Overdose death: Coroner endorses injecting centre

The death by drug overdose of a 23-year-old man in the toilet of a Kings Cross hotel has led to a strong endorsement of the Medically Supervised Injecting Centre (MSIC) by the NSW Coroner.

Chance Mullins had a history of acute mental illness, and drug use and was on bail, convicted on armed robbery charges. The court had ordered him to attend the Salvation Army’s Endeavour Program in Morisset where he also attended Narcotics Anonymous meetings.

But after eight weeks on the program he left halfway through an NA meeting and caught a night train to Sydney, “clearly in breach of his bail” according to the Coroner.

The next morning at Oxford Street Post Office Mr Mullins picked up $300 his mother had wired to him and at 10.22am went to the MSIC to inject himself with drugs he had scored somewhere. There, he was refused entry on the basis that he was already intoxicated. This was backed up by a railway Transit Officer who had earlier seen him looking “shaky, sweaty and pale”.

MSIC guidelines exclude intoxicated people because they present a risk to themselves, staff and others if allowed into the injection facilities in Stage 2 of the Centre. Mr Mullins was spoken to in the Centre’s Counselling Room and advised of the risks of an overdose, but he left and went to a doctor seeking a prescription for Valium, claiming to be epileptic.

The doctor testified Mr Mullins did not appear intoxicated and he demonstrated credible knowledge of epilepsy. A call to the Doctor Shopper line revealed he was not listed. The prescription was issued and immediately filled at a nearby pharmacy.

However the Coroner criticised the doctor for failing to look up Mr Mullins’ online medical history, which would have shown that he had been refused Valium previously. He had also previously presented a forged doctor’s note to the same doctor. The matter had been dealt with by the Medical Board.

Mr Mullins then went to the MSIC where he was again refused entry. CCTV from The Crest Hotel showed him crossing the street from the MSIC. He entered the hotel, went to a toilet cubicle, injected himself, and was found dead at 2.30pm.

Valium and similar drugs increase the risk of a heroin overdose because both drugs suppress the nervous system, and someone accustomed to heroin may not realised the extent to which the milder drug is still active some time after a dose.

The Coroner found that Chance Mullins died of “multiple drug toxicity self-administered but without the intention of taking his own life”.

Mr Mullins had been registered with the MSIC since 2004 and had attended 232 times up until December 2006.

Mr Mullins’s mother submitted that the MSIC should adopt more interventionist protocols which may have saved her son’s life. But the Coroner defended the existing protocols, saying the MSIC “had got it right”.

The report notes that ambulance callouts for overdoses in Kings Cross had reduced by 80 per cent since the establishment of the MSIC, double the reduction seen in other parts of the state during the ‘heroin drought’. There was also a 50 per cent reduction in the number of syringes discarded in public in the area.

The report also notes that the Centre, after ten years’ operation and several independent reviews which endorse its record, was nevertheless still kept on a trial basis by the NSW government. While understanding the political difficulty of giving the Centre permanent status, the report concludes that “the evidence heard… is a powerful argument in favour of the MSIC being given permanency”.

Acting Medical Director of the MSIC Dr Hester Wilson agreed, saying evidence from numerous Australian and international experts is conclusive – the MSIC, which does not condone drug use, saves lives and gets people into drug treatment and off drugs.

However state Liberal Party policy is to close the centre, putting it in jeopardy if they win the next election.

by Michael Gormly