“I’ll never forget the funerals”: What it’s really like to work in a safe drug injecting centre.

I’ve been to a lot of funerals since I started work in Kings Cross nearly two decades ago. For many doctors it would be rare to attend a patient’s funeral. Indeed, it could even feel a little odd or inappropriate.

But where I work now it isn’t. The Uniting Medically Supervised Injecting Centre is a unique place that genuinely meets people where they need it and walks beside them in an effort to help. Sometimes we are all the family a client has.

When the Uniting MSIC opened 15 years ago it was a first in the Southern Hemisphere. Kings Cross was in crisis, and the community knew something needed to be done differently. After it opened, the number of ambulance call-outs to the Cross fell by 80 per cent and the number of discarded needles in the street halved.

But working here these last eight years, I see the people behind the statistics.

Scott* comes to Uniting MSIC and used to be addicted to heroin as well as alcohol. The first time I met him he was severely intoxicated, with major health problems – he had hepatitis C and along with his alcoholism, and so his liver was on track to kill him.

That first day, he was so unwell we had to call an ambulance. Eventually, we convinced him to get his liver scanned. His score was nearly off the scale. It was a huge wake up call.

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The last time I saw Scott he had come a long way. Today, not only has he stopped drinking, he is also getting treatment for his Hep C. It is amazing we can now cure Hep C. Scott still uses opiates occasionally, but he has changed dramatically. Most importantly to me, his life is no longer in danger.

Of course, it’s wonderful when we can help someone stop using drugs completely. But that’s not the only way to change someone’s life, and it’s not the only measure of success.

Another member of the Uniting MSIC family is Mike*, a long-term heroin user, who was homeless and had untreated epilepsy when he first came to us. He was having seizures almost weekly, and attempts to get him into stable housing always failed.

We eventually discovered that he didn’t want stable housing. He was afraid of having a seizure alone. He was frightened of his own mortality. And on the streets, he took solace in the fact that at least someone would see him and call for help.

It took a while, but we were able to get him onto medication to manage his fits and see a specialist. When his epilepsy was under control -- for the first time in nearly a decade -- we were finally able to secure him stable housing.

He still uses drugs, but again, I see this as a success story, the start of a path leading elsewhere for Mike. We need to remember our aim is first about someone’s life, their health and their wellbeing.

Dr Marianne Jauncey. Image via Uniting MSIC.

We can’t save everyone of course. And I will never forget the funerals I’ve been to, of people I knew and cared for.

Anna* was a small-framed, waif-like lady who used to come to Uniting MSIC. She had a long history of drug addiction coupled with untreated schizophrenia. Living on the street, she was well known in the local area, but at times cruelly vilified and belittled.

She was only in her 30s when she died. My only comfort is that we managed to get her admitted to hospital, so she spent her final moments somewhere she could feel respected and reassured. It could so easily have happened on the street, with people stepping over her and looking away.

People like Anna face some of life’s worst challenges. If we had seen them when they were children – perhaps as toddlers being abused, neglected, hungry, discarded – we would have been outraged and desperate to protect them.

But somewhere along the line in society we lose sympathy. I don’t know why. She was ultimately still the same person when she came to us – someone who was neglected and desperately in need of help.

We provide a safe, supportive place to people who need compassion. It may be confronting work for some people. But what is even more confronting is the reality of what happens to these vulnerable people when they inject drugs without access to a safe, medically supervised space.

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Remember, they are already injecting drugs and indeed they have already bought drugs that very day ready to inject. The best efforts of society have not prevented this from happening. So, surely when they present to a service created to help such people, we should be allowed to try. It is through a non-judgemental approach that we stand the best chance of getting them into the treatment and care they need.

I understand that some members of the community struggle with the idea of services like Uniting MSIC, but I invite anyone with questions to visit us. We are professional health staff, with experience and empathy. And we need your support because being able to open more places like this will undoubtedly save more lives.

To find out more about the Uniting MSIC, visit www.uniting.org or call 02 9360 1191.

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