{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:35:26Z","timestamp":1773009326622,"version":"3.50.1"},"reference-count":69,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The Uniting Medically Supervised Injecting Centre (MSIC) in Sydney (Australia) provides a supervised space for people to inject pre\u2010obtained drugs. We investigated injecting patterns among clients over time and the impact on overdose risk and client behaviours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      MSIC holds information on visit\u2010specific drug injected, overdose, and sanctions for disruptive behaviour. Data for May 2001 to December 2024 were analysed. Where amphetamines or opioids were injected, the study record was marked accordingly. Data were aggregated to an annual visit summary and drug categorised into\n                      <jats:italic>Annual drug visits<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the study period the proportion of amphetamine injections increased from 2% to 7% between 2002 and 2011 to 50.1% in 2024 (Kendall's tau\u2009=\u20090.6,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The proportion of clients who exclusively inject amphetamines on\u2010site has significantly increased from 8.9% in 2001 to 43.9% in 2024 (Kendall's tau\u2009=\u20090.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), as has the proportion injecting both amphetamines and opioids (5.6% in 2001 to 33.2% in 2024) (Kendall's tau\u2009=\u20090.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). People who inject both opioids and amphetamines had a lower likelihood of overdose compared to those who injected exclusively opioids (adjusted OR 0.64 (95% CI 0.54, 0.75);\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Incidents of challenging behaviour appear unrelated to amphetamine injection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>There has been an increase in amphetamine injection at MSIC, with the most frequent service attenders most likely to report injecting both opioids and amphetamines. There has been no parallel increase in disruptive behaviour. Those exclusively injecting amphetamines do not attend the service frequently. Strategies to support opportunistic intervention are clearly warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70099","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T04:26:04Z","timestamp":1770697564000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changing Drug Consumption Patterns Among Clients Attending the Medically Supervised Injecting Centre, Sydney: Implications for Service Provision and Harm Reduction Response"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3051-9765","authenticated-orcid":false,"given":"Mark","family":"Bartlett","sequence":"first","affiliation":[{"name":"Uniting Medically Supervised Injecting Centre  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"Jauncey","sequence":"additional","affiliation":[{"name":"Uniting Medically Supervised Injecting Centre  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8995-9386","authenticated-orcid":false,"given":"Michael","family":"Livingston","sequence":"additional","affiliation":[{"name":"Harm and Risk Reduction Burnet Institute  Melbourne Australia"},{"name":"National Drug Research Institute Curtin University  Perth Australia"},{"name":"Centre for Alcohol Policy Research La Trobe University  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8609-0075","authenticated-orcid":false,"given":"Amanda","family":"Roxburgh","sequence":"additional","affiliation":[{"name":"Harm and Risk Reduction Burnet Institute  Melbourne Australia"},{"name":"National Drug and Alcohol Research Centre UNSW Sydney  Sydney Australia"},{"name":"Specialty of Addiction Medicine, Central Clinical School, Sydney Medical School, Faculty of Medicine and Health The University of Sydney  Sydney Australia"},{"name":"Monash Addiction Research Centre Monash University  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Australian Drug Trends 2022: Key Findings from the National Illicit Drug Reporting System (IDRS) Interviews","author":"Sutherland R.","year":"2022"},{"key":"e_1_2_10_3_1","first-page":"1.e1","article-title":"Estimating the Number of Regular and Dependent Methamphetamine Users in Australia, 2002\u20132014","volume":"153","author":"Degenhardt L.","year":"2016","journal-title":"Medical Journal of Australia"},{"key":"e_1_2_10_4_1","volume-title":"Australian Drug Trends 2023: Key Findings from the National Illicit Drug Reporting System (IDRS) Interviews","author":"Sutherland R.","year":"2023"},{"key":"e_1_2_10_5_1","volume-title":"Australia's Illicit Drug Problem: Challenges and Opportunities for Law Enforcement. 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