June 22, 2020
Medically supervised injecting centres save lives
The Alcohol and Drug Foundation welcomes the recent Victorian Government announcement that the Medically Supervised Injecting Centre (MSIC) trial in North Richmond will be extended for a further three years.
This decision is in line with evidence that the trial is saving lives and helping people who are experiencing a dependence on drugs.
In conjunction with this announcement, the ADF is also pleased to hear that the government has decided to establish a second MSIC site in the City of Melbourne, to further reduce drug-related harm in the community.
What are MSICS?
Medically Supervised Injecting Centres (MSICs) are places where people inject drugs, such as heroin or methamphetamine (ice), under the supervision of medical staff and health professionals. MSICs are also referred to as supervised injecting facilities, drug consumption rooms, injecting rooms, or safe injecting facilities.
The opening of the new centre means that Australia will have three MSICS nationally, including the location in Kings Cross, Sydney, which opened in 2001.
While acknowledging that injecting drugs is not considered 'safe', MSICs allow for a safer environment for people to inject drugs, access emergency care (if required) and obtain sterile injecting equipment. These centres also offer broader health services and pathways into rehabilitation, treatment, and other essential services.
What can MSICs achieve?
Reduce health problems arising from drug use such as managing overdoses, reducing risk of blood-borne viruses, reducing infections and health issues associated with the use of non-sterile equipment.
- North Richmond: Over an 18 month period, it was estimated that the North Richmond Centre was accessed by 119,000 people, successfully managed 3,200 overdoses, saved an estimated 21 to 27 lives, and provided important screening, assessment and treatment initiation and monitoring of blood-borne viruses to approximately 300 people.1
- Sydney: Since the MSIC opened in 2001, there has been more than 1 million injections supervised and more than 8500 overdoses managed without a single fatality.2 In a 2010 report, current clients reported an increase in knowledge of the risk of spread of blood-borne viruses and described behavioural changes that reflect safer injecting practices to minimise this risk.3
Improved access to education and support services inclusive of social, health and therapeutic services as well as education around blood testing, hygiene practices and ways to reduce risks.
- North Richmond: Staff provided 10,540 services beyond the supervision of injecting during the trial period. This was most commonly health promotion, dressing wounds, providing medication and first aid. It also provided social welfare needs, mental health, counselling and family violence support.1
- Sydney: More than 14,500 referrals have been made, connecting clients to health, drug treatment and social welfare services. Among frequently attending clients, 80% have ultimately accepted a referral for treatment.2
Reduce impact and trauma on the greater community who may witness public drug use and overdose.
- North Richmond: There has been a decrease in local community reports of witnessing public injecting.1
- Sydney: Of residents surveyed during 2010, 27% reported seeing public injecting in the past month compared to 55% in 2000.3
Reduce public nuisance associated with an open scene including crime reduction, loitering and discarded drug paraphernalia.
- North Richmond: Community perceptions around seeing discarded needles and syringes and other drug-related paraphernalia did not change. There were anecdotal reports of increased crime, and during the trial period support for the centre reduced.1 However, along with the recent extension of the trial period, the Victorian Government also announced a $9 million investment to undertake neighbourhood renewal and improve the area around the North Richmond facility to alleviate concerns.5
- Sydney: The number of publicly discarded needles and syringes approximately halved after the centre opened, 70% of local businesses and 78% of local residents supported the centre’s existence and it was found that it had no impact on crime in the Kings Cross area.4
Reduce health costs associated with drug use including a reduction of new HIV/hepatitis cases and reduced burden on emergency services.
- North Richmond: Ambulance Victoria data showed a trend towards a reduction in ambulance attendances after the centre opened, but there were no observable changes in emergency department presentations.1
- Sydney: The number of ambulance call-outs to Kings Cross dropped by approximately 80% after the centre opened,2 and the average monthly emergency department presentations that were opioid-related fell by 20% post-MSIC.3
International success of injecting centres
The success of MSICs is not limited to Australia.
The first centre was opened in Switzerland in the 1980s. There are now dozens of centres worldwide – the majority of these are in European countries including Germany, Spain, the Netherlands, Norway, Luxembourg, and Denmark. Canada has also seen a significant national expansion of centres.
In operation since 2003, evaluations have demonstrated that this MSIC led to:
- 35% reduction in fatal overdoses in nearby areas6
- 30% increase in the use of detox services and an increase in people getting addiction treatment7
- Observable changes in public order including a reduction in public drug use and public syringe disposal.7
MSICs may initially seem like a confronting prospect, but evidence has consistently demonstrated that they are a crucial harm reduction strategy that helps people with a dependence, reduces drug-related harm in communities, provides relief to our health care system and saves lives.
- Medically Supervised Injecting Room Review Panel. Review of the Medically Supervised Injecting Room. Melbourne: Victorian Government; 2020.
- Uniting. Uniting Medically Supervised Injecting Centre 2020 [cited 2020 June 16].
- KPMG. Further evaluation of the Medically Supervised Injecting Centre during its extended Trial period (2007-2011). NSW Health; 2010.
- International Network of Drug Consumption Rooms. Australia - overview; 2015 [cited 2020 June 16].
- Victorian Government. Saving And Rebuilding Lives From Drug Addiction; 2020 [cited 2020 16 June].
- Marshall BDL, Milloy MJ, Wood E, Montaner JSG, Kerr T. Reduction in overdose mortality after the opening of North America's first medically supervised safer injecting facility: a retrospective population-based study. The Lancet. 2011;377(9775):1429-37.
- Wood E, Tyndall MW, Montaner JS, Kerr T. Summary of findings from the evaluation of a pilot medically supervised safer injecting facility. Canadian Medical Association Journal. 2006;175(11):1399.