TY - JOUR

T1 - The impact of medically supervised injection centres on drug-related harms: a meta-analysis

AU - May, Tom

AU - Bennett, Trevor

AU - Holloway, Katharine

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Background: Medically Supervised Injection Centres (MSICs) are legally-sanctioned facilities where users can consumepre-obtained drugs under medical supervision. Although there is a substantial body of research exploring their effectiveness, there have been few attempts to quantify outcomes across studies. In order to determine the impact of the body of research as a whole, outcomes from studies were synthesised using meta-analysis.Methods: Literature sources were identified through searches in four bibliographic databases. Inclusion in the final review was dependent on the study meeting certain eligibility criteria, including a minimum of pre-test, post-test, control group designs. Data were extracted and pooled in a meta-analysis using both fixed and random effects methods.Results: Eight studies met the inclusion criteria. Overall, MSICs had a significant, but small, positive effect on outcomes based on the fixed effect analysis and no effect based on random effect analysis. The results of the independent outcome analyses showed that MSICs had a significant favourable result in relation to drug-related crime and a significant unfavourable result in relation to problematic heroin use or injection. MSICs were foundto have no effect on overdose mortality or syringe/equipment sharing. Conclusion: Whilst the effectiveness of the early versions of MSICs remains uncertain, this should not rule out continuing to test and develop MSICs in locations where public injecting and other drug-related harms are a major problem. It is important, however, that evaluation research publishes replicable data to enable future meta-analyses and to expand the body of knowledge in the field.

AB - Background: Medically Supervised Injection Centres (MSICs) are legally-sanctioned facilities where users can consumepre-obtained drugs under medical supervision. Although there is a substantial body of research exploring their effectiveness, there have been few attempts to quantify outcomes across studies. In order to determine the impact of the body of research as a whole, outcomes from studies were synthesised using meta-analysis.Methods: Literature sources were identified through searches in four bibliographic databases. Inclusion in the final review was dependent on the study meeting certain eligibility criteria, including a minimum of pre-test, post-test, control group designs. Data were extracted and pooled in a meta-analysis using both fixed and random effects methods.Results: Eight studies met the inclusion criteria. Overall, MSICs had a significant, but small, positive effect on outcomes based on the fixed effect analysis and no effect based on random effect analysis. The results of the independent outcome analyses showed that MSICs had a significant favourable result in relation to drug-related crime and a significant unfavourable result in relation to problematic heroin use or injection. MSICs were foundto have no effect on overdose mortality or syringe/equipment sharing. Conclusion: Whilst the effectiveness of the early versions of MSICs remains uncertain, this should not rule out continuing to test and develop MSICs in locations where public injecting and other drug-related harms are a major problem. It is important, however, that evaluation research publishes replicable data to enable future meta-analyses and to expand the body of knowledge in the field.

KW - meta-analysis

KW - Medically supervised injecting centres

KW - Harm-reduction

KW - Heroin

KW - MSICs

KW - Drug Consumption Rooms (DCRs)

KW - Safe Injection Sites (SISs)

U2 - 10.1016/j.drugpo.2018.06.018

DO - 10.1016/j.drugpo.2018.06.018

M3 - Article

C2 - 30077946

VL - 59

SP - 98

EP - 107

JO - International Journal of Drug Policy

JF - International Journal of Drug Policy

SN - 0955-3959

IS - September 2018

ER -