Suchergebnisse

The Sydney Medically Supervised Injecting Centre (MSIC) is the first supervised injecting facility (SIF) in Australia and the English-speaking world. It commenced operations in May 2001 as a trial to be independently evaluated. The MSIC was to be the only SIF in Sydney's Kings Cross, a "red-light" area where the drug-using population had previously injected in public or in illegal "shooting galleries" that had proliferated in nearby commercial sex premises since 1990. The aim of the MSIC is to reduce the public health and public order issues arising from unsupervised and public injecting at a local community level. A clinical service model was developed, which would maximize the number of injecting episodes accommodated in a professionally supervised setting and integrate with the other harm reduction services nearby. In its first two years of operation 4,719 registered IDUs made 88,324 visits to inject at the MSIC. There were 553 drug overdoses (81% heroin) managed on site, with no fatalities. Among 1,852 client referrals made for further assistance, 44% were for the treatment of drug dependence. This early experience suggests that the MSIC's clinical model has been acceptable to a significant number of the street-based drug injecting population in this setting.

This paper describes characteristics of clients registered in the first 12 months of the Sydney Medically Supervised Injecting Centre's (MSIC) operation, as well as predictors of frequent attendance. The study is based on information collected from clients at their initial registration and subsequent service utilization. Most of the 2,719 clients were male (71%), almost half had previously experienced at least one nonfatal heroin overdose, and one quarter had accessed formal drug treatment in the previous 12 months. Characteristics associated with frequent attendance at the MSIC were reporting previous attendance at the local primary health service for injection drug users (IDU), injecting drugs other than amphetamine, reporting sex work, injecting at least daily, and injecting in a public place in the month before registration.

INTRODUCTION AND AIMS: Take-home naloxone (THN) programs commenced in Australia in 2012 in the Australian Capital Territory and programs now operate in five Australian jurisdictions. The purpose of this paper is to record the progress of THN programs in Australia, to provide a resource for others wanting to start THN projects, and provide a tool for policy makers and others considering expansion of THN programs in this country and elsewhere. DESIGN AND METHODS: Key stakeholders with principal responsibility for identified THN programs operating in Australia provided descriptions of program development, implementation and characteristics. Short summaries of known THN programs from each jurisdiction are provided along with a table detailing program characteristics and outcomes. RESULTS: Data collected across current Australian THN programs suggest that to date over 2500 Australians at risk of overdose have been trained and provided naloxone. Evaluation data from four programs recorded 146 overdose reversals involving naloxone that was given by THN participants. DISCUSSION AND CONCLUSIONS: Peer drug user groups currently play a central role in the development, delivery and scale-up of THN in Australia. Health professionals who work with people who use illicit opioids are increasingly taking part as alcohol and other drug-related health agencies have recognised the opportunity for THN provision through interactions with their clients. Australia has made rapid progress in removing regulatory barriers to naloxone since the initiation of the first THN program in 2012. However, logistical and economic barriers remain and further work is needed to expand access to this life-saving medication. ; The Canberra THN evaluation was supported by funding from ACT Health. The Perth evaluation was funded by Mental Health Commission of WA (formerly the Drug and Alcohol Office of WA). The Melbourne THN evaluation was funded through the Centre for Research Excellence in Injecting Drug Use [NHMRC ID: GNT1001144] and the Victoria University Out-of-Cycle Collaborative Grants Scheme. Simon Lenton is supported by funding from the Australian Government under the Substance Misuse Prevention and Service Improvement Grants Fund through its core funding of the National Drug Research Institute.