Implementation of Safe Injecting Rooms within Australian Cities - Essay Example

The health care arguments for and against the implementation of Safe Injecting Rooms within Australian Cities Introduction Worldwide, there are diverse philosophical approaches to illicit drug policy. Overall, there are three dominant discourses centering on illicit drug use; prohibition, legalization, and harm minimization. The implementation of safe injection rooms within Australian cities is one of the drug policies directed at reducing harm flowing from illicit drug use. The principle of harm reduction shaped the foundation of drug policy framework in Australia since 1985. Harm minimization, in this context, infers the policies and programs designed to avert and minimize drug-related harm. Though an intensely contested term, harm minimization recognizes that while illicit drug use can never be fully eradicated, measures can be implemented to minimize its negative consequences. The core aim of this approach is to enhance the health and socio-economic results for both the society and the individual via a balanced application of three main strategies; supply reduction, harm reduction, and demand reduction. In Australia, the implementation of harm minimization strategies is an intricate, yet controversial issue. While there is an extensive agreement on the necessity to adopt an integrated approach to the drug menace in Australia, there are opposing views concerning the effectiveness of the drug policies. As a consequence, protagonists back fresh “innovative” drug strategies (considered radical by antagonists) such as supervised injecting facilities (Green2002, p.28). The divergence of view has led to the polarization of the debate centering on such issues. The supervised injecting facilities debate reached fever pitch between 1999 and 2001 when Australia Capital Territory, Victoria, and New South Wales attempted to launch such facilities. The debate was characterized by an enhanced level of conflict between groups with divergent moral and political beliefs regarding drug use. The use of illicit drugs within Australian society has become prevalent over the years. A National Drug Household Survey (1998) revealed that about 46.4% of the Australians (aged 14 years and above) have used a prohibited drug once in their life, with an approximate 22.8% reporting to have used a banned drug within the prior 12 months. The debate on Safe Injecting Rooms Safe injecting rooms (also referred to as safe injecting facilities) represent legally endorsed, indoor facilities, where injecting drug use transpires under the direction of medically trained personnel, and in safe and hygienic state with access to a wide range of sterilized injecting equipment (Green2002, p.29). The fashioning of Self Injecting Facilities aims at attaining a set of goals, which include reaching the target population, persuading service uptake, enhancing health and minimizing risk behaviors, reducing the prevalence of infectious disease, minimizing public nuisance and disorder, reducing drug overdoses and related fatalities, and curtailing an increase in neighborhood crime. Government sanctioned safe injecting facilities have operated in several cities around the world in countries such as Netherlands, Switzerland, and Germany. The facilities are characteristically housed within integrated centers, which also encompass cafes, counseling facilities, primary medical care services that avail opportunities for referral to proper services such as drug treatment, advocacy, and material aid services, among others. Safe injecting facilities represent   a practical harm reduction approach for vastly concentrated open drug scenes, typified by deteriorating health conditions for drug users who visited them, and the escalating public nuisances correlating with highly visible street based drug acquisition and use (MSIC Evaluation Committee 2003, p.35). Arguments for the implementation of Self Injecting Facilities The ballooning visibility of street-based heroin markets and the associated health and other harms can be perceived to be the driving force of Australian interest in supervised, safe injecting rooms as a probable beneficial harm reduction approach. The envisaged benefits of the implementation of safe injecting facilities hinges on their potential to aid in reducing harms associated with injecting drug use, such as the prevalence of fatal and non fatal illicit drug overdose, blood-borne virus transmission (especially hepatitis C and B, and HIV), and reduced incidence and impact of street-based injecting (Wood et al. 2005, p.126). Similarly, safe injecting facilities significantly reduce the risk of acquiring diseases such as skin abscesses, which may result from the utilization of unsterilized injection equipments. Moreover, the implementation of safe injecting room was expected to derive benefits such as enhanced access to health and welfare services for drug users, besides saving public resources. The implementation of safe injecting facilities may also derive fiscal benefits emanating from lower ambulance and hospital utilization. The facilities provide onsite treatment for a large number of overdoses and contribute in the reduction of wound infections or vein damage (Wood et al. 2002, p.422). Much of the harm linked with injection drug use flow from the absence or scarcity of sterile injection equipment and the user’s apprehension of the criminal justice system. The anxiety about social rejection and arrest dissuade most people from subscribing to health and preventative services, forcing them into clandestine locations poorly suited for hygienic injection. The lack of proper syringe disposal facilities and accompanying legal disincentives to safe disposal enhance the likelihood that the used syringes will be improperly discarded. This creates public anxiety, besides enhancing the risk of accidental disease transmission (Green 2002, p.30). Safe injecting facilities are essential in addressing unsafe drug consumption environments. The mechanisms outlining how safe injection facilities avert infections and illicit drug overdose cases among clients are clear-cut. The facilities avail safety to injectors living with the threat of overdose. Studies on the issue have reported constructive results for clients and positive or neutral results for the localities (neighborhood). A considerable proportion of fatal and nonfatal illicit drug overdose episodes took place within private settings such as homes. Thus, safe injecting facilities should be perceived as but one section of an integrated and multifaceted set of initiatives and strategies directed at reducing the harms linked with illicit drug overdose (Gardner and Barraclough 2010, p.7). The establishment of such facilities pursues minimization of health and public order problems (reduce externalities of public drug use within communities) associated with illicit drug use. One of the outstanding social problems that self injecting facilities are likely to reduce encompass disturbance (nuisance) associated with injecting in public. The facilities can aid to reduce the amount of injection related litter such as discarded syringes within the vicinity, which declines exposure to accidental disease transmission (Wood et al. 2005, p.127). Similarly, the implementation of such facilities contributes to enhanced access to services for individuals who inject illicit drugs. Safe injection facilities are effective gateways for addiction treatment, counseling, and other services. There is strong evidence in Australia and internationally that harm minimization policies such as supervised injecting facilities and needle and syringe programs significantly minimize the social, economic, and health costs emanating from illicit drug use. The Australian government has over the years engaged in publicly funded programs that avail syringes and needles to injecting drug users, with a concise understanding that they will be utilized in administering illicit drugs. In such circumstances, it would be detrimental and short sighted to shy away from providing safe and hygienic premises in which illicit drug users can safely inject themselves (Gardner and Barraclough 2010, p.6). The health and public safety gains that can be derived from the program clearly outweigh the policy consideration advanced against condoning an otherwise illegitimate behavior. Health Care Arguments against the Implementation of Self Injecting Facilities Opponents to the implementation of safe injecting rooms argue that the facilities may “send the wrong message,” disregard drug abuse within the society, congregate drug users and drug peddlers within the locality such as cities, and delay the incorporation of drug users into drug treatment programs (Roman, Ahn-Redding and Simon2007, p.215). Furthermore, such facilities may in essence increase occurrences of crime or drug dealing within the vicinity. In fact, such facilities create a “honey-pot” effect for drug users within the vicinity of the facility. The operation of self injecting facilities can be perceived to be a step that admits drug use and drug trafficking. Self injecting facilities offer illicit drug users a “license” to indulge in the consumption of prohibited substances. Thus, such facilities are likely to enhance drug taking and drug trafficking, which threatens the overall health and social wellbeing of the society. Opponents to implementation of safe injection facilities point out that such facility would encourage new drug use, thus making the measure counterproductive (Roman, Ahn-Redding and Simon2007, p.216). In addition, they assert that the implementation of harm reduction strategies such as safe injecting facilities will unlikely discourage cessation. The ambivalence towards harm minimization programs such as implementation of self injecting rooms is informed by the belief that they condone illicit drug use. In exchange, the antagonists to the policy call for law enforcement measures (supply reduction measures) such as interdiction of illicit drugs flow into Australia. Conclusion In theory, safe injecting facilities can aid in saving public funds by preventing or reducing deaths associated with illicit drug overdoses and drug related crime. However, the analysis of such costs and benefits flowing from the implementation of harm minimization strategies is limited. Researchers assert that it is complex to assess the exact effect of the implementation of safe injecting facilities. The findings emerge as positive with reduction in the levels of public nuisance in certain areas and an enhancement in the health and social functioning of the clients (drug users). Similarly, the implementation of safe injecting rooms has led to a reduction in the prevalence of overdose deaths and complications emanating from non-overdose deaths, as well as risk behavior linked with the transmission of blood borne viruses. References List Gardner, H. & Barraclough, S. (2010). Health policy in Australia, Oxford, Oxford University Press. pp.4-8. Green, C. (2002). Minimizing the harm of illicit drug use: Drug policies in Australia, Brisbane, Queensland Parliamentary Library. pp.28-30. MSIC Evaluation Committee. (2003). Final report on the evaluation of the Sydney Medically Supervised Injecting Centre, Sydney, MSIC Evaluation Committee. pp.33-38. Roman, C., Ahn-Redding, H. & Simon, R. (2007). Illicit drug policies, trafficking, and use the world over, Plymouth, Lexington Books. pp.215-216. Wood, E., Tyndall, M., Kerr, T., Spittal, P., O’Shaughnessy, M. & Schechter, M. (2002). Safer injection facilities for injection drug users: The debate continues, Canadian Medical Association Journal 166 (4). pp.422. Wood, E., Tyndall, M., Li, K., Lloyd-Smith, E., Small, W., Montaner, J. & Kerr, T. (2005). Do supervised injecting facilities attract higher-risk injection drug users? American Journal of Preventive Medicine 29 (2). pp.126-130. Read More