Shooting blanks

Posted: Jul 16, 2003 12:00 AM

When trendy drug programs -- such as Australia's Medically Supervised Injecting Centre, which allows junkies to shoot up under medical supervision -- are born, they invariably are touted as the savvy new way to address the world's drug problems.

Sydney's center was billed when it opened in May 2001 as a model of the "harm reduction" philosophy -- which is gaining momentum in the United States and seeks to minimize the negative consequences of risky drug use. Sponsors said the center would "decrease overdose deaths, provide a gateway to treatment, and reduce the problem of discarded needles and users injecting in public places."

So junkies are allowed to buy drugs on the street -- it's against the law for the government to distribute heroin -- then inject themselves at the center under medical supervision in case they overdose. Health workers also can refer drug users for drug rehabilitation or other government services.

Junkies, however, can't smoke at the center. Smoking, you see, is hazardous to their health.

News flash: A report released this month on the center's impact shows that letting junkies shoot up in a clinic has failing-to-dubious results.

Did the center reduce drug overdoses? The report found that the substantial reduction in opioid overdoses "could not be attributed to the operation of the MSIC." Yes, there was a reduction in use because a heroin drought hit Down Under before the center opened. (When I visited the center in August 2001, I was stunned at the bad timing. Shortages were taking care of much of the heroin problem, but the do-gooders were pushing a plan to make it safer to shoot up.)

To answer the question, the report's best guesstimate was that the center prevented at least four deaths each year. (Which a different program might also have done.)

A gateway to treatment? The evaluation said the MSIC provided referrals for drug dependence to 11 percent of the clients. But that doesn't mean junkies followed up. In June, Sydney's Daily Telegraph reported that the Salvation Army announced it had received no referrals to its drug rehabilitation program from the Sydney injecting clinic, ever -- even though its drug program has a vacancy rate of 20 percent.

Fewer needles in the neighborhood? Community residents said they saw fewer needles. (No surprise, there's a heroin drought.) Syringe counts of the MSIC's Kings Cross neighborhood showed a decrease when the center opened, followed by a "gradual increase" in syringes.

Here's some not-so-great news: "The available evidence does not suggest that there was a large increase in drug-related loitering in Kings Cross following the opening of the MSIC." Oh joy, not a large increase.

If a traditional anti-drug program showed such sorry results, politicians on the left would denounce it as yet another dumb big-spending drug program. But under the "harm reduction" aegis, failure apparently is acceptable.

New South Wales Special Minister of State John Della Bosca announced that the report "makes a strong case for the center's continuing operation." Australia's Green Party backs opening new injecting centers in rural areas.

Daily Telegraph columnist Piers Akerman, however, has taken on the thankless task of challenging the center, with its $1.8 million budget last year. "At $63 a throw (it was projected to cost only $37), the shooting gallery isn't delivering value," Akerman writes. "The same funding could have supported 100 residential rehabilitation beds in nongovernment institutions, offering residential drug dependence treatment."

When the center opened, it was supposed to be for an 18-month "trial." But with its "harm reduction" philosophy, the verdict was fixed: The center can fail to provide a gateway for users to enter rehabilitation, do little to clean up needles and neighborhoods, and show unclear results on overdoses, but as long as it suggests there can be safer hard-core drug use, the center cannot fail.