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Supervised drug injecting room trial considered a success

BMJ 2003; 327 doi: (Published 17 July 2003) Cite this as: BMJ 2003;327:122
  1. Bob Burton
  1. Canberra

    An evaluation report into an 18 month trial of Australia's first medically supervised injecting centre has cleared the way for the continuation of the $A2.4m (£1m; $US1.6m; €1.4m) a year project.

    The 233 page evaluation found that from May 2001 to October 2002, 3810 registered individuals made 56861 visits to the centre. A total of 409 incidents of drug overdose were recorded—including 329 from heroin and 60 from cocaine—though none were fatal.

    The report estimates that at least four lives were saved as a result of the proximity of users to medical staff. The report was prepared by the evaluation committee headed by John Kaldor, professor of epidemiology and deputy director of the national centre of HIV epidemiology at the University of New South Wales.

    The establishment of a supervised injecting centre followed a drug summit in May 1999 hosted by the New South Wales government. The summit canvassed options for reducing the impact of drugs on society and users. After a protracted debate—and an unsuccessful legal challenge from the local business community—the centre opened in May 2001 (BMJ 2001;323:532) in Kings Cross, a district in inner city Sydney long associated with gambling, prostitution, and drugs.

    The government approved the trial in the hope that it may “decrease overdose deaths, provide a gateway to treatment, reduce the problem of discarded needles and users injecting in public places.”

    The evaluation found that the injecting centre made 1385 referrals to drug treatment services “especially amongst frequent attenders” and that there was no negative effect on the community nor any evidence of an increase in crime. Support for the centre among local residents rose from 68% to 78% during the trial period.

    Launching the report, the special minister of state for New South Wales, John Della Bosca, backed the continuation of the centre beyond its legislated end date of 30 October 2003. “The centre did save lives; there was no ‘honey pot’ effect detected, no increase in crime or drug related loitering in the Kings Cross precinct,” he said.

    Draft legislation will be introduced in September to make the injecting rooms permanent. The New South Wales branch of the Green party—one of the parties holding the balance of power in the upper house—are advocating that centres be established outside Sydney.

    The report has not persuaded the Australian prime minister, John Howard. “I've never supported heroin trials and I've never supported heroin injecting rooms, and this government never will,” he said.

    The Australian Capital Territory's government has indicated that it too will now consider establishing a medically supervised injecting room.

    The Sydney trial is one of only 59 equivalent drug consumption centres operating in 33 cities in Germany, Switzerland, the Netherlands, and Spain.

    Final Report of the Evaluation of the Sydney Medically Supervised Injecting Centre is available at

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