Work

Initiation, cessation and resumption of attendance at the Melbourne supervised injecting room among a cohort of people who inject drugs

Year: 2026

Type: article

Abstract: • Half of the cohort initiated MSIR attendance during the study, indicating strong service uptake. Initiation rates exceeded cessation rates, with equal rates of cessation and resumption suggesting stable overall use. • MSIR attendance was more common among men, individuals with Aboriginal and/or Torres Strait Islander heritage, and those recently experiencing homelessness—groups often at higher risk of overdose and injection-related harm. • The service’s ability to engage clients with complex needs highlights its role in addressing health disparities and supporting people who may otherwise be underserved by traditional healthcare systems. • Participants prescribed opioid agonist therapy (OAT) were less likely to attend the MSIR frequently, likely reflecting lower injecting frequency and increased stability. Supervised injecting facilities (SIFs) reduce drug-related harms and associated costs, but evidence is limited to a few settings. This study estimates rates of initiation, cessation, and resumption of Melbourne’s Medically Supervised Injecting Room (MSIR) use among a cohort of people who inject drugs. Data were drawn from SuperMIX, an ongoing cohort study since 2008. Participants complete baseline and annual surveys, including MSIR use since its opening on 30 June 2018. We reported baseline characteristics and calculated incidence rates (IRs) of MSIR initiation, cessation, and resumption, stratified by recent homelessness and opiate agonist therapy (OAT) use, per 1000 person-years (PY). Of 1650 eligible participants, 685 (42%) reported MSIR use at baseline. MSIR attenders were slightly older (median 43 vs. 41 years) and less often female (28% vs. 35%) than non-attenders. Most (71%) were infrequent attenders (<50% injections at MSIR). Frequent attenders ( n = 202) injected more often (median monthly injections = 50) than infrequent (median = 30) and non-attenders (median = 20). The MSIR initiation rate was 525 per 1000 PY, similar between frequent and infrequent attenders (RR 1.10, 95% CI 0.94–1.28). The cessation rate was 264 per 1000 PY, with no difference between attendance groups (RR 1.11, 95% CI 0.60–2.04). The resumption rate was 250 per 1000 PY, also similar across infrequent and frequent attenders (RR 0.99, 95% CI 0.47–2.09). We found high MSIR service uptake, relative to cessation. Attendance was higher among men, Aboriginal and/or Torres Strait Islander people, and those recently homeless, with frequent attenders injecting more often and those on OAT less likely to attend frequently.

Source: International Journal of Drug Policy

DOI: 10.1016/j.drugpo.2026.105150