Inside the Kings Cross Medically Supervised Injecting Centre

If anyone personifies the 1990s, with all its garbage couture and junky chic, I’d suggest Courtney Love. Bearer of lingerie street fashion. Reviled wife of Kurt Cobain. Heroin addict.

So as Courtney kicked off her Australian tour last month, I made a tour of the Kings Cross medically supervised injecting centre (MSIC).

I admit, I wasn’t sure about the tour. The idea of it put a bad taste in my mouth. I came close to cancelling.

The MSIC is the only facility of its kind in the southern hemisphere, one of only 96 around the world.  It opened at a time when much of Australia, especially places like Kings Cross and Newcastle, where I am from, were on their knees to heroin.

It’s a time I remember well. It seemed like every second person you met was on the gear.  The scourge spanned professions, cultural backgrounds, and social and economic groups.

I have heard people comment that because it’s illegal to possess illegal drugs, a place for them to inject them shouldn’t exist. Others argue that tax payers should not be funding a project that condones and supports behaviour that is illegal.

On busy Darlinghurst Road, the centre has a sterile and inconspicuous facade that makes it looks like an unbranded accountancy office.

Around 200 to 250 people visit to inject drugs each day the centre is open.

Inside it has the appearance of an ordinary waiting room. Metal chairs with vinyl upholstery along two walls. Magazines. A long front desk. There are about twelve people for this pre-arranged tour: mostly medical students.

Our guide, a registered nurse who has worked at the centre for several years, gives us the history of the centre. First, he clarifies the legal point.

“If you’re on the other side of that door, it’s illegal to be in possession of an illicit substance. Once you step inside, it is not. The Drug Misuse and Trafficking Act was amended to allow the centre to begin operations on a trial basis.”

In the ‘90s, a number of brothels started renting rooms for 15 and 30 minutes for the use of injecting drugs and became known as ‘shooting galleries’. At the time, there were overdoses every few hours. The sound of ambulances was constant.  The Cross was littered with capped and uncapped syringes. People injected on the streets.

In 1997, there was the Royal Commission into the NSW Police. Having a medically supervised injecting centre was the frank and practical recommendation of Justice James Wood. By 1999,  the problem was at its peak. NSW Drug Summit was held. Then-Premier Bob Carr sought to investigate Wood’s recommendation. Clover More supported the endeavour and the trial began.

Wood found that although the shooting galleries were exploiting people for money, one benefit  of them was that they saved many lives.

“If the user’s fifteen minutes elapsed and they were still in there, the manager banged on the door. If they didn’t respond, they called an ambulance.”

The facility is set up to operate in three stages. It’s a one-way journey. Clients come in through the front door and move through various rooms. Exit by the back. In the reception area, stage one, a client is met. We take their name, basic demographic data, and the drug they are going to be using.

It is a condition that they must be a legal adult and they cannot come with a minor. They also have to be a regular user. They won’t accept anyone coming in to start.

After the duty staff is satisfied they meet the criteria, they climb a narrow white staircase to stage two. Here, a bank of eight stainless steel carrels, each with two chairs and a large plastic yellow sharps bin, faces away from an injecting supervisor.

“Heroin is still around,” says our guide. “But the street drug landscape has changed. Eighty per cent of clients come to inject prescription drugs.”

OxyContin, the brand name for oxycodone, a narcotic analgesic prescribed for strong pain relief and also known as hillbilly heroin, is the most common.

‘Oxy’ is designed as an oral pharmaceutical. Clients may be shown how to filter out the insoluble microcrystals, which can do severe damage to the heart and lungs if crushed and injected.

In an adjacent room, oxygen and narcotic reversal can be administered in the event of an overdose. Clients are supplied with clean syringes (size depending on the drug they plan to inject), medicated swabs for the injection site, vials of purified water, and cotton for filtration.

According to the MSIC’s research, there has been over 5,000 overdoses and not a single fatality.

In state three, clients continue their move forward to emerge into the ‘chill out room’.

“Clients can have a cup of tea or coffee, read a magazine, rest, talk to staff, and get linked in to other services they may need, such as accommodation support, drug and alcohol treatment programs, detoxes, and general engagement activities.”

There are vividly colourful posters on the walls. The chill out room is the opportunity for health promotion, as well as things like the phone photography competition that is running when I visit.

“We’re seeing the cohort of users from the 1990s ageing, so there are other health issues than just drugs.”

The average age is 39.

“Most of the clients are homeless men. This is a very difficult to reach group of people. For most of the, this is the only service they use, so it’s important we try to engage them. We don’t try to force anyone to go into treatment, we give them information and help them organise it when they’re ready.”

So do you get any success stories?

“People come in all the time.”

The MSIC’s supports include: The Australian Medical Association and the Royal Australasian College of Physicians. Its trial status was lifted in 2010.

The MSIC is run as an initiative of UnitingCare NSW ACT.

Funding comes from the Confiscated Proceeds of Illegal Activity account, which is managed by NSW Treasury. MSIC receives no government funding.

A second facility is being considered in Brunswick, Melbourne, a place experiencing some of the problems Kings Cross had in the ’90s. I hope they get it over the line.

I toured the facility as part of the Australasian Society for HIV Medicine.