Victoria’s first medically supervised injecting room has been dogged by controversy from the outset. And the facility has been thrust back into the headlines in the countdown to the state election, with Liberal leader Matthew Guy declaring he would shut it down within a week if he becomes premier.
But a year after Premier Daniel Andrews conceded a change in policy late last year and threw his support behind a trial facility, and six months after it opened its doors, the North Richmond Community Health Centre is quietly getting on with the business of reducing harm and saving lives.
Most days it deals with one, sometimes several, potential overdoses. Meanwhile it has also been offering clients access to a range of medical services which they otherwise may not receive.
One important initiative is to screen for and treat hepatitis-C, a program introduced in August in response to an overwhelming expression of interest from the room’s users.
The centre’s medical director, Dr Nico Clark, told The Citizen that since opening, over a third of the users have registered for testing and treatment of the blood borne virus, and he hopes that this number will continue to grow.
‘If we can make (the process) seamless enough then the others will come on board and we will be able to treat everybody who comes through here,’ he said.
In line with Australia’s ongoing commitment to reaching World Health Organisation targets and eliminating hepatitis-C by 2030, almost half of the national annual treatment quota of 10,000 cases must go towards people who inject drugs. And given figures from the North Richmond Centre of 500 treatments monthly, it appears to be making a significant contribution to the overall eradication.
Dr Clark said that the centre’s location plays a crucial role in helping patients. Unlike Australia’s only other supervised injecting facility in Kings Cross, the North Richmond room is directly attached to an existing community health centre and is therefore able to offer other health and social services on-site.
‘The existing health system has not effectively catered for the chaotic lifestyles of day-to-day drug users, who have difficulty keeping appointments and getting to different medical facilities,’ he said.
As well as hepatitis-C treatment, services available at the centre include dental care, hepatitis-A and B vaccinations, blood borne virus testing, wound care, general practice and access to drug treatment, and mental health care services.
‘Our clients are able to access a range of vital health and social services in one location, in a space they have become familiar with and from staff they have seen before, making them more likely to seek out treatment.’
From the moment users set foot in the centre they are greeted, often on a first-name-basis, by experienced drug and alcohol care workers. After registering at the front desk, users move into the injecting space.
They are provided with sterile syringes and cleaning equipment by medical staff before sitting down in one of the 11 open-backed cubicles. Once they have injected, users move into a relaxation room where they can help themselves to tea and coffee and are free to sit for as long as they like.
It is in this supervised aftercare space that information regarding wider health needs is made available and where conversations are had with medical staff regarding referrals or ongoing treatments.
While employees of the centre are wary of being heavy handed in advocating for wider health management, incidents of patient retaliation are almost none. One nurse described the centre’s clients as “chatty” and “generally keen on getting healthy”.
The future of the facility will depend on the result when Victorians go to vote tomorrow. As it stands, it is operating on a two-year trial basis, with the passing of new legislation required to ensure its future.
But earlier this week Matthew Guy vowed to “close down the ice and heroin injecting room” if his party is elected. According to representatives from Richmond’s injecting facility, the drug “ice” accounts for 1% of the drugs used in the room.
Executive Officer of the Yarra Drug and Health Forum, Greg Denham, said he hoped whoever won government would make a determination on the future of the injecting room after reviewing the evidence collected throughout the trial.
Beyond the current figures on the work within the facility – 320 overdose treatments, 61 life-saving naloxone administrations and reported reductions in ambulance callouts and syringe clean-ups – Mr Denham said that the centre was improving the length and quality of life for many of its clients.
Like Mr Denham, Jill Tomlinson, a prominent doctor and Richmond resident, advocates for the centre’s necessity and hopes that the saving of lives is at the forefront of policy making.
In September she tweeted that “since the injecting room trial started (she) hasn’t needed to resuscitate drug users on Victoria Street”.
So, while the future of the injecting room remains unclear, evidence so far indicates that the positive impact it is having on its patients’ lives is not.