Medically supervised injecting centres are facilities in which people can inject drugs under the supervision of medical staff including registered nurses and health professionals.
Where an overdose or health issue arises, staff are able to treat the person, providing immediate access to emergency medical care.
This provides a safe environment where harm is significantly reduced, noting that drug injecting would otherwise often occur in public and under dangerous conditions.
However, they are only available in two locations in Australia. These locations are in North Richmond, Victoria (referred to as a ‘Medically Supervised Injecting Room’) which opened in 2018 and in Kings Cross, New South Wales which opened in 2001.
In Sydney, the Medically Supervised Injecting Centre (‘MSIC’) is located at 66 Darlinghurst Rd, Potts Point, across the street from Kings Cross Station.
It has supervised over 1.26 million injections and managed 11,205 overdoses. It has been able to offer 22,000 referrals to ongoing care and support accepted by people attending the centre.
Notably, no fatalities have occurred.
The aims of the service are to prevent people dying from drug overdoses as well as connecting people with support, as well as access to health and social welfare services.
It is funded by the NSW Government through the Confiscated Proceeds of Crime Account.
The process of people attending the centre is as follows:
- A person will attend the centre, and complete the registration process if they have not previously attended which involves a discussion regarding their health and drug use history,
- The person will be asked what drug they brought in, when the last time they used a drug of that class, and whether there is anything that may increase their risk of overdose,
- The person will then be led into the drug injecting section and be given clean injecting equipment to inject their drugs with.
The layout of MSIC essentially involves three sections – being the reception, drug injecting space, and ‘aftercare’ space in which people can choose to sit and relax, or talk with staff about services including housing, legal, social welfare, drug treatment and rehabilitation, before exiting.
In the injecting room, there are eight open booths that can seat two people. It contains waste bins for used equipment as well as a resuscitation room in the event of a drug overdose or other health emergency.
No appointment is required, and visitors can remain anonymous.
The joint Responsible Authorities of MSIC are the Commissioner of NSW Police and the Secretary of the Ministry of Health which hold oversight responsibility over its operation and function.
MSIC is able to operate due to specific legislation which makes its functions legal.
This is contained in Part 2A of the Drug Misuse and Trafficking Act 1985 (NSW).
It provides the centre with a license to operate, and exemption from criminal liability for users of the licensed injecting centre.
All staff directly supervising injecting activities in the centre must be qualified health professionals.
The centre is required to contain or have satisfactory access to services including:
- Primary health care services (such as medical consultation and assessment services),
- Drug and alcohol counselling, detoxification, and rehabilitation services,
- Services of a methadone provider,
- Services for testing for blood-borne and sexually transmissible diseases, and
- Needle and syringe exchange program.
As per section 36N, it is not unlawful for a person at a licensed injecting centre to:
- Be in possession of a prohibited drug,
- Possess equipment for use in the administration of a prohibited drug, or
- To administer or attempt to administer to themself a prohibited drug.
However, it is required to be a small quantity of a prohibited drug, and the person is not permitted to be in possession of it for the purpose of supply.
For example, the ‘small quantity’ of heroin, morphine, amphetamine, cocaine is 1 gram, whereas it is 2.5 grams for oxycodone.
It also prescribes that it is not unlawful for a person to engage, participate or otherwise be involved in the conduct of a licensed injecting centre.
Those excluded from using the service include minors, women who are known to be pregnant or who are obviously pregnant, people accompanied by a child, those who are intoxicated and people who are not already an injecting drug user.
Police are encouraged to utilise their discretion not to charge people for drug possession of a small quantity if they are in the vicinity of, or travelling to and from, the service.
Due to MSIC’s connection to the Commissioner of NSW Police, this is largely observed, with junior police officers often taken on tours of the centre to understand its purpose and aims.
The legislation currently restricts the number of supervised injecting facilities in NSW to one, with the licence specifying that it must be located at its current premise.
There have been various recommendations that this current restriction be removed to allow for additional supervised injecting facilities where there was a need, however no action has been taken.