Space, scale and jurisdiction in health service provision for drug users: the legal geography of a supervised injecting facility

Abstract

Sydney's Medically Supervised Injecting Centre delivers the significant benefits of harm reduction, but has been controversial regards the law. Its contested history is examined here through the lens of legal geography. Narrative analysis reveals that the arguments for and against the centre's establishment referenced matters ranging from international treaties through to municipal governance. These arguments and their outcome were variously shaped by the different spaces and scales of jurisdiction but not simply in a zero sum game of law played out through the hierarchically ordered nesting of container-like territories. The implications for legal geography and for public health are discussed.

Keywords:

• harm reduction
• illicit drug use
• jurisdiction
• legal geography
• scale
• supervised injecting facility

Acknowledgements

This paper has benefitted variously from conversations initially had with Associate Professor Jason Prior, feedback offered by participants at the Inaugural Australian Legal Geography Symposium held at the University of Technology, Sydney (12–13 February 2015), reviews received from two referees for Space and Polity, and the support of the Institute of Australian Geographers.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes on contributor

Stewart Williams is a senior lecturer in Human Geography and Environmental Planning. His research is concerned with the geographies of risk, regulation and resilience.

Notes

1. SIFs are also called safe or safer (as well as supervised) injecting spaces, places, sites or centres. They are the main type of facility known as drug consumption rooms (DCRs) and distinct from alternatives such as safe or supervised inhalation rooms which cater for people who use drugs by means other than injecting.

2. Recent counts include that provided by Hedrich et al. (2010, p. 307) who state: “By the beginning of 2009 there were 92 operational DCRs in 61 cities, including in 16 cities in Germany, 30 cities in the Netherlands and 8 cities in Switzerland.”

3. One exception is Prior and Crofts’ (2015) analysis of the MSIC understood as a space of sanctuary.

4. The variation among states and territories regarding the provision of SIFs has also been apparent with NSPs, methadone maintenance treatment programmes and funding for drug user organisations in Australia.

5. These treaties comprise the Single Convention on Narcotic Drugs of 1961 as amended by the 1972 Protocol, the Convention on Psychotropic Substances of 1971, and the Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988.