Heroin - part I

Back in early May, Bob Carr wrote two pieces on his blog Thoughtlines about the safe injecting centre that was set up in Kings Cross during his tenure. You can read them here and here. I do enjoy Bob's blog, but he has a bad habit of leaving some of my comments in moderation forever - such as this one that I penned on the 12th of May.

But let's not get wrapped up in Bob's policy on comments. Maybe he's got better things to do these days than moderate comments from people like moi.

In his posts, Bob made a number of statements about the effectiveness of the injecting rooms. I thought I'd do a bit of reading and see how they stack up (yes, that's partly why I've been very quiet of late). Amongst other things, Bob wrote:

At the end of the 1999 drug summit convened by the government in parliament house two ministers, Craig Knowles and John Della Bosca, stood in my office with a proposal for a medically supervised injecting room and persuaded me. The ultimate argument ? It might just save lives – the lives of people who are using heroin until a time ( often their late 30s ) when they get sick of it and decide to make a break with that life. We need to sustaint them till they reach that point. 

The facility, as my government designed it, would be a gateway to treatment. It would mean paramedics would not be called to dark carparks or back alleys to rescue a victim of an overdose at the risk of needlestick injury to themselves. By taking injecting indoors it would mean the streets of Kings Cross would be improved.

and:

There have been approximately 600,000 visits over 10 years. There are about 200 injections a day – that is, with medical supervision on hand, whereas without the centre…? 

To reinforce this point, the number of drug overdoses successfully managed stands at more then 3,500. 

Now this is also important : there have been more than 8,500 referrals for addiction treatment, mental health, homelessness or acute medical problems. We always envisaged this as a portal to treatment. 

There are 90 supervised injecting centers in the world but not all of them provide such a gateway to treatment. 

By the way, there is no evidence of a “honey pot” effect, drawing addicts to Kings Cross.
All those injections – 200 a day – would have taken place in public places or, at least, without access to medical intervention. Kings Cross had the highest concentration of drug overdose deaths in the country. 

Good policy or not?

It was the last line that got me - "Good policy or not?" I'm going to make a big assumption here - Bob's blog is generally followed by fellow travellers, so most are likely to agree with the idea that it was good policy. Since Bob pushed that policy, he would also think it was a fabulous idea. Trouble is, there are pernickety people like me out there that like to test these assertions using things like evidence and logic instead of feelings.

As I write this, I haven't made up my mind as to whether it was good policy or not - that will come out as I examine each bit of evidence that I've trawled up over the last few weeks. I'll take you through what I've found, and you can make your own mind up.


I've read through quite a lot of stuff over the last few weeks, and here's a short list of the most relevant ones:

Heroin Related Overdoses Position Paper - this is where the recommendation for the supervised injecting room came from

The NSW Drug Summit: Issues and Answers - a good summary from the NSW Parliamentary Library

High Risk Groups and Behaviours - this explains everything you ever wanted to know about heroin overdoses in NSW


Psycho-stimulant use, health and criminal  activity among injecting heroin users - how often do heroin users shoot up, and how much do they spend on drugs?

Estimating the number of current regular heroin users in NSW and Australia 1997-2002 - also includes data on death rates from overdoses

The impact of heroin dependence on long-term robbery trends - in case you were wondering how junkies fund their habit

Heroin Overdose: Prevalence, Correlates, Consequences and Interventions (2000) - another paper that recommended the establishment of the supervised injecting rooms

Cost of heroin - pretty self evident what this is about

Drug Law Enforcement Policy and its Impact on the Heroin Market - also shows the impact of heroin use on property crime

So there's a bit of light reading if you're interested in this topic. Most of the research is from the late 1990s or early 2000s - I couldn't find anything really up to date. Either no one is funding such research, or it's a work in progress. However, I doubt the behaviour of heroin users has changed much since 1999, so let's not get our knickers in a knot about the research not being hot off the press. Note that I was looking for research that was specific to NSW - there is tonnes of stuff out there about the experience of other countries, but I wanted to stay focused on NSW.

Murder, assault and imprisonment in the NT

A slightly more depressing topic for today. I read in the paper last week that the rate at which Aboriginals are imprisoned in the NT is something like 8 times that of the rest of the population. I thought I'd do a bit more digging. As Professor Sumner Miller used to say, "Why is it so?"

To start with - the Bureau of Statistics and an article on Indigenous People's experience of crime and justice in the NT.

Indigenous people comprise about 30% of the NT's population. In 2008 Indigenous people had higher victimisation rates than non-Indigenous people for all selected personal offences excluding robbery in the NT.

There were 5,261 victims of assault in the NT; of these, 59% (3,110 victims) were Indigenous and 34% (1,795 victims) were non-Indigenous. The assault victimisation rate for Indigenous persons was more than four times higher than the rate for non-Indigenous persons at 4,942 Indigenous victims per 100,000 Indigenous persons compared with 1,143 non-Indigenous victims per 100,000 non-Indigenous persons.

Of the 372 victims of sexual assault, 50% (186 victims) were Indigenous and 38% (143 victims) were non-Indigenous. Indigenous people in the NT had a sexual assault victimisation rate that was more than three times higher than the rate for non-Indigenous people at 296 Indigenous victims per 100,000 Indigenous persons compared with 91 non-Indigenous victims per 100,000 non-Indigenous persons.

Indigenous people comprised 65% (17 victims) of the 26 victims of homicide and related offences in the NT, while 23% (6 victims) were non-Indigenous. The homicide and related offences victimisation rate for Indigenous persons was 27 Indigenous victims per 100,000 Indigenous persons, which was about seven times higher than the rate for non-Indigenous persons at four victims per 100,000 non-Indigenous persons.

In contrast, 7% (8 victims) of the 111 robbery victims in the NT were Indigenous while 81% (90 victims) were non-Indigenous. The robbery victimisation rate for Indigenous persons was about one-quarter of the rate recorded by non-Indigenous people at 13 Indigenous victims per 100,000 Indigenous persons compared with 57 non-Indigenous victims per 100,000 non-Indigenous persons.

In short, if you are indigenous and live in the NT, you are much more likely to be killed, beaten or raped than any other group. And I mean much more likely.

Doesn't sound good.

So, to the next question - who is doing all the bashing, killing and raping?

The report also has some info on the prison population:

The NT's prison population increased by 11% (from 953 to 1,056) from 30 June 2008 to 30 June 2009, compared with a 6% increase nationally. At 30 June 2009 about four in five prisoners in the NT were Indigenous (82%), the highest proportion of Indigenous prisoners of any state or territory.

At 30 June 2009 the NT continued to have the highest crude imprisonment rate in Australia at 658 prisoners per 100,000 adult population, almost four times higher than Australia's overall rate of 175 prisoners per 100,000 adult population.

The age standardised imprisonment rate for the NT's Indigenous population at 30 June 2009 was 1,700 Indigenous prisoners per 100,000 adult Indigenous people. The equivalent rate for the NT's non-Indigenous population was 153 non-Indigenous prisoners per 100,000 adult non-Indigenous population. This represented an age standardised rate of imprisonment for the NT's Indigenous population that was 11 times higher than the rate for its non-Indigenous population.

I found a much more detailed report on the NT's Justice site - the Correctional Services Annual Statistics. It makes for rather depressing reading. The table on page 24 is worth trawling through - the stats are quite shocking. It shows the sentence for each type of crime, and breaks it down into indigenous and all.

Here are the stats on prisoners in 2008-2009:

Murder

4 indigenous, 0 other

Manslaughter

10 indigenous, 2 other

Acts intended to cause injury

Indigenous 935, other 64

Sexual assault

Indigenous 21, other 14

Unlawful entry with intent (break and enter)

Indigenous 117, other 13

About the only major stat where the numbers are reversed is for drug crime:

Illicit drug offences

Indigenous 17, other 34

Interestingly, most of the assault cases carried a sentence of 6 months or less:

0-1 months - 92

1-3 months - 278

3-6 months - 321

6-12 months - 132

1-5 years - 112

If you want to read about some of these cases, you can find all the Supreme Court sentencing decisions here, as well as the sentencing remarks. It's worth having a quick read through those some to get a flavour for the sort of crimes being committed.

eg, The Queen vs Luke Corbett or the Queen vs Roland Djmiti Barrawanga. Here's some detail from the last case:

HIS HONOUR: Roland Djimiti Barrawanga, the offender, has pleaded guilty to causing serious harm to Ruby Blake contrary to s 181 of the Criminal Code. The maximum penalty for this offence is imprisonment for 14 years.

The offender is an Aboriginal man who was born on Elcho Island on

1 January 1973. He is 38 years of age. He grew up at Galiwinku on Elcho Island where he attended school for a period of time. He did not attend high school and he cannot read or write. He can speak a little bit of English.

The offender has not been able to obtain a lot of meaningful employment over the years. He has done some work under the Community Development Employment Program at Galiwinku and Nhulunbuy. He also did some work with his wife as a tour guide on the Cox Peninsula. The offender has not done very much work at all since 1994.

The offender is a good musician. He is a very good didgeridoo player. He makes his own didgeridoos.

The offender is married. His wife is the victim of his crime.

The offender has a criminal record. His criminal record extends for three pages. Of relevance, he has only been convicted of one previous crime of violence. In 2007 he assaulted the same victim by striking her twice with his hand to her face and head. The offender committed no offences between 10 September 1999 and 31 December 2007 and he committed no offences between 31 December 2007 and 4 August 2010 when he committed the crime for which he is to be sentenced today.

The facts of the offending are as follows:

The offender and Ruby Blake were in a domestic relationship from 2000 until the time the offender was incarcerated.

On Wednesday 4 August 2010, the offender was with the victim and her mother drinking alcohol at a bush camp in Karama. The offender consumed an unknown quantity of moselle and both he and the victim got drunk. Some time later the victim accidentally fell on the offender's tent. This caused the offender to pick up a didgeridoo and hit the victim while she was on the ground.

The offender hit the victim once on each arm with force. The offender then kicked the victim once in the stomach.

After the assault, the victim went to the Karama shops to get help. Police were called and attended a short time later.

The victim was taken to Royal Darwin Hospital by ambulance for treatment. She suffered bad fractures to her left arm and her right arm and she had to undergo surgery in hospital on 7 August 2010. After the operation there were problems with the injury to her left arm because the injury became infected and she had to go back to theatre on 14 August 2010 for further treatment.

If no medical treatment was received, the victim would have suffered longstanding and significant functional problems with her left upper arm.

Why am I bothering with this?

Because the Intervention in the NT copped a lot of flak when it was started. If the critics had bothered to look at the prison stats, or the victims of crime stats, or had read a few sentencing reports, they might have gained an understanding as to why the government of the day was reduced to undertaking such desperate measures. Webdiary for instance gave it the usual sneering approach.

The sad fact is that NT prisons are full of Aboriginal males who have raped, beaten or murdered mainly Aboriginal women. I am not fond of people saying, "Something must be done", and then doing nothing. Something has been done - whether it works is another matter.