Second Australian hydromorphone trial announced

The Victorian Government has announced plans to start Australia’s second trial of a hydromorphone injection clinic at a newly built community centre across from Flinders Street Station.
 
Studies out of Canada – the first country to trial a facility for the drug – have found that supervised hydromorphone injection is an effective way to improve treatment retention and reduce illicit drug use, incarceration, and criminal offenses.
 
The Melbourne facility will be the second of its kind in Australia, with a small, 22-person trial already up and running in Sydney.
 
Dr Hester Wilson, Chair of RACGP Specific Interests Addiction Medicine, told newsGP the Sydney pilot is specifically targeted at people for whom methadone had been ineffective.
 
‘[Methadone] doesn’t help them to stop using, it doesn’t help them to get stable and get their lives back on track,’ she said.
 
‘What they’ve done with that trial, and it really was a feasibility trial, is ask can it be done?’
 
Dr Wilson, who is a GP and addiction specialist, said the Sydney trial appears to have generated promising results.
 
‘They haven’t published on this yet, but the preliminary results are that it can be really useful for a small group of people and, for that group of people, engage them in treatment,’ she said.
 
Hydromorphone is a synthetic injectable opiate, similar to morphine and codeine, that can be prescribed for pain relief.
 
The Victorian Government announced its trial for hydromorphone as it dropped plans for a second safe injecting room.
 
Dr Wilson said there is strong evidence that treating chronic relapsing opioid dependence with structured and supervised opioid programs has multiple beneficial outcomes.
 
‘It’s very effective. It stops them from overdosing and dying, decreases blood-borne viruses, improves their mental health, improves their physical health, [and] improves their health outcomes,’ she said.
 
‘The reality is that if you are out on the streets trying to source heroin, you are doing that through the illicit market and you are at risk of harm.
 
‘Because it is expensive, people are forced to commit crimes in order to get that money potentially.
 
‘Whereas if you have access, you know that twice a day you’re going to go get your injection and you’ll be fine, you can just get on with your life.’
 
Dr Wilson said the treatment ideally occurs ‘in combination with counselling and psychological support’ aimed at helping people struggling with addiction to get their life back on track.
 
‘But even if you just have the medication, it does improve outcomes,’ she said.
 
‘It could really assist people to have access to evidence-based respectful care within a health setting and this is a group of people that would have experienced lots of stigma and discrimination in the past and found it really hard to access health services.
 
‘Being in a in a program like this, it is kind of meeting them where they are at and it has real potential.’
 
Although Dr Wilson is supportive of the Melbourne-based trial, she believes each government jurisdiction needs to look at the evidence and their own community to establish what is needed.
 
‘There are different realities in different jurisdictions in Australia,’ she said.
 
‘Other state governments and territories just need to look at the evidence, look at what’s happening in their communities.
 
‘It’s not going to be a blanket thing, it’s going to be potentially an approach for a small group of highly vulnerable people.’
 
The Flinders St facility is expected to open in 2026 at a cost of $36 million.
 
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