Reducing Risks – How do SIFs help?

Reducing Risk in Drug and Alcohol Misuse – Supervised Injecting Facilities how do SIFs help?

Saving lives by preventing overdoses

Trained staff supervise drug injecting that may otherwise happen in public places and under more dangerous conditions. When an overdose or other health issue occurs at a SIF, staff can give immediate emergency care, including the reversal of overdoses.

To date, there have been no reported deaths within SIFs around the world.^9,10,11,12

“Successful treatment and rehabilitation is only possible if someone is still alive. My son died in 1997, before the Uniting Medically Supervised Injecting Centre opened, and I will always wonder what may have been.”¹³

Tony Trimingham OAM, founder and CEO of Family Drug Support and author of ‘Not my family, never my child’.

Reducing harms associated with drug use

SIFs’ staff provide advice and education around safer and more hygienic injecting practices, as well as providing clients with clean equipment, reducing the chances of:

• blood-borne infections such as HIV or hepatitis C and other health issues associated with the use of non-sterile injecting equipment or needle sharing
• rushed injections, resulting in injured or damaged veins – rushed injections often happen in public places when someone is afraid of being seen
• injecting in public which is commonly associated with bacterial infection
• unsafe disposal of needles and syringes.^14-17

Providing pathways to support services

SIFs are well placed to recognise and respond to the complex needs of people who visit the centre.⁸

Staff are able to engage and build trust with people who use the service and can help them access a range of wrap-around support services, such as referrals to drug treatment, physical and mental health services and employment, housing and financial supports.^8,7,10,11

“The MSIR has helped me a lot. Not just because I am able to safely inject, but you guys talk to me and help me with all kinds of things. I can even have something to eat and drink. I really trust the staff, I’ve had a few very low moments and the staff here has really helped me”¹⁸

North Richmond MSIR client

Who uses SIFs?

SIFs attract some of the most vulnerable members of the community, with many attendees considered ‘high-risk’.

These attendees may come from more marginalised population groups, have a history of unsafe injecting practices, and might be experiencing complex social and mental health issues.^{8, 19, 20}

Clients attending a supervised injecting service in Germany reported histories of public injecting, imprisonment, sharing injecting equipment and unstable accommodation.^{21, 22}

A surveyed group of frequent attendees to the Sydney SIF found that 82% of them had a mental health diagnoses; 96% had a history of trauma; 54% had attempted suicide; and a third had a history of self-harm.²⁰

“Our centre reaches out to some of the most disengaged and disadvantaged members of our community who often live life on the street.”¹³

Dr Marianne Jauncey, Medical Director, Uniting Medically Supervised Injecting Centre (Sydney)

SIFs are a ‘low-threshold’ health service, meaning people can access full health care through them, even if they choose to continue using alcohol or other drugs.

Where a barrier to using other health care services can be the stigma experienced by clients ^23-25, SIFs are a safe, non-stigmatising space. People who attend report social acceptance, safety and refuge.^26-28

“I can’t really compare it to anything else, ’cause I’ve never really gotten any help anywhere else, other than there.”²⁹

Client of Insite, Vancouver’s injecting centre

There is growing evidence that SIFs can have a positive impact on:

• social connectedness and community
• emotional support and stress reduction
• safety and security
• current shelter status and search for housing
• health service access and use.²⁶

References
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