{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:02:57Z","timestamp":1781071377313,"version":"3.54.1"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In January 2023, following a 20-year ban, the New South Wales (NSW) Needle and Syringe Program (NSP) Guidelines permitted NSPs to provide winged infusion sets (\u2018butterflies\u2019) and larger-volume syringes (\u2018barrels\u2019) commonly used for injecting methadone liquid intravenously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach<\/jats:title>\n                    <jats:p>The Kirketon Road Centre (KRC) integrated the distribution of \u2018butterflies and barrels\u2019 (referred to as \u2018butterfly packs\u2019) into its service delivery in April 2023 and developed resources in collaboration with the Uniting Medically Supervised Injecting Centre (MSIC) and the NSW Users and AIDS Association (NUAA). This case report presents an audit of service delivery and self-reported client outcomes following the introduction of \u2018butterfly packs\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Since April 2023, KRC has been consistently supplying \u2018barrels\u2019 and \u2018butterflies\u2019 to clients who inject methadone. The proportion of NSP visits by clients who reported methadone as the last drug injected increased significantly after the program\u2019s introduction (from 2.2 to 4.0 methadone-related attendances per month), and so did the amount of corresponding injecting equipment and verbal education sessions. Among 18 survey respondents, the majority reported improved health or safety since accessing butterfly packs (89%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Equipment for intravenous methadone administration can be safely and efficiently distributed by NSP programs. Access to harm reduction services should be based on vulnerability and need, with services tailored accordingly. The policy reversal allowing \u2018butterflies and barrels\u2019 and service innovations such as KRC\u2019s program have addressed a longstanding gap, advancing equity in harm reduction for people who inject methadone in NSW.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1741947","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T05:40:10Z","timestamp":1781070010000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Reintroduction of winged infusion sets to needle syringe programs - advancing equity in harm reduction"],"prefix":"10.3389","volume":"17","author":[{"given":"Caroline","family":"James","sequence":"first","affiliation":[{"name":"Kirketon Road Centre, South Eastern Sydney Local Health District","place":["Sydney, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vendula","family":"Belackova","sequence":"additional","affiliation":[{"name":"Kirketon Road Centre, South Eastern Sydney Local Health District","place":["Sydney, NSW, Australia"]},{"name":"Social Policy Research Centre, Faculty of Arts and Architecture, University of New South Wales (UNSW)","place":["Sydney NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Machin","sequence":"additional","affiliation":[{"name":"Kirketon Road Centre, South Eastern Sydney Local Health District","place":["Sydney, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Thackeray","sequence":"additional","affiliation":[{"name":"Kirketon Road Centre, South Eastern Sydney Local Health District","place":["Sydney, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louisa","family":"Jansen","sequence":"additional","affiliation":[{"name":"Kirketon Road Centre, South Eastern Sydney Local Health District","place":["Sydney, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Resiak","sequence":"additional","affiliation":[{"name":"Kirketon Road Centre, South Eastern Sydney Local Health District","place":["Sydney, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Hutchinson","sequence":"additional","affiliation":[{"name":"Kirketon Road Centre, South Eastern Sydney Local Health District","place":["Sydney, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Anderson","sequence":"additional","affiliation":[{"name":"Kirketon Road Centre, South Eastern Sydney Local Health District","place":["Sydney, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Rich","sequence":"additional","affiliation":[{"name":"Kirketon Road Centre, South Eastern Sydney Local Health District","place":["Sydney, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Read","sequence":"additional","affiliation":[{"name":"Kirketon Road Centre, South Eastern Sydney Local Health District","place":["Sydney, NSW, Australia"]},{"name":"The Kirby Institute, University of New South Wales (UNSW) Australia","place":["Sydney, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.1999.94811757.x","article-title":"Methadone injecting in Australia: a tale of two cities","volume":"94","author":"Lintzeris","year":"1999","journal-title":"Addiction"},{"key":"B2","volume-title":"Methadone Injection in New South Wales","author":"Southgate","year":"2001"},{"key":"B3","article-title":"What are the reasons for injecting methadone? 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