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= Uniting Medically Supervised Injecting Centre =

The Uniting Medically Supervised Injecting Centre Kings Cross (also known as Uniting MSIC or Sydney Medically Supervised Injecting Centre) is a state government-supported facility in Kings Cross, New South Wales that provides safe injecting rooms, sterile equipment and medical supervision for individuals who wish to administer an illicit drug intravenously.

The centre, which opened in May 2001, was the first legal injecting site in Australia with the primary purpose of preventing the risk of injuries and death resulting from unsafe and unhygienic injecting practices.

As one of the first medically supervised injecting centres in the world, Uniting MSIC has received global attention for its successful reduction in drug-related emergencies.

As of 2016, the centre had successfully supervised over one million injections with no fatalities.

History
From the 1970s, Sydney saw a rapid growth in the availability and consumption of heroin. At the heart of the illegal drug trade scene was the inner-city suburb of Kings Cross, which was heavily affected by homelessness and the sex industry.

Throughout the 1990s, King Cross became home to an increasing amount of illegally operated shooting galleries leased by sex trade businesses. For a small fee, these 24-hour rooms provided the timed use of a space for drug users to consume drugs safely, away from the threat of police detection or other drug users and with the security of clean equipment and on-site employees who could intervene in the case of an overdose.

The 1997 Wood Royal Commission into police corruption in New South Wales led to a large majority of shooting galleries being closed down, having previously been operating under the blind-eye of local authorities. Despite this, the uncovering of these shooting galleries gave rise to a new interest in the value of supervised injecting sites for the management of public health and order.

After a long period of public and parliamentary debate between the years of 1996 and 1999, the NSW State Parliament passed legislation permitting the 18-month trial of a supervised injecting centre in 1999. Originally secured by the Sisters of Charity Health Service, who withdrew their proposal on advice from the Vatican, the NSW Government invited the Uniting Church of Australia to oversee the operation of such facility. With the highest number of drug overdoses in Australia and a majority support of residents and local government in favour of the establishment of a supervised injecting centre, the NSW Government recommended Kings Cross as the location for the trial centre.

On the 6th of May 2001, the Uniting Medically Supervised Injecting Centre was opened at 66 Darlinghurst Road, Kings Cross. The trial period of the injecting facility was extended three times in 2002, 2003 and 2007. Following clear longitudinal evidence of positive results from independent evaluation bodies such as KPMG, the NSW Parliament voted in favour of overturning the trial status of the Uniting Medically Supervised Injecting Centre. Legislation was passed on the 1st of November 2010 to officially permit the permanent legal licence for the operation of the centre.

Services


The Uniting Medically Supervised Injecting Centre offers supervision for a number of drugs including heroin, cocaine, methamphetamines and prescription pain medications such as oxycodone and morphine.

Clients move through three separated areas when visiting the centre; the waiting room and assessment area, the injecting room and the after care area. Staff first register the patient to understand their health history, what drugs they intend on consuming and to offer counsel on the risks of injecting. Once this is completed, clients proceed to injecting booths where they are provided with clean equipment and water to inject with. In cases where overdose occurs, staff in the injecting room are trained to use oxygen masks and administer naloxone to respond to the overdose. Once a client has safely intravenously consumed the drug, they proceed to the after care room where they can stay with the support of staff until they feel ready to return to the public through the back exit.

The centre provides a number of related medical services such as basic medical assessments and vein care. Health promotion in the form of both casual verbal exchanges and counselling forms a key part of the day-to-day operation of the centre and involves education around safe injecting techniques, sexual health, nutrition and liver health. On occasion, these will lead to staff issuing referrals to further services which include but are not limited to drug treatment programs, social services, housing support, mental health support, hospitals and legal centres.

Effectiveness
In a study by the National Centre in HIV Epidemiology and Clinical Research, 49% of users stated they would have injected in public had they not used the injecting centre. Against the current numbers at the time of the study, this revealed over 191 673 events of public drug consumption that had been successfully prevented.

There has been a positive response in clients' willingness to rehabilitative treatments with 16% of all clients receiving referrals on average per year. For 70% of clients, the Uniting MSIC is the first health service they have ever accessed.

Between 2001 and 2016, the centre had supervised over one million injections with no recorded fatalities and intervention only being required in less than 10% of interactions. The centre has contributed to a significant relief on local emergency services with early studies showing an 80% drop in the number of ambulance call-outs to the Kings Cross area.

Frequently updated research on crime in the area has continued to show no correlation between crime and the establishment of the injecting centre. In the first 6 years of operation, monthly publicly disposed needle and syringe counts revealed a 50% decrease in the Kings Cross area. Theft, robbery, loitering and drug use and supply offences have seen no marked increase or decrease that can be attributed to the centre.

The local community continues to support the Uniting Medically Supervised Injecting Centre with 73% of residents and business owners supporting the continued operation of the centre. In a 2005 study, a significant decrease was noted in both residents and business owners who had witnessed a public injecting within the last year.