Intended for healthcare professionals

Education And Debate

Supervised injecting centres

BMJ 2004; 328 doi: (Published 09 January 2004) Cite this as: BMJ 2004;328:100
  1. Nat M J Wright, general practitioner consultant in substance misuse and homelessness (,
  2. Charlotte N E Tompkins, research assistant2
  1. 1Centre for Research in Primary Care, Leeds, LS2 9PL
  2. 2North East Leeds Primary Care Trust, Leeds LS6 2HF
  1. Correspondence to: N M J Wright
  • Accepted 17 October 2003

Medically supervised injecting centres are “legally sanctioned and supervised facilities designed to reduce the health and public order problems associated with illegal injection drug use.”1 Their purpose is to enable the consumption of pre-obtained drugs under hygienic, low risk conditions (box).1 They differ from illegal “shooting galleries,” where users pay to inject on site.2 Worldwide, medically supervised injecting centres (also referred to as health rooms, supervised injecting rooms, drug consumption rooms, and safer injecting rooms or facilities) are receiving renewed attention. In 2001, the first medically supervised injecting centre in recent times was opened in Sydney, Australia. By 2002, there were 16 centres in five German cities,3 over 20 in the Netherlands, and some in Switzerland and Spain.4

The UK Home Affairs Select Committee recently recommended “that an evaluated pilot programme of safe injecting houses for heroin users is established without delay and that if this is successful, the programme is extended across the country.”5 However, the Home Secretary rejected this recommendation, stating that medically supervised injecting centres would be supported only as part of a heroin prescribing programme.5 We argue that this decision should be overturned.

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Supervised injecting centres enable the use of pre-obtained drugs under hygenic, low risk conditions


Functions of medically supervised injecting centres

  • Enable safe oversight by nursing staff of self injection of street drugs in an explicitly clinical setting. Does not entitle staff to help drug users inject drugs

  • Open from morning to late evening to accommodate drug users who inject up to three times a day

  • Full range of resuscitation equipment (including intramuscular naloxone) …

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