June 2008

In light of the decision of the NSW Government to continue to support the trial of the Medically Supervised Injecting Centre (MSIC) in Sydney, the Australian National Council on Drugs (ANCD) recently revisited its position on MSIC. As a result it makes the following observations and conclusions:

• The Kings Cross area of Sydney presents a unique set of community circumstances with the need to improve public amenity and increase access pathways to treatment making the availability of a supervised injecting centre an appropriate option for community consideration;
• Whilst the ANCD recognises the importance of prevention, education and treatment in addressing drug issues, we also recognise the importance of measures that reduce the harm to injecting drug users, their families and the wider community. We must accept that despite our best efforts as a community to prevent the uptake of drug use the reality remains that some people will engage and continue to engage in injecting drug use. The most humane and compassionate response to this reality is to try and ensure the range of potential harms caused by this activity are reduced – this is noted as being a clear goal of MSIC;
• Accordingly, the ANCD has and will continue to support and advocate for initiatives that reduce overdoses, save lives, reduce the risk of HIV, and other blood borne infections and diseases, and lead to improvements in community safety and well being;
• The ANCD acknowledges that Australia has developed and implemented one of the most comprehensive responses to minimise the HIV rate amongst injecting drug users, as evidenced by the success of the needle and syringe program and peer based interventions. In order to continue this successful process it is important that Australia continue to trial and rigorously evaluate innovative program approaches designed to maintain and potentially even further minimise the risk of HIV and other blood borne infections and diseases;
• The ANCD also recognises the complexity of evaluating the impact of a single facility such as the MSIC, especially within the context of changes in the availability and usage patterns of various illicit drugs. Nonetheless the evaluations undertaken by the MSIC Evaluation Committee of the MSIC and its outcomes have indicated a benefit to the individual clients and the wider community, although the difficulty in quantifying these benefits warrants further investigation;
• The ANCD hopes that further evaluations will collect evidence on the effectiveness of the MSIC including a focus on the current model’s capacity to engage with, and where appropriate, refer clients to other health and welfare services, including drug treatment agencies;
• The ANCD recognises the decision of the NSW Government to continue to operate the MSIC as a trial and believes that whilst all programs should be subject to ongoing review and evaluation, including cost analysis it is important to also provide some certainty of tenure for programs;
• Whilst there is a majority of support amongst ANCD members for the current MSIC, the ANCD also has members that cannot support MSIC because of a view that such centres either present a legislative dilemma with regard to possession and use of illicit substances; can give a perception to the community that drug use is condoned; or they believe that there are more efficient ways to engage those clients targeted by the MSIC.

Finally, the ANCD again wish to acknowledge the independent nature of the evaluations and commended both the evaluation team and the staff of the MSIC for their work in this difficult area.

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