SAFE INJECTING ROOMS

Implementation of Safe Injecting Rooms within Australia

Implementation of Safe Injecting Rooms within Australia

Introduction

The injection sites (CIS) are structures where injection drug users can inject drugs coming-of-way that provide safer and more hygienic environment, under the supervision of qualified personnel. Historically, the injection sites were created under the pressure of several phenomena: the amplification of drug injection (heroin or cocaine), the arrival of the AIDS epidemic and viral hepatitis C, the growing presence of drug in extreme social insecurity, often homeless and using drugs by injection in the public space. Currently, there are injection sites in 8 countries: Australia, Canada, Spain, Luxembourg, Norway, Netherlands and Switzerland. These centers serve the purpose of reducing risk and harm to drug users and the community in the areas of public health and public order.

Description and Analysis

All available studies on the subject show that these centers allow reaching and caring for high-risk users: which are homeless, with frequent use of injections in public, with a history of recent overdose, porters' infectious diseases, having failed in their addiction treatment. These centers are even more popular, they are close to meeting places. All centers evaluated, have demonstrated their capacity to ensure stable operation, ensuring good conditions of hygiene and safety for users and staff.

These centers have proven the other hand of the reduction of mortality and diseases associated with overdoses. They provide a quick and effective response in case of overdose. No fatal overdose was recorded in CIS, despite millions of injections, and several estimates of avoided fatal overdoses have been achieved. The CIS provide hygiene promotion injection (hand washing, disinfection), the provision of sterile equipment and also supervision of injection, sometimes teaching safer techniques. Studies clearly demonstrate a decrease in abscesses and other injection related diseases, reduced risk behaviors for transmission of the AIDS virus and hepatitis C (Loff 2000, 16).

There is no evidence that the presence of such centers increases or decreases in drug users or in the community or that it increases the relapse of drug users in treatment. Implementation costs and Operating CIS are important. On the other hand, two economists analyzes conducted on CIS in Vancouver and Sydney, have concluded that the opening of the CIS, by their effect on preventable fatal overdoses and the transmission of HIV can reduce the financial burden for the future society. That will be a potentially profitable investment.

In view of all these factors, the CIS can be considered as a complementary measure (not concurrent) to others in the range of services offered to users to meet the needs of specific risk reduction associated with the injection. They are a place of refuge (safety injection under hygienic conditions, ability to receive specific advice and instructions) and access to basic healthcare and to other services for users with very high risks. They are also used by users in treatment who have not (yet) have abandoned the injection. Expectations regarding CIS must be realistic and take into account the specificity and ...