Discussion
The National Drug Strategic Framework In Australia Mainly Focuses To Diminish And Nipping In The Bud The Harm That Is Caused By The Intake Of Drugs Like Alcohol, tobacco, and the likely. The six sub-strategies of the drugs mentioned in this framework are alcohol, tobacco, ice, and workforce development. The Framework recognizes the national priorities of Australia concerning alcohol, tobacco, and the likely. The main purpose of this Framework is to advise the government in partnership with the service providers to tackle the harmful effects of drugs using multiple strategies (Drug Strategy in Australia, 2022). The strategies are reduction of demand, supply, and the harm from alcohol. These are the three pillars. This paper conforms to the introduction of MSIC in Sydney and its relation with this Framework and then followed it with a conclusion.
The Medically Supervised Injecting Centre (MSIC) in Sydney, Australia has proved itself as the first Supervised Injecting Facility (SIF) in the continent and the English-speaking world. It was first established in May 2001 only as a trial that was supposed to be evaluated independently. The King’s Cross area in Sydney is a ‘red-light’ area where the residents who use drugs had formerly pushed the drugs in public or in the shooting galleries which are supposedly illegal (Groves, 2018). MSIC had predominantly targeted to diminish the public health issues which had resulted from injecting drugs at a community level. When it first started its operations, within the first two years, the number of registered IDUs was 4719 and this added up to 88,324 visits to inject (Van Beek, 2003). The number of drug overdoses was 553 out of which 81% were heroin but no fatalities (Van Beek, 2003). The number of client referrals who were required further assistance were1852 out of which 44% were cases of drug dependence treatment (Van Beek, 2003). This proves the success of MSIC and its acceptance to the street-based population who were injecting the drug in this setting.
According to the Environmental Policy: Protection and Regulation, generally, a policy process has different stages which pertain to:
- Problem emergence
- Agenda setting
- Consideration of policy options
- Decision-making
- Implementation
- Evaluation (Jordan and Adelle, 2012).
According to this textbook, these are stages that occur in chronological order. Firstly, the environmental groups must obtain a specific problem on the agenda which will be subject to discourse and rumination by the policymakers. Then the course of action which will suit best is jointly decided upon by the policymakers and these decisions are entirely based on the advice rendered by the specialists. The best decision is then selected relying on the advice by the specialists and then making the policy. After this, the policy is handed over to the administrators for implementation (Benson & Jordan, 2015). These are the stages of policymaking and involve different parts of the government in its process. The people who inject drugs (PWID) can inject the drugs legally in MSIC under the supervision of health professionals. In a recent study, it has been observed that the majority of the PWID have a poor level of education and thereby are not employed, have been imprisoned many times, and also have poor access to housing (Goodhew et. al., 2016). Therefore, the first stage of the policy process which pertains to the emergence of problem, in this case, pertains to the emergence of mental health problems of PWID and they suffer from mood swings, anxiety, personality, and psychotic disorders, tendency to commit suicide, high rate of trauma, post-traumatic stress disorder (PTSD) and also harms own self. The second stage pertains to agenda-setting. The entire agenda-setting of the MSIC has already been discussed in detail in the previous sections of the paper. The main agenda of the MSIC is to prevent drug overdose by letting the PWID inject the drugs legally in a supervised environment. The main purpose of the MSIC is to authorize the intake of illegal drugs under hygienic conditions of low risk. They are unlike the ‘shooting galleries’ where the PWID pay so that they can inject the drugs (Wright & Tompkins, 2004). The third stage pertains to the consideration of policy options. The Department of Health is pledged to work with services related to alcohol and drug, the people who are addicted to the consumption of alcohol and drug, and their friends and families to develop frameworks and policies that ameliorate outcomes for the PWID. The legislation issues a governing framework to build up the policies of alcohol and drug in the red-light areas which are more prone to the harmful effects of the drug intake. The service providers of alcohol and other drugs are expected to act following the Victorian legislation which includes:
- Severe Substance Dependence Treatment Act 2010
- Drugs, Poisons and Controlled Substances Act 1981
- Mental Health Act 2014
- Children, Youth, and Families Act 2005 (Legislation, 2022).
Policy-making Process of MSIC
The fourth stage deals with the decision-making process. The MSIC also conforms to this stage. The Victorian government has decided to extend the MSIC trial in North Richmond for 3 years more until 2023 in June. The decision was taken by the government since this policy has shown successful results and achieved the target of saving lives through a drug overdose. The policymakers along with specialists have also decided to open a second site of MSIC in Melbourne which will further aid to achieve the target (MSIC, 2020). The implementation of the MSIC had already been discussed earlier in the paper which was May 2001. The final stage is the stage of evaluation. The first evaluation report was published in 2003which covered the initial 18 months of its operation. The license for this operation was later extended and the evaluation reports of the second series were published by the government of Australia (National Centre in HIV Epidemiology and Clinical Research, 2007). Therefore, it is evident that the MSIC conforms to all the stages of a policy process.
The policy response of MSIC has been successful in achieving its target of reduction of harm and possible deaths due to drug overdoses. Many findings reiterate this fact and are listed as follows:
- The harmful drug-related behaviors of the PWID were reduced to a large extent. One report showed that 75% of the PWID showed a significant change in the behavior and another study, it was observed that 23% of the PWID stopped injecting drugs when the period of observance reached its end. In another study, it was seen that 57% had received proper treatment (Stephanie & Jason, 2014).
- It was found that the PWID in the MSICs felt much safer than the PWID in the public areas as well as the private areas too. If it is a public area, then the risks of women increases, and also the risks of robbery and physical violence increase too.
- It was also found that there was a 35% fall in the areas nearby to an MSIC (MSIC, 2020).
- A slow rise in the population getting addiction treatment and also a 30% rise in the utilization of detox services (MSIC, 2020).
- Changes in the public order were positive.
According to the theory proposed by Grindle and Thomas (1991), policy-making has three phases namely the agenda phase, the decision phase, and finally the implementation phase. A decision should be taken at each phase of the model which can be either for the policy or against it. For example, at the agenda phase, the decision pertaining to the policy or against it may pertain to the fact of putting the policy on the agenda or not. Similarly, in the decision phase, the policy reform may or may not conform to the agenda. And finally, in the implementation phase, the policy may be successful or a failure (Policy Models, 2022). Therefore, the policy response of MSIC in the agenda phase had put the policy on the agenda form, and in the decision phase, it was decided to form MSIC as a policy response to the National Drug Strategy and finally, in the implementation phase, the policy response of MSIC was successful.
(Policy Models, 2022)
Conclusion
The MSIC has always shown success in its policy implementation although at first, it does seem like a confronting prospect. It has successfully reduced the harmful effects caused to society from the intake of alcohol and drugs. The MSIC primarily helps the people who are in dire addiction to drugs and genuinely need assistance and are dependent for the assistance. The MSIC also reduces the harm in communities that are caused by the intake of drugs and also provides reassurance to the department of health care and most importantly, saves lives. Therefore, it can be well concluded that MSIC was a successful policy response to the National Drug Strategy.
References
Adelle, C., Jordan, A., & Turnpenny, J. (2012). Policy making. In Environmental Policy in the EU (pp. 235-252). Routledge.
Benson, D., & Jordan, A. (2015). Environmental policy: Protection and regulation. In International Encyclopedia of the Social & Behavioral Sciences (pp. 778-783). Elsevier.
Drug Strategy in Australia. (2022). Drug Strategy in Australia – Alcohol and Other Drugs Knowledge Centre. Alcohol and Other Drugs Knowledge Centre. Retrieved 19 March 2022, from
https://aodknowledgecentre.ecu.edu.au/key-resources/drug-strategy-in-australia/.
Goodhew, M., Salmon, A. M., Marel, C., Mills, K. L., & Jauncey, M. (2016). Mental health among clients of the Sydney Medically Supervised Injecting Centre (MSIC). Harm reduction journal, 13(1), 1-5.
Groves, A. (2018). ‘Worth the test?’Pragmatism, pill testing and drug policy in Australia. Harm reduction journal, 15(1), 1-13. Doi: 10.1186/s12954-018-0216-z
Legislation. (2022). Legislation governing alcohol and other drug treatment. Health.vic.gov.au. Retrieved 19 March 2022, from https://www.health.vic.gov.au/aod-policy-research-legislation/legislation-governing-alcohol-and-other-drug-treatment.
MSIC. (2020). Medically supervised injecting centres saves lives. Adf.org.au. Retrieved 19 March 2022, from
https://adf.org.au/insights/medically-supervised-injecting-centres/.
National Centre in HIV Epidemiology and Clinical Research. (2007). Sydney Medically Supervised Injecting Centre Evaluation Report No. 4: evaluation of service operation and overdose?related events.
Policy Models. (2022). Policy Models | Policy NL. Policynl.ca. Retrieved 21 March 2022, from
https://www.policynl.ca/policydevelopment/pages/policymodels.html#:~:text=Kingdon%20(1984)%20suggests%20that%20policy,for%20a%20policy%20to%20emerge.
Stephanie B. & Jason G. (2014). Rapid Response Service. Rapid Response: What is the effectiveness of supervised injection services? Toronto, ON: Ontario HIV Treatment Network.
Van Beek, I. (2003). The Sydney medically supervised injecting centre: a clinical model. Journal of Drug Issues, 33(3), 625-638. https://doi.org/10.1177/002204260303300305
Wright, N. M., & Tompkins, C. N. (2004). Supervised injecting centres. Bmj, 328(7431), 100-102. doi: 10.1136/bmj.328.7431.100
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