While officials in the US—and the UK where I live—debate the introduction of safe consumption spaces (SCS), it’s important to remember that about 120 of these sites already operate legally in about 12 countries around the world. Many have existed for years. They save lives, reduce the spread of disease, reduce public costs and bring many other benefits.
One place where SCS operate is Australia. In 2018 I visited the country and had the opportunity to take a series of photographs at the long-running SCS in Sydney and the newly opened site in Melbourne. Part of the collection was recently exhibited at the Harm Reduction International conference in Portugal.
I present these photographs in the hope that by demystifying SCS and the vital work that happens inside them, we can accelerate their spread in countries where people who use drugs don’t yet have access.
Sydney Medically Supervised Injection Centre
The front street view of the Sydney Medically Supervised Injecting Centre (MSIC), which opened in 2001. People using the center enter through reception, use their drugs in the injecting booths and then stay for a while—often having a hot drink and a chat with staff in the rest area before leaving through the rear of the building.
The main injecting area at the Sydney MSIC has a number of booths with nursing and support staff on hand. When this image was taken the centre was having a promotion about the overdose reversal medication naloxone.
One of the MSIC staff cleaning down a booth for the next person. The contrast between how clean the area is compared with places I’ve seen people street-injecting is huge.
The Photograph Not Taken
The photograph I didn’t take showed people being supported to find veins by nursing staff, people able to calmly inject without worrying about police or others stopping them, and even a couple who chatted about their day while preparing their shot. But because of the stigma faced every day by people who use drugs that’s not a photo I’m comfortable sharing—so this will have to stand in its place until I can.
Waiting to Wipe Down
Tui Hull from the Sydney MSIC waiting for a booth to be empty so it can be fully cleaned before the next person uses it. This minimizes risks of accidental blood-borne virus and bacterial infections.
The Sydney MSIC provides a pill crusher and disposable bags for crushing pills in, to help with the preparation of pills for injection.
MSIC Recovery Room
The Sydney Medically Supervised Injecting Centre has an area just off the main injecting room for assisting people who overdose on the premises. People are given naloxone and/or oxygen as needed, and nurses are on hand to monitor people. No one has died of an overdose in the center since it opened 18 years ago.
Staff at the MSIC observe people while they use their drugs, and provide medical assistance or advice if needed. This provides an important safety net—one that’s not available to someone injecting alone on the street. The staff I met all approached the role in an open and non-judgemental way.
Spoons given in for disposal after drug preparation.
Responding to an Overdose
Many people overdose at the MSIC, but no one has died. Every staff member has a clear role to play during an overdose. Without the MSIC, the woman in this photo—and many others—would likely have died. This photograph is deliberately taken in a way to minimize any identifying details.
Melbourne Medically Supervised Injecting Room
The Melbourne Medically Supervised Injecting Room (MSIR) opened in 2018. At the time these photographs were taken it was situated within a medical center.
Injecting booths at the Melbourne MSIR. Although the center had only just opened and was still building trust with the local community of people who use drugs, the booths were soon in heavy use.
Nico is the medical director at the Melbourne MSIR. This photo was taken as he returned from responding (successfully) to an overdose in a local car park.
At its most basic, a drug consumption room is a safe, clean space to use drugs and minimize the risk of dying of an overdose. It doesn’t take much: a clean surface, some naloxone and people who care enough if someone lives or dies.
People who use the project are encouraged to give feedback so services can constantly improve.
MSIR Recovery Room
If someone overdoses they will be given medical assistance, naloxone and/or oxygen as needed.
All photographs by Nigel Brunsdon / NigelBrunsdon.com.