GET YOUR FIX AT NUMBER 66

THE person who walks through the front door of 66 Darlinghurst Road, Kings
Cross, is typically male, 31 years old, didn't complete high school, lives
on social welfare benefits, has a 25 per cent chance of having been in jail
in the past year and speaks English at home - which in 11 per cent of cases
is a squat, shelter or the street.

When he takes his place at one of the eight cubicles, he most likely will
be about to inject heroin into his veins. He's been shooting up since he
was 19, there's a 44 per cent chance he has overdosed in the past and he
has dropped out of treatment.

In 28 minutes he will be back on the street, he will have spent less than
two minutes in reception, 12 minutes in the cubicle and 14 minutes in
after-care.

The visit has just cost taxpayers $58.36 and some addicts go there three
times a day. But what price do you put on a life?

Australia's first, and only, medically supervised injecting centre is
slap-bang in the middle of the Kings Cross red-light district, a place
where strip club spruikers solicit, hookers hover and the last of the
autumn leaves swirl in the gutters.

Conspicuously inconspicuous with its grey opaque windows and opening hours
stuck to the front door, the centre is run by the Uniting Church's
UnitingCare NSW.ACT.

Next door is the Tudor Hotel, a one-star establishment where a drug
syndicate set itself up in a bid to attract new customers, just three days
before the centre opened on May 6, 2001.

Syndicate ringleader George Herheb was nabbed by detectives after they
intercepted 1900 conversations on his mobile phone relating to the sale of
"hot chocolate" (heroin) and "cappuccino" (cocaine). The drugs were packed
inside Disprin capsules and sold by street-dealers for $50-70 each, netting
$14,000 a day.

This is the notso-pretty part of the famed Emerald City. It is a place
where, under the bright lights, drug addicts often face their darkest
hours. It is here that a young man was found in a toilet desperately
trying to remove tiny balloons full of deadly heroin from his own faeces.

But it is also where 44-year-old Ingrid van Beek runs the injecting centre,
a converted pinball parlour which opened 27 months ago in a storm of
controversy and whir of television cameras - and a mission statement that
sounds like an impossible dream.

The dream is to cut the number of fatal drug overdoses and spread of
blood-borne viruses such as HIV and Hepatitis B and C, channel addicts into
drug treatment, health care and social welfare - and reduce the incidence
of users injecting in public and discarding syringes in a suburb which is
one of, if not the biggest, drug markets in Australia.

"I think that we've managed to attract a core population of drug users we
were hoping would use the facility - entrenched drug users, largely
street-based, often sex workers, who are at most risk of overdosing,
particularly those who have had little or no ongoing contact with health
agencies," Dr van Beek says.

The recommendation for the establishment of a licensed, supervised drug
injecting centre was made during the Wood Royal Commission into the NSW
Police Service in the mid-1990s.

An unscanctioned supervised centre, known as the Tolerance Room, operated
briefly out of The Wayside Chapel in Kings Cross in early May 1999.

It was run by a band of clergy, health and welfare workers and parents of
dead and alive drug addicts, including Tony Trimingham, whose son Damien
died of a heroin overdose.

The room was closed down by police but a legal, medically supervised
injecting centre was high on the agenda of the NSW Parliament's Drug Summit
later that month and, guided by summit recommendations, the Carr Governemnt
gave its support to an 18-month trial in Kings Cross.

Part of the legislation governing the centre provided for an independent
evaluation of its first 18 months of operation and the ensuing 233-page
report was released by NSW Special Minister of State John Della Bosca on
July 9.

The centre already has been granted one extension to October 30 and, for it
to continue beyond that date, new legislation will need to be passed by the
Parliament.

Mr Della Bosca believes the evaluation team's report is justification
enough: "From my own point of view, I think there is a strong case to
recommend that the trial be allowed to continue."

The evaluation has revealed that 3810 "clients" used the injecting centre
56,861 times in the 18-month period.

On the centre's busiest day, 206 drug addicts walked through the door to
shoot up an illegal substance. While some addicts visited the centre only
once during the 18 months, one went 646 times.

Drug addicts were turned away 151 times, including on 72 occasions because
they were intoxicated; 27 because they were under 18; 12 for bad behaviour;
eight because they were accompanied by children; six because they were or
possibly were pregnant and six for not previously being an injecting drug user.

So just how many lives were saved by the injecting centre?

By the time it opened, there already had been a substantial reduction in
the availability of heroin in Australia. But the heroin drought meant
addicts were shooting up more cocaine, amphetamines and benzodiazepines.

"There was no evidence that the operation of the medically supervised
injecting centre affected the number of heroin overdose deaths in the Kings
Cross area," the evaluation report stated.

But there were 409 (including 329 heroin) overdoses at the centre during
its first 18 months of operation, none of which were fatal. One addict
overdosed there a staggering 10 times.

And it was the evaluation team's opinion that it was the addicts' presence
in the centre at the time they overdosed which probably saved their lives.

Of the 44 per cent of centre clients who said they had overdosed in the
past, 36 per cent said it had been in a public place, 73 per cent said they
had been attended to by an ambulance and 68 per cent said they had been
administered Narcan.

If there had been no injecting centre, 42 per cent of addicts said they
would have next shot up on the stret, park, beach or public toilet.

"On the basis of clinical and epidemiological data on heroin overdose
outcomes, at least four deaths per year are estimated to have been
prevented by the clinical intervention of the staff at the medically
supervised injecting centre," the report said.

One point of contention has been the level of referrals of drug addicts
from the injecting centre into drug treatment.

Just two weeks before the evaluation report was released, Salvation Army
social program secretary Gerard Byrne claimed that it had received no
referrals from the centre into its drug rehabilitation programs.

According to the report, however, 1385 verbal and written referrals to
various drug treatment and health agencies and social welfare organisations
were given out in the centre's first 18 months of operation but only 20 per
cent were followed through.

A further breakdown reveals that 43 per cent of the referrals were for the
treatment of drug dependence, 32 per cent to primary health-care facilities
and 25 per cent to social welfare services.

"In interpreting these findings, it is noted that there is no benchmark for
successful referral, and a projected rate of successful referral from the
medically supervised injecting centre was not specified before the centre
opening," the report said.

"The rate of referral from the centre, however, is within the lower bounds
of the range reported for intravenous drug users seeking drug treatment
referrals in needle and syrine programs and community health settings."

But Dr van Beek defends the low 20 per cent follow through rate.

She says that given the methodology used to track the referrals - a
postcard given to the drug addict to hand to the drug, health or welfare
agency, which then had to be sent back to the evaluation team - the result
is not disappointing.

"As you can imagine, an essentially homeless person might not be that good
at keeping that card for the week or however long it takes until they get
an appointment," she says.

Despite the incident at the Tudor Hotal, and the fact that a phone booth
was removed from outside the train station across the street from the
injecting centre when it was discovered it was being used to facilitate
deals with drug addicts attending the centre, the evaluation team found no
evidence of the so-called "honey-pot" effect.

Overall, the centre was found to have resulted in no increase in crime or
increase in the risk of blood-borne virus transmission.

It referred addicts, particuularly those who attended the centre
frequently, into drug treatment and, a small number of overdoses managed at
the centre may have been fatal had they occurred elsewhere. There has been
no loss of public amenity.

But the injecting centre's critics believe the facility is a waste of money
and the $2 million cost of setting it up and operating it would have been
better spent on getting more drug addicts into treatment and on law
enforcement.

They ask how a substance can be illegal on one side of the door and
sanctioned by the NSW Government on the other.

But it is an argument that does not wash with Dr van Beek, who clearly sees
drug addiction as a health issue, not a law enforcement one.

"If we look at the wide range of illnesses that we provide health-care
services for, a lot of those are associated with behaviours like smoking
and drinking that are all arguably self-afflicted," Dr van Beek says.

"For us in an affluent society to turn around and say 'sorry, you are not
deserving' is a hard line to take."

At the height of debate over the Tolerance Room, Prime Minister John Howard
said injecting rooms were sending Australia's youth "bad signals" and the
release of the medically supervised injecting centre's evaluation
committee's report had done nothing to change his view.

"I believe very strongly in the Tough on Drugs strategy my Government has
pursued," Mr Howard said. "I have never supported heroin trials and I have
never supported heroin injecting rooms and this Government never will."

While Mr Howard continues to voice his disapproval, ACT Helath Minister
Simon Corbell said the evaluation of the Kings Cross trial provides support
for the setting up of Australia's second injecting centre in the national
capital.

"I think it would be a relatively straightforward process to establish such
a facility in the ACT in the next 12 to 18 months if, and I stress if, the
Government agreed to progress it," Mr Corbell says.

NSW Greens MLC Lee Rhiannon believes the evaluation "debunks the hysteria
that comes from the zero tolerance brigade that has been led over the years
by Prime Minister John Howard and (Salvation Army officer) Major Brian
Watters".

But Kings Cross Chamber of Commmerce president Malcom Duncan disagrees.

"The statistic that doesn't appear anywhere in the report, or in anything
that Ms van Beek says, or anything that the Minister (Mr Della Bosca) says,
is the number of people who, after 18 months of this trial, are no longer
dependent on drugs," Mr Duncan says. "And the reason for that is, the
statistic is zero.

"This facility is not getting addicts off drugs. This facility is being
run to keep people who engaged in very, very high-risk behaviour alive so
that they can indulge in it again."

Sydney's St Vincent's Hospital alcohol and drug service director and key
backer of the Tolerance Room, Alex Wodak, has likened Australia's drug
crisis to a "Port Arthur (massacre) every two weeks".

"When Port Arthur happened, to his eternal credit, the Prime Minister moved
heaven and earth on gun laws ... now he doesn't have the ticker to do what
needs to be done," Dr Wodak has been quoted as saying.

"This is about keeping young people alive," he says.

Even the injecting centre's most vehement critics cannot argue with that.