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'Supervised injecting facilities save lives'

North Richmond Community Health CEO Demos Krouskos talks about the state government's 'historic' decision to start a trial safe heroin injections program to stop the overdose crisis plaguing the community

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North Richmond Community Health CEO Demos Krouskos, pictured with a member of the NRCH staff at a fundraising event. Photo: Supplied

06 November 2017

In what is certainly a significant change of position, the Victorian government announced on Tuesday the start of a two-year trial program to introduce a safe injecting room in North Richmond, as an attempt to halt the 'epidemic' of heroin-related deaths in the area. The initiative was announced by Premier Daniel Andrews and the Victorian Minister for Housing and Mental Health, Martin Foley. The facility will be based at the North Richmond Community Health Centre, which has been trying to get a program of this kind running for several years, building on a successful methadone program and a needle exchange that has run for two decades now. Neos Kosmos reached the CEO of North Richmond Community Health, Demos Krouskos, who offered valuable insight on the program and the potential benefits for the community.

How did the North Richmond Community Health Supervised Injecting Facility come to be?
This historic development is the result of decades of committed work from activists and organisations across the alcohol and drug sector. The North Richmond Community Health medically supervised injecting facility would not be happening if it weren't for the hundreds of people across the years who have advocated for this change. As the organisation at the heart of North Richmond, we see the devastating impact of overdose every day. We see the trauma and grief it inflicts on family members, friends, and the entire community. In the past few years, it became obvious that this is a problem that is getting worse, not better. We knew a change was needed, urgently.We have worked with many people to pursue this change, including the Yarra Drug Health Forum, local residents, the state government, and organisations across Australia and internationally.

What are the benefits of such a facility in regards to public health, safety, or even crime?
Supervised injecting facilities save lives. We have the opportunity to combat the terrible overdose crisis that our community is experiencing. The facility is also expected to improve amenity and the environment for the local community, by moving drug use from outdoors into a controlled, medically supervised environment. After other medically supervised injecting facilities have opened, residents have reported a decrease in discarded needles. In Sydney, ambulance call-outs decreased by 80 per cent after the medically supervised injecting facility opened. Bringing drug use into a supervised environment will also reduce the potential trauma experienced by the local community, who may witness public drug use and overdose.

What kind of preparation did you have to do to be able to go through with this project?
Our staff have researched supervised injecting facilities intensively, travelling to Canada and Europe to observe other supervised injecting facilities and to determine the best possible model for our facility. We have committed a lot of time to research, partnerships, and advocacy, and will continue to do so over the coming months.

What is the main challenge you expect to face?
Our main challenge will be continuing to cope with North Richmond's overdose crisis in the coming months, before the facility is launched. Tragically, we will continue to see overdoses and deaths in the community until the facility is opened.

What has the experience with the methadone program and the syringe exchange program been?
Our Alcohol and drug program is nationally recognised as the leading harm reduction program in Australia. We have strong relationships with the community here in North Richmond, coupled with excellence in medical practice and a holistic, non-judgemental approach to care. Our methadone and syringe exchange programs are fully integrated into our health centre, proving that we can support the full range of people who live in our diverse community.

What goals have you set for the safe injecting facility?
We aim to create a facility which not only saves lives, but improves safety and well-being for the entire community. Our goal is to create a service where people do not just inject, but where they can also access health services, and a pathway towards treatment and rehabilitation.

Why is North Richmond the best suited area to host the first program of its kind in Melbourne?
North Richmond has the highest level of need for a medically supervised injecting facility of any area in Melbourne. Richmond experiences the highest number of overdose deaths of any area in Victoria, with the majority of those deaths occurring in North Richmond. The level of public need is tremendous.
North Richmond Community Health is the best suited place to host the facility for two main reasons: Firstly, it is located in close proximity to Richmond's drug market. To get as many people off the street and into the facility as possible, it's important that the facility is located where people already buy and use drugs. Secondly, we have proven that it is possible to integrate health services. Our model at North Richmond Community Health is about taking care of many different elements of a person's mental and physical health, no matter what their circumstances are.

What would you say to people fearing that such programs 'normalise' drug use?
We understand people's concerns. However, there is no evidence that medically supervised injecting facilities promote drug use, or are associated with an increase in drug use at all. In fact, we hope to provide people who currently use drugs with a pathway to treatment and rehabilitation.

What is your response to the government changing their stance on this issue?
We commend the government for listening to the community, and responding to their needs.

How did you form your personal opinion on this issue?
I have been lucky enough to be a part of the North Richmond community for many years. I have seen the resilience and optimism of this community, and I have seen the tragic loss of life which has become too common here. It has affected me profoundly, as it has affected everyone in this community.

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