Medically supervised injecting centres save lives

The ADF supports the trial of a medically supervised injecting room (MSIR) in Melbourne’s CBD.

Initially, a MSIR was trialled for five years in North Richmond. And, the Victorian Government has now introduced legislation to make the North Richmond service ongoing.¹

Melbourne CBD medically supervised injecting room trial

Since opening in 2018, the North Richmond MSIR has safely managed over 7,049 overdoses and saved up to 63 lives.^2,3

In June 2020, an independent panel of experts recommended that a second MSIR be set up in the City of Melbourne.⁴ The government accepted this recommendation and an independent consultation and report on a MSIR CBD trial was recently completed.¹

It’s vital that overdose prevention services are located where there is need.

Between 2020-2022, more than one person per month has died of heroin overdoses in the City of Melbourne. This is the highest number of heroin deaths of any Victorian local government area.^5,6

And in recent years, heroin-related ambulance callouts in the City of Melbourne have increased by 28%.^6,7

A Melbourne CBD MSIR can play a vital role in:

• preventing overdose deaths
• reducing drug-related harm
• connecting people with vital health and social support services.

What is a medically supervised injecting room?

A MSIR is a safety-first, medical approach to reduce harm.

MSIRs are places where people can inject drugs under the supervision of medical staff and health professionals. They provide:

• onsite healthcare
• links to other health and social services - such as housing, alcohol and other drug treatment, legal, family violence, and mental health services
• immediate medical care in the event of an overdose.¹

MSIRs are also referred to as:

• medically supervised injecting centres (MSICs)
• overdose prevention centres
• safe injecting facilities
• supervised injecting facilities.

We know that these services can reduce deaths and health burdens, while limiting public injection litter.²

MSIRs provide a safer, non-judgemental environment for people to inject drugs, access emergency care and get sterile injecting equipment.

These services save lives, reduce drug harm, and link clients with critical health and social services.³

Results from North Richmond MSIR

Since the opening of North Richmond’s MSIR in 2018, there have been:

• over 391,335 visits to the centre
• 7,049 overdose events that were safely managed, with no overdose deaths
• up to 63 deaths prevented - around 16 lives saved each year
• more than 127,000 health and social support services provided onsite
• reduced ambulance attendances due to overdose
• reduced reports of public injecting in the North Richmond area.^2,4,3,8

The North Richmond MSIR has benefited from the Sydney Medically Supervised Injecting Centre’s (MSIC) 20+ years of experience. This has helped them set up processes, especially when it comes to treatment guidelines and data collection.⁴

But this success isn’t limited to Australia, there are dozens of centres worldwide making a positive difference, particularly across Europe and Canada.⁹

What are the impacts of MSIRs?

Reduce overdose deaths and harm

• North Richmond: Since 2018, the MSIR has seen over 391,355 visits, managed 7,049 overdoses, and saved up to 63 lives. ^8,3
• Sydney: Since the MSIC opened in 2001, it has seen over 17,960 clients, reversed nearly 11,000 overdoses without a death, and provided over 20,420 referrals to treatment and services.¹⁰

Improved access to education and support services

• North Richmond: Since 2018, more than 127,000 onsite health and social support services have been provided. Across 2020 – 2022 alone, there were 15,975 services provided by organisations like St Vincent’s Hospital and Launch Housing. A further 890 referrals have been made to community-based services such as homelessness support and general health care.²
• Sydney: There’s been over 20,420 accepted referrals to ongoing care and support for drug dependence, healthcare, and social welfare services.¹⁰

Reduce the demand on health services

• North Richmond: Since the MSIR began, there has been declining opioid overdose presentations at the closest public hospital’s emergency department (St Vincent’s Hospital). This trend has not been seen in other comparable hospitals (such as the Alfred and Royal Melbourne Hospitals). And ambulance attendance involving naloxone (used to reverse a heroin overdose) has reduced by almost 50% within 1km of the MSIR.²
• Sydney: Since opening, the centre has led to an estimated 80% reduction in ambulance call-outs in the local area.10 And the average monthly opioid-related emergency department presentations has reduced by 20%.¹¹

Reduce the spread of blood-borne viruses (BBV)

• North Richmond: Between July 2018 - June 2022, staff provided more than 22,500 health promotion services to support safe injecting practices. They also delivered over 950 BBV/sexually transmitted infection testing and treatment services to clients.²
• Sydney: MSIC clients report an increased knowledge of the risk of blood-borne viruses, and described behavioural changes that reflect safer injecting practices to minimise this risk. ¹¹

Reduce public and discarded injecting equipment

• North Richmond: There has been a partial reduction in public injecting. While discarded needles remain a problem, people who use the MSIR generally dispose of their needles appropriately on-site.²
• Sydney: The number of publicly discarded needles and syringes in Kings Cross almost halved when Uniting MSIC opened. There’s been a steady decline in publicly discarded needles since then, with the greatest reduction in areas closest to the centre.¹¹

Improved neighbourhood for residents and local businesses

• North Richmond: Some local residents have reported a quieter neighbourhood since the MSIR opened. But others have reported that discarded needles, congregation around the MSIR, and anti-social behaviour has negatively impacted their perception of safety. The 2023 Review of the Medically Supervised Injecting Room report found that this is likely a result from those who access Richmond’s longstanding drug market, not necessarily the MSIR. Some of the negative perceptions can also be attributed to raised local expectations that the MSIR would lead to an end to public injecting, rather than a reduction which has been seen.^2,4
• Sydney: In Sydney, 70% of local businesses and 78% of local residents support the centre and found that the centre has little impact on crime in the Kings Cross area.^11,12

The role of stigma

The North Richmond MSIR has been successful at saving lives. But, unlike other evidence-based health policies, they are often highly contested.² We know that people who inject drugs often experience intensified stigma, discrimination, and social exclusion. It’s important that we all work towards reducing this stigma as it can significantly prevent and delay access to healthcare, life and social services that all individuals need and are entitled to access.¹³

Stigma and discrimination are common and complex for people who experience drug dependence. For people who inject drugs, stigma is common in healthcare settings in Australia.¹⁴

Experiences of stigma and discrimination contribute to feelings of shame, rejection, and hopelessness.

A cycle is created where people avoid seeking help and support, only seek support when their needs are critical, and then experience repeated stigma and discrimination.

Non-judgmental spaces like MSIRs can help build trust in health and support services and connect clients with services they may not otherwise access. Learn more about why language matters through our Power of Words resource.