Supervised injecting room linked to dramatic fall in heroin callouts

The introduction of a medically supervised injecting room (MSIR) in Melbourne has resulted in a 71% drop in heroin-related ambulance attendances over five years, new research has found.
 
First opened in 2018 in North Richmond, the facility provides a supervised health setting for drug users, with immediate medical care available in the event of an overdose. It also connects patients with health and social support services including mental health care, drug treatment, wound care and housing support.
 
The injecting room services the inner-city suburbs of Richmond and Abbotsford, which have historically been key areas of heroin use in Melbourne and have experienced high rates of overdose and associated harms.
 
To measure its impact, a study published in the International Journal of Drug Policy assessed changes in heroin-related ambulance attendances, including overdose events, within the MSIR’s catchment area before and after its opening.
 
Before opening, there were 48 heroin-related ambulance attendances per month, but this dropped to 14 by the end of the study period in 2023.
 
This ‘significant and sustained reduction’ represents a drop of about 71% in the five years after the facility opened, the researchers wrote.
 
They also found the decline in heroin-related ambulance call outs in the injecting room catchment was greater than in surrounding Melbourne and broader Victoria regions.
 
Associate Professor Marguerite Tracy, Deputy Chair RACGP Specific Interests Addiction Medicine, said this research adds to existing knowledge on the important role the centres play in healthcare, and puts forward a case for increased services to support people wherever they live and use drugs.
 
‘They keep people alive and offer additional services and support for people who inject drugs,’ she told newsGP. 
 
‘Medically supervised injecting places are highly effective in improving the health and reducing adverse health outcomes for people who inject drugs.
 
‘What the research showed though was that it was a local effect. It is not only Richmond and inner Sydney where people inject drugs so these services need to be expanded so that others can be afforded the benefits.’
 
Undertaken by Monash University and Turning Point, data was collected by the National Ambulance Surveillance System, which is a long-standing, population-level monitoring system for acute alcohol and other drug-related harms.
 
Senior Research Fellow at Turning Point and Monash University, Associate Professor Bosco Rowland, said the findings provide the strongest Australian evidence to date that supervised injecting facilities reduce acute heroin-related harms at a population level.
 
‘Before the MSIR opened, heroin-related ambulance attendances in the Richmond and Abbotsford area were the highest in Victoria and increasing. After it opened, we saw a significant shift to a sustained declining trend,’ he said.
 
‘Importantly, we didn’t see the same scale of reduction in central Melbourne or across the rest of Victoria, which strengthens the case that the MSIR itself is driving the change.’
 
Professor Dan Lubman, Executive Clinical Director of Turning Point, said the findings reinforced the critical role of harm reduction services in reducing pressure on emergency services.
 
‘This research shows that the MSIR is not only saving lives inside the facility – it is reducing the burden of heroin-related emergencies on ambulance services in the surrounding community,’ he said.
 
‘These are real-world outcomes captured over nine years of ambulance data. The evidence is clear that the MSIR is delivering measurable public health benefits for the local community.’
 
Associate Professor Tracy added that centres like this also provide take home naloxone which can reverse the effects of an opioid overdose, although an ambulance is still required as the effect can wear off.
 
‘Take home naloxone is also available for free at drug health services and many pharmacies and is very easy to learn to use,’ she said.
 
‘People from across our community use substances and we should be striving to make this as safe as possible for everyone – our family, friends, co-workers and community.’
 
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