Heroin - part III

We don't hear much about heroin overdoses and deaths these days - they rarely seem to interest the media anymore unless they relate to a celebrity. However, back in 1999, it was a different story. Heroin use had exploded, as had the number of overdoses and deaths.

The Australian National Council on Drugs reported that:

The number of deaths associated with heroin overdose has increased markedly in the past 25 years. National Drug and Alcohol Research Centre publications record that the number of deaths in the 15-44 year old age group has increased from 6 people in 1964 to 737 people in 1998. Recent reports further suggest that this figure has again increased in 1999. The 1998 figure equates with almost 9% of all deaths in this age group being attributed to heroin related overdose.

Some studies estimate that up to 60% of all heroin users have experienced at least one overdose. Each heroin related overdose potentially represents another fatality

That's quite an increase - from 6 deaths in 1964 to 737 in 1998. It's worth noting that:

The highest rate of fatal overdose occurs in New South Wales. In 1998, overdose fatalities in NSW accounted for 48.6% of all fatal overdoses nationally.

That's why we ended up with a Drug Summit - heroin was killing a lot of people back then. One of the outcomes of the Summit was a safe injecting room in Kings Cross. The question is - did the safe injecting room make a difference? Did it materially reduce the number of deaths from heroin overdoses once it opened?

Heroin - part II

Why did we a supervised injecting room in Kings Cross? The answers can be found in the 60-odd pages of the 1999 paper The NSW Drug Summit: Issues and Outcomes. It's actually worth reading - it's well put together and it has input from a wide range of characters.

I had a good laugh reading the first few pages, as they catalogued a series of knee jerk reactions from the government of the day to adverse media reports. I'm old enough to remember the following photo:

On 31 January 1999, a photograph of a teenage boy engaged in injecting drug use in a lane-way in Redfern, appeared on the front page of a Sydney newspaper.  This acted as the catalyst leading to the establishment of the Summit.   In the articles which accompanied this photograph the age of the boy was given as 12 or 13 (he was subsequently identified and his age confirmed as being 16 ), and it was asserted that the injecting equipment was obtained from a near-by needle exchange (a NSW Department of Health report into the incident later revealed that the boy did not obtain any injecting drug equipment from the near-by needle exchange outlet ).  

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The then Minister for Health, Hon A Refshauge MP, reacted by immediately closing down the needle exchange outlet, and ordering a review of the $9 million statewide needle exchange program

Not long after that:

On 25 February a youth welfare group, Open Family, announced its intention to open rooms in its Cabramatta and Footscray offices for young heroin users to inject drugs.  Open Family’s plan was partially supported by Footscray’s local council, but met widespread condemnation from other drug welfare groups and the  local community.   In Sydney the Carr government condemned the plan as ‘irresponsible, dangerous and illegal’. 

We then had an election on 27 March 1999, with Labor (led by Bob Carr) romping home against a rather useless Coalition.

Bob then convened the Drug Summit between 17 May and 21 May 1999. It's interesting to look back at the actions of the government just prior to the election, and what it actually did after that election.

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.

I haven't gone out of business

I decided to do a bit of research into heroin a few weeks back, and the effort kind of put me off writing for a while. I'm still around - but my muse isn't. Service will resume shortly I'm sure.

This tickles my fancy

Jesus tells Archbishop to shut it

Squaregating Air Farce muppets

If there's one thing the Air Farce (and its cadets) can't do it's march in time without square gating. A whole bloody parade of them going up George St in the middle of the day - half out of step, the other half square gating. The bloke in front was the only one to swing his arm up properly - the rest waggled them lazily back and forth a few inches.

Christ on a bike, any one of the NCOs that I served with would have been roaring up and down this line of sad sacks turning the air blue with "suggestions". Ah, hang on. The most common suggestion made to a digger that couldn't march properly was "to join the fucking air force".

New definition of "racist"

Bought a coffee this morning in a cafe. On the counter was a brochure for a coffee loyalty scheme iPhone app. You load the app, buy a coffee and then scan a barcode that's stuck on the counter - when you get to x number of coffees, the next one is free.

I asked the barista if many people were using it. The answer was "yes".

His next statement was a ripper though; "It's pretty racist though - it only works on iPhones".

We now have different races of smart phones?

Trees killed for no good reason

The kids have been watching the 1999 series of Walking With Dinosaurs. It was cutting edge computer graphics back then - it looks a bit clunky now, but it's still very good. I like Kenneth Branagh as a narrator.

I was so taken with this scene of a huge dinosaur pushing over trees, I just had to post it. Listen to what Kenneth has to say - they're not pushing over the trees in order to make furniture or floor boards or cardboard or paper. They're not even pushing them over to eat them. They're pushing them over to get at the ferns underneath.

Where's Greenpeace when you need them? Why aren't there bearded ferals running around the forest, chaining themselves to trees in order to stop this senseless slaughter of the forests? Is it ok for nature to thin the trees (as elephants still do today), but not ok for man to harvest them and put them to good use?

The next scene is all about a massive dinosaur fart - I've left that bit on the cutting room floor.

US Imperialism created Osama

So says this poster on George St. It's our old friends from the Socialist Alliance.

They sure were quick off the mark.

GetUp housing strike - what a stupid idea that was

Left wing media junky group GetUp (a clone of the US MoveOn group) had a stunt fall flat this week - a house buying strike.

(What is it with groups like GetUp, who generally hate the US, but copy every left wing idea that the US ever produces?)

Of course a house buying strike was going to fall flat, especially with GetUp members. Most GetUp members are baby boomer Canberra bureaucrats - in other words, just the sort of people who will own not only their own home, but possibly an investment property or two as well. They're the group that has benefited most from the housing price bubble in Australia. Self interest dictates that they're not going to poop in their own nest - they want house prices to continue to increase, thus increasing their retirement nest eggs.

Normally, I can't stand Leunig

But I just couldn't help touching up this rather notorious cartoon of his. Ironically, I lifted it from Antony Loonstein.

Maybe I will refrain from punching out idiot drivers

Cyclist admits manslaughter of grocer

A cyclist who killed a greengrocer in a road-rage attack has been told to prepare himself for jail.

Paul Lambeth, 35, pleaded guilty yesterday to the manslaughter of Tony Magdi, who died after a single punch to the head in Portland Road, Hove in November last year.

Mr Magdi was attacked as he opened his car door into the path of three cyclists, causing them to swerve out of the way.

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Bugger me, it's tempting at times, but I'll just stick to waving my fist and swearing a lot.

Hold this thought

There are those that decry the execution of Bin Laden. They say that killing people never solved anything, and never got us anywhere.

If that's the case, why do terrorists kill people?

Terrorists want something - money, power, glory, fame, whatever. They believe that they will get what they want if they kill people. They believe killing people is an effective way to get things done, to solve problems, to get you closer to where you want to be.

So if terrorists believe that killing people is an effective solution to their problems, why is killing terrorists not an effective solution to our problems?

Welcome to the underclass

Great photos and video of how the underclass treats taxpayer supplied property. Great, as in everyone should have a good look at how some people live. It's disgusting and frightening.

Don't look it you are scared of cockroaches.

That obviously didn't go down very well

Hmm, no takers so far on my suggestion for a mardi gras float in next years parade.

I guess I'll have to tone it down a bit. Maybe the shotguns were a bit over the top, but they would have been useful for repelling boarders - particularly bearded fanatics with knives intent on lopping a few gay heads off.

So here's plan B.

I call it "Osama pig Laden".

We stick with the giant papier mache head, except do one of a pig's head on a platter (with an apple in its mouth - or a bomb if you prefer). Add a patented bin laden beard, and everyone will recognise it for what it is - Osama pig Laden.

You know it makes sense.

Suggestion for 2012 Mardi Gras Organising Committee

My Dear Committee members

I'd like to share with you an idea I've had for a Mardi Gras float next year. You might recall that back in 2008, there was a float featuring Fred Nile's head (I think it had something to do with John the Baptist). There wasn't much outrage in the gay community when this float appeared, given that Fred had said some less than pleasant things about gays in the preceding years.

Well, someone that hated gays even more than Fred has been in the new lately, and I think it would be the perfect time to feature his head on a Mardi Gras float.

Yes, I'm taking about Osama Bin Laden. Fred was less than complimentary about gays in NSW; Osama was a very important person in a part of the world where they are regularly executed. If Fred deserved to be mocked by one flat, then Osama deserves to be mocked by an entire parade.

Here's my idea - build a papier mache Osama head and mount it on a pike on the back of a truck. Suspend a large, pink thong (as in flip-flop) over  his head with a hinge at the rear. The thong can then be waved up and down to beat him over the head - a terrible insult in Middle Eastern lands.

The head should be lined with bags of pig's blood. The dancers on the float, dressed in short-shorts with a Navy SEAL theme, can take turns blowing holes in the head with shotguns. By the end of the parade, the dancers and street will be liberally smeared in a mixture of pig's blood and Osama's remains. A few of the dancers might get carried away and simulate sex with some of the newly formed holes in Osama's head.

Police protection for the float shouldn't cost more than four or five million dollars - a price well worth paying for giving the gay community the opportunity to poke Osama and his minions in the eye.

Let me know what you think.

BOAB

I wonder...

Bin Laden got taken out just down the road from a number of Pakistani military installations. You have to wonder why there appears to have been no response from any of them when helicopters were buzzing around just down the road, and a firefight broke out.

Here's my take - I reckon the commanders of those installations all got a phone call shortly beforehand. The conversation probably went something like this:

*click* "Hello, Abbotobad Defence Academy, Colonel Islamonirimidad speaking".

"Listen carefully. My name is General Buck Turgidson. I command all the US Air Force assets in the Middle East. Right now, 80% of them are either circling around overhead, or doing racetrack patterns just over the border. There are more warthogs just down the road from you than there are clapped out, beaten up taxis in your town. I've got an entire wing of B-52s orbiting less than 10 minutes out.

"If you so much as open a gate to put the cat out, you and everyone else in your town will be falling as vapour droplets over India next time there is a monsoon.

"I'm told that Pakistan's Got Talent is showing tonight on Channel 5. I suggest you turn up the volume, and take that red phone on the corner of your desk off the hook.

"Goodnight".

Osama is dead....

....so how long until we see a condolence motion from Marrickville Council?

I do like this

The Peoples Cube

I know someone who might appreciate this

Cardinal George Pell opens his Diary

It is two weeks before Easter Sunday and the sacristan has covered the statues in St Mary’s Cathedral with purple material bound tightly by diagonal black bands. Only these coloured outlines remain of our two new statues of the risen Christ and Mary Magdalene at the moment she recognises He is not the gardener. The English sculptor Nigel Boonham carved them from the Carrara marble used by Michelangelo, although the quality of our stone is better because of today’s more advanced extraction technology. My large claim is that these statues are worthy of Bernini, certainly of Canova.

After Mass and a breakfast meeting on ‘Coming Home’, our proposed media programme for retired Catholics and new Catholics, I meet with a delegation from St Lucy’s, Wahroonga, a school for children with severe intellectual disabilities. The principal explained their financial plight, an annual shortfall now running at about $500,000. One of the mothers asks whether our fund for disadvantaged children’s education could be used for St Lucy’s, although it is located outside the boundaries of the Archdiocese.

The young intellectually disabled should be counted among our first responsibilities, rather than granted something from what is left over and they too have a right to religion. We have no right to ask governments to shoulder all our financial burdens, but over some decades I have been part of delegations asking successive Commonwealth governments for significant increases in funding for disabled children. The economic return on such expenditure is almost non-existent, but we have a solemn duty of care. Neither can you put a monetary value on innocence and love. The Sydney Archdiocese will do more, but it won’t be enough.

(From The Spectator).