BY AMELIA DONDAS
Is the law barring under 18s from mainstream crisis services such as the Medically Supervised Injection Centre unrealistic?
Drug dealers don’t ask for ID, and there is no bouncer outside public bathrooms after hours to make sure a person going in to shoot up is over 18 years old. Even with the number of services offered to at-risk youth in Sydney, is the current legislation that bans this minority from using the only Medically Supervised Injection Centre (MSIC) in Australia itself a risk?
Clients of the MSIC go through three stages: registration, injection, and chill out. At the chill out stage users can access medical advice, vein care, counselling, and links to methadone and rehab facilities. Kings Cross is fast becoming infiltrated by Sydney youth, who flock to the flashing lights and a wide array of drugs. By banning under-18s from the MSIC are we placing them in the front line of contractable diseases and back-alley overdoses?
Stories of paedophile fathers and abusive mothers are everywhere in the Cross. One girl’s story makes the MSIC seem like Grandma’s house. Kate* lived in Queensland in a little town outside Brisbane. Her dad was a paedophile, and would crawl into her sister’s bed at night. The kids at school made fun of her for having “a dad like that”. Her mother was a crack-head who disowned her, along with most of the family, for her dad’s behaviour. A string of bad relationships ensued, and Kate found herself in Sydney at age 17 with no one to help her prepare for the school formal or university. Sometimes you see Kate sitting outside the newsagent with a magazine she bought from the proceeds of begging. You can picture her in her bedroom with her iPod, her toenails freshly painted, waiting for a text message from her best friend. Instead a much older man comes over and jerks her up and she is led away into the night.
Newsreaders would have a field day with the words minors, heroin and Kings Cross.Kids being refused beer but allowed space to “boot” make the wrong headlines. Research officer Travis Gilbert from Homelessness Australia explains: “A potential PR nightmare would follow a direction to allow minors (to use the centre).”
“It would be fair to say that this was done for political reasons,” Marianne Jauncey, The Medical Director at MSIC says of the restrictions. The centre is constantly under surveillance from opposition groups such as The Australian Christian Lobby who are losing the battle against public opinion. Since the centre opened in 2001 a wide variety of residents and business owners have come to appreciate the needle-free streets and safe spaces where heroin users’ bodies once lay.
Before its official opening in 2010, the centre required an evaluation every four years and new legislation to be passed through NSW government. In the beginning the original medical board found two impediments to the smooth sailing of the centre. Laws that ban smoking inside public health care facilities were not popular with visitors – smoking enhances the effect of heroin, so banning it resulted in a downturn of clients hanging around after stage 2. The second was a motion to allow minors already using drugs into the centre MSIC. The idea was quickly dismissed so that the centre could open. “Medically, I think there is no justification for this exclusion,” Marianne Jauncey explains, “because obviously if an underage person has a history of injecting drugs, then first and foremost you want to engage with them as much as possible, in order to provide assistance, acknowledging just how ‘at risk’ they are. And the reality is that most people when they hear they are unable to use the service leave abruptly.” They then go on to inject in unsanitary environments, she says. Pregnant women are also barred from the centre, even though it is more dangerous for an unborn baby to go through the withdrawal process than it is to be administered methadone or opium. Drugs Free Australia was unwilling to comment on under-18s being provided with clean injecting equipment or being admitted into the MSIC. Government services refused to answer any question that could be perceived as being either for or against the centre. “I think there are ethical issues with allowing minors to use the centre,” says Travis Gilbert from Homelessness Australia. “That said, particularly in the areas in and around Darlinghurst and the Cros,s there are likely to be a reasonable number of people who inject drugs who are aged under 18.”
More than 500 services cater to homeless and at-risk young people in Sydney. These services include crisis teams that perform after hours checks on kids sleeping rough and provide food, accommodation and life management shelters. However, there are few free public health clinics available to young people involved in sex work and heavy drug use. Professor Carla Trevor from the National Centre in HIV social research says it’s dangerous to be an at-risk underage person in Australia, where the percentage of Hepatitis C is higher than 50 per cent in people who inject drugs. “Being young (and being new to injecting) are independent risk factors for exposure to Hepatitis C infection,” Professor Trevor says. There are services that cater to the using youth, but none on as intimate a level as the MSIC. “It is remarkable to think that a 17-year-old could be turned away one day, but be eligible to attend MSIC the very next day on his or her 18th birthday- nothing would have changed clinically or socially within the course of one day,” Professor Trevor says.
Dr Dom Ingall from the Sunshine Coast Medical Centre is treating three brothers, all addicted to heroin. “One is 18 and has just developed a spinal infection which can be contracted by dirty needles,” he says. A practicing GP for more than 20 years, he thinks hard when questioned about allowing minors into the MSIC. “It’s a funny one isn’t it? … the first reaction is to say no …” But, he concludes, there are no medical reason for the exclusion. The minors Doctor Ingall and Professor Trevor see are the most vulnerable on the streets of the Cross, not only for their lack of knowledge, but also for the lack of considered services they can attend whilst in the area to buy or use drugs with older or same aged friends. Workers at the Needle Syringe Programs around the inner city admit to being slack when it comes to checking IDs, only because they worry about the repercussions of refusing a clean needle to a person.
Kings Cross allows many to lose themselves on a strip of 24 hour access to women, money and drugs. Excess takes over when as humans they crave more of the bright embrace of Darlinghurst Road’s happy hours. People come here to make the most of what they have and try turn it into something, to win big on the pokies or numb the pain of daily life through crack and heroin. The Cross is here to stay, as is the only Medically Supervised Injection Centre in Australia. As Darlinghurst blossoms into a more gentrified residential area attracting young people and university students, will it fight for the right of teenagers to register at the centre where they are given the most direct form of treatment known to cure and prevent sickness? Or is it destined to stay an 18 + only zone for the duration of its existence?
*not her real name
Sydney Medically Supervised Injecting Centre http://www.sydneymsic.com/
Homelessness Australia http://www.homelessnessaustralia.org.au/site/index.php
City of Sydney Drug & Alcohol Services http://www.cityofsydney.nsw.gov.au/community/HomelessnessServices/InformationKitForVolunteers/Module2/DrugAndAlcoholServices.asp