he's had a detailed look at but it isn't the evidence. Or even today's news (see here).
I'm not going to regurgitate all of the statistics which show that SIFs are good on pretty much every measure. Because if after all of the years of these figures being made public you still have such an absurd view, you obviously don't respond too well to evidence. So I'll tell you a story, an example
Supervised injecting facilities look like this.
Do you think this environment looks attractive to kids? Do you think that they would look at this and think, 'Hey, I wanna go shoot some smack?'. No, I didn't think so. And this is when the place is empty! Imagine it with five or so smelly, homeless, sad-faced individuals sitting on those chairs - do you think it would become more or less appealing? Do you think that this image glamorises injecting drug use?
But not all injecting drug users are homeless and smelly you say. I KNOW. But the ones who aren't homeless are really unlikely to stroll down to the supervised injecting facility to hang out in this clinical environment when they can shoot in the comfort of their own home. That's the point - the people who access SIFs aren't just drug users, they're typically homeless individuals with nowhere else to use. So why use at all? Well, as one welfare worker I've interviewed put it, '... I would far rather be sleeping on the streets stoned than sleeping on the streets straight'.
And while we're on this point, think about the smacked-out homeless people you've seen in your time - do they glamorise injecting drug use? Do you think young kids see them and think 'that's what I want to do when I grow up?'. I doubt it. But you know what, even if you think that this is what happens - that kids see drug users and are influenced to become a drug user - irrespective of the failure in your logic, it's another reason why you should support supervised injecting facilities - it keeps the drug use behind closed doors.
And here's some other points - most people are scared of needles. The idea of injecting anything is not appealing. Facilities like that shown above won't change that. And there's that other issue - people who don't use the facility are unlikely to know what it is, or where it is, or why it is.
And really Baillieu, you don't want to send off the message to kids that it's okay to dabble in drugs? Then make all government events alcohol-free and ban alcohol sponsoring and advertising.
Then there's those of you who support SIF and really push the 'it improves the community' point.

Well, yeah. But, er, no.
Yes, certainly, it's better people use in supervised facilities than in public toilets, and it's certainly good to prevent the public from stumbling upon the body of a person who has overdosed in such circumstance. But, given how infrequent it is that a member of the public stumbles upon a body it's probably not the best selling point, it's not an experience most members of the electorate can relate to.
But I don't think a SIF needs to have benefits given that it poses no harms. I also don't think that we need to see people reducing their drug use to measure the success of SIFs. We can't expect a reduction in drug use while we are not addressing the issues that have lead to the drug use. The role of the SIF is first and foremost to provide a space, with medical supervision, where injecting drug users can avoid death, overdose and blood borne viruses.
I also don't think that SIFs will eliminate public drug use entirely, but I think it will reduce the number of people using alone in public. And given that accidental overdose is far more likely to happen when one is alone, this is a good thing. But, it may not benefit you. For instance, a group of people who hang out in a public housing estate on weekends and sneak behind the cars to use before returning to the communal area to friends are probably going to keep on using like that. You see, they feel safe. They have friends there to monitor for overdose and keep an eye out for police, so they don't have to go anywhere. So, if you're a tenant in those flats who feels uncomfortable walking through this area, that's unlikely to change. On the upside, these people are very conscientious about safe disposal so you needn't worry about standing on dirty syringes. And given that there's a group of them, you won't be left to find a dead body.
Another reason that we will keep on seeing 'drug users' on the street is that, as I've pointed out, the minority of injecting drug users who would access a SIF are those people who are homeless. So while their drug use may be moved indoors - they are not. Homeless people will still be homeless and you will still have to reconcile how we live in a country that is so inequitable (oh, you don't think that when you see homeless people? Cold hearted person you are.).

So while I am not here telling you how you will personally benefit from supervised injecting facilities, here's the facts:
  • They won't harm you either
  • They won't encourage drug use
  • They save other people lives
  • They prevent police telling a mother that her child's dead body was found in a public toilet
  • They prevent the spread of disease through provision of clean equipment and advice on safer using
  • Ambulances are limited. Less ambulances attending street overdoses means more ambulances able to respond to you.
If they don't affect you, but they might help someone else, then why not support them?

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