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Medically supervised injecting centres should be piloted in the UK

Supervised injecting centres, BMJ Vol 328, pp 100-102


A programme of medically supervised injecting centres should be piloted in the UK, as part of an integrated public health strategy, say the authors of an article in this week's BMJ.

Injecting centres - "designed to reduce the health and public order problems associated with illegal injection drug use" - have been set up in Australia, Germany, and the Netherlands, and a pilot programme for the UK was recently recommended by the Home Affairs Select Committee. Home Secretary David Blunkett rejected this advice however - a decision which should now be reconsidered say the article's authors, as fresh evidence has emerged from an Australian pilot study regarding the effectiveness of such initiatives.

Medically supervised injecting centres allow drug users to inject 'street drugs' in a clinical environment, with resuscitation equipment and nursing staff on hand in case of overdose or other complications. Trained staff can offer safer injecting advice - including help to move away from intravenous drug use - but are not permitted to assist users with injecting.

The article's authors argue that pilot studies in other countries have shown positive results. An eighteen-month project in Sydney, Australia showed that clients attending the centre were more likely to start treatment for their addiction, and half the users reported their injecting practices had become less risky. Local residents and businesses complained of fewer sightings of public drug injecting, and discarded syringe counts dropped.

Criticisms that such centres promote drug use is not supported by the evidence, say the article's authors. Similar charges were levelled at needle exchange programmes in the 1980s - a strategy which has been shown to improve public health. The Home Secretary's support of a different initiative - prescribable heroin centres - in preference to injecting centres should now be reconsidered, say the authors, since they are largely appropriate only for long term heroin addicts. Medically supervised injecting centres are targeted instead at homeless and socially excluded drug users, and are an essential part of a successful public health strategy.


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