Devine ain’t that divine when it comes to harm reduction
My friend and colleague emailed me a link to this article by Miranda Devine earlier this week with the friendly caution: ‘open at own risk, outrage may ensue’. Taking my friend at their word and mindful of my workload, I have waited until now before reading this woefully ill informed attempt at journalistic ‘opinion’. Lacking any kind of real analysis or basis in evidence, Miranda Devine has attempted to leverage the tragic murder of 19 year old Thomas Kelly in the Kings Cross area as a springboard to attack the presence of three drug treatment/ harm reduction centres in the Kings Cross area.
So what’s wrong with the article?
Let’s start with the accompanying illustration by John Tiedmann. Captioned ‘Drugs are bait for the dregs of society’, showing a syringe on a fishing hook, the illustration appears to have little in common with Devine’s rant (sorry I mean article). The caption and accompanying image provide a very blunt position on drug users: that they are the dregs of society, somehow less than the right thinking, non users of illicit drugs. Sorry for interrupting a handy stereotype, but if you had a good look around you, you will undoubtedly find that people who use drugs come from all walks of life.
According to the most recent National Drug Strategy Household Survey :
“In 2010, around 7.3 million people in Australia reported having ever used an illicit drug and almost 3 million had used an illicit drug in the 12 months before the survey.”
(Australian Institute of Health and Welfare 2011)
If we are to adhere to the stereotype conveyed by the article’s accompanying image, then approximately 1/3 of our population were somewhat ‘dreggish’ in their time, while 1 in 7 of the population remain below society’s contempt. If this is in fact the view of Miranda Devine and the editors of the Daily Telegraph, then they have a rather sad and pessimistic view of the world. I am sure that if I went looking for the diversity of people who currently use or who have used drugs in our society I would find poets and tradesman, mothers and uncles and probably policeman and journalists too. The truth is that illicit drug use isn’t confined to a socio economic class or a personality type. It’s prevalence can be found across our society and characterising people who do use illicit drugs as the ‘dregs of our society’ is ill informed, irresponsible and just plain hateful. The perpetuation of such stigmatising concepts can only cause harm to our communities, not better them.
The article is slanted
Moving on to the body of the article, Devine provides us with a far from balanced opinion piece. Using the accounts of two local residents, she makes a less than credible connection between the existence of the three alcohol and other drug health services in the Kings Cross area with the unfortunate death of Thomas Kelly. Devine has wilfully ignored the fact that police have not commented on either the motive or what drugs Kelly’s alleged attacker may (or may not) have consumed prior to the assault. Additionally the link she draws between the existence of the alcohol and other drugs services in the area and the murder are irresponsibly tenuous:
“I can’t provide any evidence but it’s possible the (Kelly) murder was linked to it somehow,” says Andrew Woodhouse, president of the Potts Point and Kings Cross Heritage Conservation Society and a resident for 22 years.”
At no time is the perspective of any of the treatment centre’s presented. It is important to note that while Devine has presented the views expressed by two local residents, an independent audit of the Medically Supervised Injecting Centre in Kings Cross found that 78% of local residents surveyed and 70% of local businesses supported the establishment of the MSIC (KPMG 2010).
Additionally despite the prevalence of venues that serve that legal drug, alcohol, Devine only makes passing reference towards the end of her article how the concentration of licensed venues is contributing to the demise in public amenity, instead choosing to focus her attacks upon the alcohol and other drug services and illicit drug users. There is in short a distinct lack of balance in her journalistic endeavours and a fair bit of myth perpetuation for good measure.
The ‘Honey pot’ effect
The chief vehicle Devine uses to place the demise of public amenity and the supposed increase in violence in the Kings Cross area on the shoulders of alcohol and other drug services is the concept that has often been referred to as the ‘Honey pot effect’.
“Residents are fed up with having drug addicts approaching them violently on the street. The Cross has gone from bad to worse. The concept of treating injecting users is something the community believes in, but we’re carrying the load for all of NSW.”
The Honey pot concept is an oft used reason used to oppose the location of an alcohol and other drugs treatment service. The rationale is that by placing a drug treatment service in a particular location that it will somehow draw people from other locations to endeavour in the obtaining and use of drugs in the area. The reasoning is flawed and nowhere more than in the Cross. You see Kings Cross has a long history of being a drug hotspot that dates back to the early days of cocaine prohibition in the 1920’s. More recently Kings Cross has retained it’s reputation as being the epicentre of both the illicit drug trade and sex work in New South Wales. People congregate in Kings Cross to obtain drugs and have done so well before the existence of the alcohol and other drug services in the area.
Improvement to public amenity
The placement of such services is an action designed to proactively reach these populations, to provide crucial services that not only improves the health and lives of the people who access these centres but also improves public amenity. The improvement of public amenity since the development of health services to meet the needs of injecting drug users in the area is well evidenced. Prior to the commencement of operations of the Medically Supervised Injecting Centre in Kings Cross, the area maintained a record of having the highest prevalence of overdose deaths in Australia (MSIC 2012). While it is difficult to infer precisely the impact of the of the Medically Supervised Injecting Centre on the number of public overdoses due to fluctuations in drug markets and other factors, it is safe to assume that due to the provision of a supervised area for injecting many public overdoses and subsequent requirement for ambulance callouts has been reduced.
Overall public injecting in the Cross appears to have decreased:
“The proportion of the local community who have seen someone injecting in the previous month has declined substantially over time with the proportion of local residents who report having seen public injecting in the previous month halving since MSIC opened (from 55% in 2000 to 27% in 2010).”
Additionally the Kirketon Road Centre provides an assertive needle syringe disposal program collecting injecting equipment inappropriately disposed in the area. Data has demonstrated that the amount of inappropriately discarded injecting equipment found in public spaces in the area has decreased since the commencement of operations of the MSIC. (KPMG 2010). This of course reduces risk to the local community and improves public amenity.
Devine decries the opening of a third alcohol and other drugs health service in the form of a needle syringe program which remains open longer on Saturdays than either the Kirketon Road Clinic or the MSIC. What Devine fails to comprehend (or wilfully ignores) is that the availability of sterile injecting equipment dramatically increases public health by decreasing the risk of transmission of blood borne viruses:
“A study conducted between 1978 and 1999 compared HIV prevalence in 103 cities around the world. In the cities that had introduced Needle and Syringe Programs, the HIV prevalence had decreased by an average of 19 per cent annually. In the cities that had not introduced Needle and Syringe Programs, the HIV prevalence had increased by an average of 8 per cent annually.”
Furthermore the operation of such a service provides another viable option for people who use drugs to access assistance and discard of injecting equipment in an appropriate manner: again decreasing the risks to both themselves and the broader community.
Devine’s opinion piece at best is an ill informed attempt at commentary on the health and public amenity issues experienced in the King’s Cross area. When accompanied by the highly stigmatising image and caption however, one must assume that Devine is seeking to raise unfounded controversy by targeting the services that assist a group of people who are already stigmatised in our society, with the only possible benefit accruing to Miranda Devine herself, as she so blatanly seeks public attention.
Devine has stated via Twitter that she was trying to tell the full story by focussing on the seemingly neglectfully reported existence of these services near the site of the tragic death of Thomas Kelly. The only neglect I can see however is a lack of any real evidence to substantiate her opinion.
Anex website, Needle Syringe Programs (NSP) http://www.anex.org.au/harm-reduction/needle-and-syringe-programs-nsps/ (accessed 20th July 2012)
Australian Institute of Health and Welfare 2011. ‘2010 National Drug Strategy Household Survey report’. Drug statistics series no. 25. Cat. no. PHE 145. Canberra: AIHW.
Devine, M. Sunday Daily Telegraph. ‘Drug triangle creates vortex of fear in Cross’ http://www.dailytelegraph.com.au/news/opinion/drug-triangle-creates-vortex-of-fear-in-cross/story-e6frezz0-1226428493040 published 18th July 2012 (accessed 20th July 2012)
KPMG (2010) ‘Further evaluation of the Medically Supervised Injecting Centre during its extended Trial period: Final Report’. KPMG
Sydney Medically Supervised Injecting Centre (MSIC) website. ‘Background and Evaluation’. http://www.sydneymsic.com/background-and-evaluation#Rationale accessed 20th July 2012