By Mary Ward
The medically supervised injecting centre at Kings Cross remained open during Sydney’s lockdown but, in addition to its usual operations, there was something else being drawn into syringes: the COVID-19 vaccine.
As the virus entered the inner city’s vulnerable communities – with scores of cases recorded in public housing and homelessness services – the centre gave vaccinations, screened for symptoms and provided support.
Dr Marianne Jauncey says the ice inquiry ‘called a spade a spade’.Credit: Janie Barrett
“We stayed open the entire time, but we were pretty quiet,” says Dr Marianne Jauncey, who has been medical director of the centre since 2008. She believes movement restrictions as well as programs to house the homeless resulted in fewer people around.
Twenty-five people who used the centre tested positive for COVID-19. However, no transmission occurred on site.
Post-lockdown, the centre – which still offers COVID-19 vaccinations, and is particularly working on outreach to the local Indigenous community – now sees about 100 people every day.
“Slowly, people are coming back; things are going back to normal,” Dr Jauncey says.
A return to normality also means a return to the same problems with NSW drug and alcohol services, such as long wait times for treatment. It is a difficult statistic to quantify because there are rarely waiting lists – people just stop trying to get help.
“If I had a patient who had breast cancer and I was saying ‘oh, you have to wait for that mastectomy’ or ‘oh, it’s a six-month wait for chemo’ it would be an outrage – but that is what I have to say every day to our clients,” Dr Jauncey says.
“If you’re not able to help in the moment where someone is ready to have that conversation about their use, you can miss them.”
Like many others in the sector, Dr Jauncey is still waiting for the NSW government’s response to the 104 recommendations from the ice inquiry delivered by commissioner Professor Dan Howard, SC, nearly two years ago.
Another five recommendations – including another supervised injecting centre and pill testing – were dismissed outright.
“[Professor Howard] has called a spade a spade,” she says. “There are problems and I really do think this is a case of good intentions being thwarted by loud minorities.”
Last month, Attorney-General Mark Speakman said the response to the recommendations was “imminent”, noting he would be “disappointed” if the government failed to make its response in 2021.
Statistics released by the National Drug and Alcohol Research Centre this week showed amphetamines and other stimulants were still the source of the largest proportion of drug-related hospitalisations in 2019-20, accounting for 27 per cent of all admissions.
Over lockdown, people working in the sector say alcohol and opioid use – particularly heroin – both increased, while methamphetamines such as ice declined.
“Every single one of the recommended responses [in the inquiry] is a broad, generic response which could be made about most issues involving substance use in Australia,” says Associate Professor Nick Lintzeris, the president of the chapter of addiction medicine in the Royal Australian College of Physicians and the director of drug and alcohol services for South Eastern Sydney Local Health District.
Dr Lintzeris says the state’s drug and alcohol system is not user-friendly, with multiple entry points and people seeking treatment facing a “postcode lottery”. Outcomes often depend on whether a GP has the connections, or a local hospital has the services, to provide help.
Services were significantly scaled back when NSW’s health staff mobilised to tackle the vaccination of millions of people and bolster hospital emergency and COVID-19 units, Dr Lintzeris says.
Those measures, which resulted in reduced treatment capacity, have since been reversed. However, while much has been invested into mental health support post-lockdown, he says little is being done to tackle the drug and alcohol problems which will likely also follow the disruption of the year.
“I don’t begrudge the mental health investment – that’s fantastic,” he says. “But drug and alcohol problems absolutely are the other arm of that impact, and we have seen no investment.”
In October, an alliance of medical bodies, including the colleges of physicians, GPs and psychiatrists as well as the NSW branch of the Australian Medical Association, called for the state government to urgently respond to the recommendations, develop a whole-of-government drug and alcohol policy and significantly increase funding of services.
Emma Maiden, the director of advocacy at Uniting, which operates the supervised injecting room, says she wants to see the recommendations of the inquiry taken seriously.
“In COVID, we heard a lot about ‘following the health advice’. This is what has been recommended. So, let’s follow the health advice.”