NCJ Number
204895
Date Published
2003
Length
233 pages
Annotation
This report presents the methodology and findings of a process, outcome, and economic evaluation for a pilot medically supervised injecting center (MSIC) in New South Wales, which is a legally sanctioned health and social welfare facility that provides for the hygienic injection of pre-obtained drugs under professional supervision in a nonjudgmental environment.
Abstract
The purpose of the MSIC is to reduce the mortality and morbidity associated with drug overdoses; reduce the public nuisance associated with public drug use, intoxication, and discarded injecting equipment; reduce blood borne virus risk behavior; and serve as an access point for drug treatment, health care, and social welfare assistance. In addition to determining whether or not the implementation of the MSIC in King Cross (the pilot site) complied with the mandates of the enabling law, the outcome evaluation focused on the likely effect of the MSIC on criminal activity. Three types of offenses were considered: crimes committed to fund the purchase of illicit drugs, illicit drug transactions, and the use of illicit drugs in public. The evaluation also focused on the economic impact of the MSIC. The parameters of the evaluation were largely designed to address the arguments pertinent to the potential positive and negative impacts of a MSIC as presented to the Parliamentary Committee and later to the New South Wales Drug Summit. The evaluation concludes that the operation of the MSIC in the King Cross area is feasible. The MSIC also made service contact with its target population, including many who had no prior treatment for drug dependence; however, there was no detectable change in heroin overdoses at the community level. A small number of opioid overdoses managed at the MSIC might have been fatal had they occurred elsewhere. The MSIC made referrals for drug treatment, especially for frequent attenders at the center. There was no increase in the risk of blood borne virus transmission, and there was no overall loss of public amenity. Neither was there an increase in crime. The majority of the community accepted the presence of the MSIC. Overall, the evaluation concludes that the MSIC has afforded an opportunity for improving knowledge that can guide public health responses to drug injecting and its harms. It is recommended that if the MSIC continue as a service delivery model that it be continually monitored to determine the drugs injected, overdoses managed, morbidity averted, and referrals made to treatment. Some research recommendations are also offered. 77 tables, 49 figures, and appended MSIC service model, MSIC initial set-up costs, MSIC set-up costs since opening, and operating costs May 1, 2001, to April 30, 2002