Three months after its launch, the first safe injection site in Sydney, Australia, was busier than expected, and none of the potential problems that had worried neighbourhood businesses had made an appearance. More than 800 users registered and 3200 injections took place at the centre during the first 3 months. Tony Trimingham, who heads a government-funded agency working on changes to Australia's drug laws, says he's “incredibly happy with it.” A call for similar facilities was made recently in Canada (CMAJ 2001;165[4]:436-7).
Drug users enter the inconspicuous storefront building, which has tinted windows, and complete a comprehensive questionnaire to register. They move on to an injection area, which can accommodate 16 drug users at once. Users stay an average of 20 minutes, and leave discreetly via a back entrance. About half of the users inject heroin; the rest use cocaine, methamphetamine and methadone. The staff — nurses and social workers — encourage users to take their time, since haste can cause vein damage.
General health care is also offered, particularly surrounding vein-related problems and sexual health. As well, 35 people have been revived in the centre's following drug overdoses. The centre has a medical director, and 2 additional doctors are available at a nearby facility. Several family physicians in the area informally refer patients to the site, which was endorsed by the Australian Medical Association during its planning stages.
Staff are allowed to advise on drug-injection techniques but are not allowed to help people inject. “Moderation, prevention and treatment are constant messages from the staff, posters and brochures,” says Trimingham, whose son died of a heroin overdose about 5 years ago. “The service, like needle programs, accepts drug use nonjudgementally, but there is no overt message that using [drugs] is recommended.” The project will be evaluated in 15 months.