Right: Kings Cross safe injecting facility; most business owners and residents approve of its existence and surveys have found that the centre has no impact on crime in the area. As well, the problem of discarded needles has halved.
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Background information
The information below is abbreviated from two sources. The Australian information is taken from the Australian Alcohol and Drug Foundation site. It can be accessed at
The European information comes from the Wikipedia entry titled 'Supervised injection site'. The Wikipedia entry also gives information about injection centres in Canada and the United States which is not included below. The full Wikipedia entry can be accessed at Medically Supervised Injection Centres (MSICs) in Australia
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. Australia currently has two MSICs, one in Kings Cross, Sydney, established in 2001 and one North Richmond, Melbourne, established in 2018. The Victorian government has indicated that it plans to establish a second MSIC in the state, in the City of Melbourne.
Benefits of MSICs
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.
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 screening, assessment and treatment initiation and monitoring of blood-borne viruses to approximately 300 people. 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.
Since the MSIC opened in 2001 through to June 2020, there have been more than 1 million injections supervised and more than 8500 overdoses managed without a fatality. 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. More than 14,500 referrals have been made, connecting clients to health, drug treatment and social welfare services. Among frequently attending clients, 80 percent have ultimately accepted a referral for treatment.
Impact on the local community
In 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.
In Kings Cross, the number of publicly discarded needles and syringes approximately halved after the centre opened, 70 percent of local businesses and 78 percent of local residents supported the centre's existence, and it was found that it had no impact on crime in the Kings Cross area.
Supervised injecting centres in Europe
The first professionally staffed service where drug injection was accepted emerged in the Netherlands during the early 1970s as part of the 'alternative youth service' provided by the St. Paul's church in Rotterdam. At its peak it had two centers that combined an informal meeting place with a drop-in center providing basic health care, food and a laundering service. One of the centers was also a pioneer in providing needle-exchange. Its purpose was to improve the psychosocial function and health of its clients. The centers received some support from law enforcement and local government officials, although they were not officially sanctioned until 1996.
The first modern supervised consumption site was opened in Berne, Switzerland in June, 1986. Part of a project combatting HIV, the general concept of the caf� was a place where simple meals and beverages would be served, and information on safe sex, safe drug use, condoms and clean needles provided. Social workers providing counselling and referrals were also present. An injection room was not originally conceived; however, drug users began to use the facility for this purpose, and this soon became the most attractive aspect of the caf�. After discussions with the police and legislature, the caf� was turned into the first legally sanctioned drug consumption facility provided that no one under the age of 18 was admitted.
During the 1990s additional legal facilities emerged in other cities in Switzerland, Germany and the Netherlands. In the first decade of 2000, facilities opened in Spain, Luxembourg, and Norway. At the beginning of 2009 there were 92 facilities operating in 61 cities, including 30 cities in the Netherlands, 16 cities in Germany and 8 cities in Switzerland. Denmark passed a law allowing municipalities to run "fix rooms" in 2012, and by the end of 2013 there were three open. However, some of the very rationale for the projects in Sydney and Vancouver are specifically to gather data, as they are created as scientific pilot projects. The approach at the centers is also more clinical in nature, as they provide supervision by staff equipped and trained to administer oxygen or naloxone in the case of a heroin or other opioid overdose.