Victoria is eagerly anticipating a decision from the Victorian government concerning the location of a new Safe Injecting Facility in Melbourne's CBD. In February this year, an independent review panel published a comprehensive report documenting the North Richmond Medically Supervised Injection Room’s success in achieving its harm-reduction goals. By diligently monitoring drug consumption, not one of the 6000 overdoses inside the facility during its trial were fatal. In fact, there have been no overdose deaths in any injecting facility worldwide.

With a second facility in Melbourne imminent, we must ask who will miss out? 

There are around 4000 regular clients of the North Richmond MSIR, making it one of the busiest facilities in the world. CEO of Anglicare Victoria, Paul McDonald, says “this is not something to be proud of”. The 2022 Annual Overdose Report indicates that regional and rural Victoria exhibit higher rates of unintentional drug-induced deaths than Melbourne and warns that this gap is widening. The potential opening of a second facility is good news, but it’s not going to reach all Victorians.

Mobile safe injecting sites may offer us the solution. 

Mobile injecting rooms are vans or buses that are transformed into safe consumption facilities, allowing around 2 people at a time to use the service. Mobile MSIR present an innovative opportunity to increase the reach and accessibility of crucial harm-reduction services. Mobile MSIR have medical and social support staff on board to create a safe injecting environment, including the capacity to reverse the effects of heroin overdoses with naloxone. Mobile facilities also provide sterile injecting equipment to reduce the transmission of blood-borne viruses and clients can be screened for hepatitis-c and HIV and be diverted to treatment services if required. Aside from providing a safe injecting environment and public health services, MSIR act as entry points to vital harm-reduction services such as drug education, rehabilitation services and housing support. Having only one MSIR in Victoria means that access to these life-saving facilities is incredibly limited, leaving thousands of other vulnerable Victorians without access to life saving services. 

Mobile MSIR will not only save lives, but they will also save money.

By cutting ambulance call-outs for heroin overdoses by 56%, the North Richmond Centre reduced the financial strain on the local health care system. Additionally, Sydney’s consumption room costs an estimated $2.5 million to run each year. In contrast, the estimated costs for a mobile service would only be around $600’000 a year. Not only would these savings allow multiple mobile services to be run, but they would also give access to those outside of Melbourne who urgently need support. 

Bringing The Solution To The Problem 

Mobile MSIR can provide the same wrap-around services as standalone facilities on a smaller scale. While Australia promotes a commitment to harm minimisation as part of its National Drug Strategy, in many areas, we fall far behind other countries. These mobile services have already been trialled in Portugal, Berlin, Copenhagen, Barcelona and British Columbia and with successful results. Unlike standalone centres, mobile MSIR can be relocated on a weekly, daily or even hourly basis meaning more equitable access to these life-saving services. The mobility of these types of services also means that they can better respond to dynamic drug markets. Bringing solutions to the problem rather than the problem to the solution. Staff from Portugal's first mobile injection bus assert that in order to effectively reduce harm, services need to “meet people where they’re at”, fixed facilities simply cannot achieve this. 

Mobile MSIR may also alleviate community concerns of a ‘honey-pot’. There has been strong public opposition to a new injecting facility in the CBD due to fears of public safety and the impact on local businesses. The ability for these services to move means that drug users will not be concentrated in one area for a prolonged period of time, therefore erasing the ‘honey-pot’ issue. The idea of a mobile social service is not new, mobile services have already been used to provide access to healthcare and food services to vulnerable people across Australia. We need to use mobile models for safe injection to our advantage to get the public on board and to ensure more equitable access to all Victorians before it’s too late. 

We Must Act Now

The North Richmond facility can’t continue to carry the weight of Victoria's drug consumption. While the opening of a MSIR in Melbourne’s CBD is vital, the Victorian government must provide these crucial health services to all Victorians. Mobile MSIR provide a unique opportunity to reach Victorians who have been left behind. 

Drug prohibition in Australia has been an unmitigated disaster. Harm reduction services must be expanded to save the lives of vulnerable Victorians who are paying the price for the war on drugs. We need to get this thing on wheels.