Program Description

Overview:

The Sydney Medically Supervised Injecting Centre (MSIC) recognises that drug addiction is a chronic, relapsing condition. MSIC does not support or promote drug use; it simply acknowledges that it is a fact of life. We are a compassionate and pragmatic harm reduction service.

The MSIC supervises episodes of drug injecting that would otherwise happen elsewhere - often in public, and under inherently more dangerous conditions. Instead drug injection occurs in a health service under the supervision of registered nurses and counsellors/health education officers. There is immediate access to emergency medical care in the event of an overdose or adverse event. The professional staff are able to engage with users and facilitate effective referral to a variety of services, including specialist addiction treatment.

MSIC does not supply any drugs – the clients come to MSIC with pre-purchased drugs. MSIC does not support drug dealing – selling, buying or sharing drugs at MSIC is prohibited. Anyone engaging in any of these activities is removed from the premises. MSIC is responsible to both the NSW Department of Health and the New South Wales Police Force. The local police support the MSIC, and MSIC supports police efforts to reduce drug supply in Kings Cross.

MSIC’s funding comes from the Confiscated Proceeds of Illicit Activities Account, which is managed by the New South Wales Treasury.

Origins:

MSIC was an initiative of the 1999 New South Wales Drug Summit and is administered by UnitingCare, a Christian non-government organisation that provides a large number of health services in New South Wales.

After operating for nine and a half years on a trial basis, on the 27^th October 2010 the NSW Parliament passed legislation allowing for the continued operation of the MSIC. This legislation came into force on the 1^st November 2010.

Our vision:

A just, fair and compassionate society in which all people are treated with dignity and respect, enabled to live fulfilling lives, and have the opportunity to create and share in the community.

Our objectives

• Optimise health by saving lives and reducing injury from the negative effects associated with drug use
• Effective intervention in the event of drug overdose
• Provide access to health and social welfare services for a marginalised and difficult to reach population
• Uphold and promote the dignity of all people who use our service and promote awareness and understanding in the community
• Contribute to the amenity of the local community
• Contribute to the body of public health knowledge around injecting drug use

Outcomes:

Evidence shows that supervised injecting centres offer benefits to the individuals who use the service, as well as public health benefits for the local community. Evidence has shown that they do not lead to adverse community outcomes. MSIC has been independently evaluated since it opened in 2001, with all reports showing benefit. MSIC has also be shown to be a cost-effective initiative.

In the last ten years of successful operation, the MSIC has registered over 12,600 clients and has successfully managed more than 4,400 drug overdoses on site without a single fatality.

The number of publicly discarded needles and syringes has approximately halved in Kings Cross since MSIC opened.

There has been an 80% reduction in ambulance call-outs to the Kings Cross area since MSIC established.

Documented results show the majority of local injecting drug users have registered with MSIC, especially those most at risk. Nearly three quarters of all MSIC clients had not previously accessed the services in the local area for injecting drug users at registration. This shows that MSIC enhances access to necessary health and social welfare services.

There have been over 9,500 referrals made by MSIC staff. About half of these were for addiction treatment. About 40% of MSIC clients have never previously accessed addiction treatment services.

All clients are offered assistance and referrals. However the more often a person is seen at the MSIC, the more likely they are to accept a referral into treatment. Amongst those clients who we seen frequently, 80% have ultimately accepted a referral for addiction treatment. All of the other frequent attendees have had a referral offered to them, and almost all had agreed to a discussion at length about their situation with a staff member who outlined the benefits of treatment.

MSIC has provided a sensitive and timely early warning system with regards to drug trends, changes in purity and injecting risk behaviours. The MSIC environment also provides a unique opportunity to gain a better understanding of injecting practices and evolution of drug overdose.

Staff:

MSIC employs professional staff – both Registered Nurses and Health Education Officers. There are a minimum of three nurses and three Health Education Officers available at any one time. A full time Referral Co-ordinator is responsible for facilitating and coordinating referrals to a range of medical and social welfare services, including addiction treatment facilities. Referrals to drug treatment services increased 93% in the 12 months following the appointment of this Referral Coordinator in October 2004.