{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:36:45Z","timestamp":1783528605729,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T00:00:00Z","timestamp":1721347200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP 1173505"],"award-info":[{"award-number":["APP 1173505"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The Sydney Medically Supervised Injecting Centre provides a safe, non\u2010judgemental space where people can inject pre\u2010obtained substances under the supervision of trained staff. This article describes an unusual incident occurring at the Medically Supervised Injecting Centre in January 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>Two regular male clients attending the Medically Supervised Injecting Centre injected a substance they believed to be cocaine. Both clients experienced adverse reactions; one was transported to hospital, while the other became extremely distressed and agitated. Paraphernalia sent for testing returned a result of tiletamine (a dissociative used in veterinary medicine) and no cocaine, 30\u2009h after the incident.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>Where substances are novel or unknown, adverse events are often unexpected and may be more difficult to prepare for. Substance\u2010induced acute agitation can be alarming and hazardous for people consuming drugs and those around them and may pose challenges for staff. There is a substantial evidence base for the benefits of on\u2010site drug analysis and drug checking in reducing harms related to drug use, and in enhancing drug market monitoring. This incident was successfully managed by Medically Supervised Injecting Centre and hospital staff, with no major consequence, however clinical management could have been improved using point of care drug testing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.13909","type":"journal-article","created":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T12:40:28Z","timestamp":1721392828000},"page":"1592-1596","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The role of on\u2010site drug analysis within supervised injecting facilities: A case presentation of an adverse event highlighting need"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3115-6257","authenticated-orcid":false,"given":"Robert","family":"Page","sequence":"first","affiliation":[{"name":"Drug and Alcohol Services South Eastern Sydney Local Health District  Sydney Australia"},{"name":"Faculty of Medicine UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Jauncey","sequence":"additional","affiliation":[{"name":"Uniting Medically Supervised Injecting Centre  Sydney Australia"},{"name":"Discipline of Addiction Medicine, the Central Clinical School, Sydney Medical School, Faculty of Medicine and Health The University of Sydney  Sydney Australia"},{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Brett","sequence":"additional","affiliation":[{"name":"Drug Health Service St Vincent's Hospital Sydney  Sydney Australia"},{"name":"St Vincent's Clinical School, Faculty of Medicine UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Will","family":"Wood","sequence":"additional","affiliation":[{"name":"Uniting Medically Supervised Injecting Centre  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8609-0075","authenticated-orcid":false,"given":"Amanda","family":"Roxburgh","sequence":"additional","affiliation":[{"name":"Discipline of Addiction Medicine, the Central Clinical School, Sydney Medical School, Faculty of Medicine and Health The University of Sydney  Sydney Australia"},{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"},{"name":"Harm and Risk Reduction Burnet Institute  Melbourne Australia"},{"name":"Monash Addiction Research Centre Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2021.04.017"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-022-00655-z"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66475-6"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0003351"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62353-7"},{"key":"e_1_2_7_7_1","unstructured":"NCHECR.Sydney Medically Supervised Injecting Centre Evaluation Report No. 4: evaluation of service operation and overdose\u2010related events. 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