Conceptual medical abstract, rainbow coloured. Binary code and wave lengths. Credit: AdobeStock

The supervised injecting room cohort study (SIRX)

The challenge

The Melbourne Supervised Injecting Room (MSIR) opened in North Richmond in July 2018. The second such service to open in Australia, it has since become one of the busiest in the world. However, these services remain controversial because of the limited evidence on effectiveness collected to date, resulting in ongoing opposition from some community members. Our study will test the hypothesis that frequent, high-coverage MISR use will reduce harms to clients across a range of outcome measures, including mortality and non-fatal overdose, directly relevant to the legislated aims of these facilities.

The project

Supervised injecting facilities (SIFs) are designed to reduce the harms associated with injecting drugs use. The Supervised Injecting Room Cohort Study (SIRX), aims to provide new evidence of the effectiveness, including cost-effectiveness, of SIFs through evaluation of the MSIR. In partnership with the Victorian Department of Health and North Richmond Community Health, the project will provide new evidence of the effectiveness of the MSIR facilities through the establishment of SIRX, a new cohort study of people who inject drugs who use the MSIR.

The method

The SIRX design involves two prospective cohort studies: 1) new recruits to the Melbourne Injecting Drug User Cohort Study (SuperMIX; established in 2008) and 2) the SIRX-Registration cohort (SIRX-R; established in 2023), a cohort of MSIR clients who consent to a once-off behavioural survey and record linkage to administrative databases. Linkage involves retrospective and prospective data for primary and tertiary healthcare services, criminal justice contacts, and mortality. SuperMIX will provide a control group who do not use the MSIR. Analyses will measure outcome incidence (e.g. non-fatal overdoses attended by ambulance) by intensity of MSIR exposure after adjusting for potential confounders.

The impact

We anticipate that the study will provide the evidence needed to inform debate about MSIRs and that our design will deliver the strongest evidence in a strong partnership approach within a timeframe that will inform ongoing policy and practice around supervised injecting facilities over the coming decade.

Project collaborators