The role of a medically supervised injecting room in improving access to health and social services.

In June 2018 Melbourne’s first Medically Supervised Injecting Room was opened in a community health centre in the middle of a large public housing estate in North Richmond, an area which has for many years been the largest street heroin market in Australia. In addition to reducing overdoses, it was hoped the Injecting Room would improve access to health and social services for the people who used the facility. Consultations with people injecting drugs identified a desire for a 'one stop shop' with health and social services on-site, provided in a trauma-informed way.

Descriptive statistics of the characteristics of the clients, their health needs, the design of the on-site health services and their uptake of hepatitis, opioid pharmacotherapy and oral health services are presented. Descriptive outcome data are also presented.

In its first 3 and a half years of operation, more than 5800 individuals have used the service for a total of 286,000 visits, with 5000 overdoses successfully managed. 948 people have been screened for HCV, with 245 commencing treatment with DAAs, many initiating treatment on the same day. 444 people have commenced pharmacotherapy for opioid dependence on-site, the majority with long acting injectable buprenorphine, with good retention in treatment. Pre-COVID, 109 people had an oral health assessment, with 64 receiving initial treatment with a topical flouride solution and 108 referred to the oral health service in the community health centre. Clients of the service reported that accessing services in the injecting room reduces barriers to receiving care.

Our experience has shown that a medically supervised injecting room can function to improve access to health care for a marginalised population of people who inject drugs.