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Influenced by a harm reduction philosophy, the then Victorian Labor Government announced the establishment of the state's first medically supervised injecting room (MSIR) in North Richmond in late 2017. But, public and political opinion remains sharply divided as to the merits of the MSIR. One influence on policy development appears to be media commentary on the MSIR and the wider illicit drugs policy debate. This paper compares the official editorials of the two daily Melbourne newspapers, the Herald Sun and The Age regarding the MSIR, from November 2017 until November 2022. Based on 33 articles (Herald Sun, N = 28; The Age, N = 5), our findings identify philosophical differences between the two newspapers as reflected in their sources of information, language and highlighted issues. The Age was mostly supportive of both the introduction of the North Richmond MSIR and proposals for a second site. The Herald Sun's position was more ambiguous, ranging from qualified support for the North Richmond MSIR to strong opposition to further sites. [ABSTRACT FROM AUTHOR]

This paper uses data on the social context of drug-related harms in the Melbourne Aboriginal Community to inform an alternative model of harm minimisation, and discusses its potential application in programme development. The paper involves a secondary analysis of interviews and focus group discussions with 62 Community members who participated in a qualitative injecting drug use study conducted at the Victorian Aboriginal Health Service in Melbourne. Individuals and families within the Melbourne Aboriginal Community experience significant levels of harm associated with injecting drug use, and face restricted access to appropriate service options. This experience of drug use contributes to a broad range of values within the Community around harm minimisation approaches to programme delivery. We propose a fundamentally distinct harm minimisation model which explicitly acknowledges this range of conflicting values, and reflects the need for a breadth of services and programmes that address these tensions. Policies and funding must support Aboriginal Communities to negotiate through these conflicting Community values to actively create spaces in the service system for both using and non-using Community members. This includes the development of regional approaches which articulate an appropriate mix of services and the roles of Aboriginal and mainstream services in their delivery. [van der Sterren AE, Anderson IP, Thorpe LG. ‘Individual’ harms, Community ‘harms’: reconciling Indigenous values with drug harm minimisation . Drug Alcohol Rev 2006;25:219 – 225] [ABSTRACT FROM AUTHOR]

Introduction and Aims. In Australia, people who inject drugs (PWID) commonly report the use of benzodiazepines (BZDs). This paper explores the emerging use of alprazolam among PWID in Melbourne, Australia. Design and Methods. This study reports on 3 years of data collected through the Victorian Illicit Drug Reporting System (2008-2010). Structured interviews were conducted with 451 PWID and analysed using odds ratios and χ2-tests for trends over time. Results. While the proportion of PWID reporting recent BZD use remained stable over time, the proportion reporting alprazolam to be their most commonly used BZD fluctuated, peaking in 2009. Alprazolam users were significantly more likely to report using illicit BZDs and to report recent BZD injection compared with users of other BZDs. Alprazolam use was associated with the sale of drugs for cash, but not with other criminal activities. Discussion and Conclusion. The fluctuations in alprazolam use over time may be reflective of medical practitioners ceasing to prescribe alprazolam in response to reports of associated harms; however, this may in turn be driving the illicit alprazolam market. While the data do not indicate a clear association between alprazolam use and harms, considering the potential severity of associated harms and the association between alprazolam use and anterograde amnesia, patterns of alprazolam use among PWID should be closely monitored. Potential changes to prescribing practice should consider unintended consequences, such as replacement with other BZD types, or illicitly obtained BZDs.[Horyniak D, Reddel S, Quinn B, Dietze P. The use of alprazolam by people who inject drugs in Melbourne, Australia. Drug Alcohol Rev 2012;31:585-590] [ABSTRACT FROM AUTHOR]

Aims: To estimate incidence of post‐release injecting drug use (IDU) among men who injected drugs before imprisonment and determine factors associated with post‐release IDU frequency. Design, setting, participants: Prospective cohort study of men reporting monthly IDU before a period of sentenced imprisonment in Victoria, Australia, recruited between September 2014 and May 2016 (n = 195). Measurements: Any post‐release IDU and IDU frequency was measured via self‐report at 3‐month follow‐up interview. IDU frequency, measured over the preceding month, was categorised as no IDU, irregular IDU (1–4 days IDU) and regular IDU (≥5 days IDU). Incidence of any IDU was calculated at 3 months post‐release. Factors associated with IDU frequency were estimated using ordinal logistic regression. Findings Most (83%) participants reported post‐release IDU (265 per 100 person‐years, 95% CI, 227–309); with half (48%) reporting regular IDU, 23% irregular IDU and 29% no IDU in the month preceding follow‐up. Poorer psychological well‐being at follow‐up (General Health Questionnaire [GHQ‐12] score; adjusted odds ratio [AOR], 1.18; 95% CI, 1.07–1.29) and post‐release unemployment (AOR, 4.57; 95% CI, 1.67–12.49) were associated with increased IDU frequency. Retention in opioid agonist treatment (AOR, 0.49; 95% CI, 0.24–0.98) was associated with reduced IDU frequency. Non‐linear (inverted‐u) associations between IDU frequency and age (age: AOR, 1.51; 95% CI, 1.17–1.96; age‐squared: AOR, 0.99; 95% CI, 0.99–0.99) and pre‐imprisonment IDU frequency (pre‐imprisonment IDU frequency: AOR, 1.36; 95% CI, 1.15–1.61; pre‐imprisonment IDU frequency‐squared: AOR, 0.99; 95% CI, 0.99–0.99) were found, with odds peaking at age 39 and 19 days IDU, respectively. Longer baseline sentence length was associated with reduced odds of irregular and regular IDU (AOR, 0.99; 95% CI, 0.99–0.99). Conclusion: Among Australian men who inject drugs before imprisonment, resumption of injecting drug use after release from prison appears to be common, with imprisonment seeming to have little impact on reducing injecting drug use behaviour. [ABSTRACT FROM AUTHOR]

Most studies of injecting drug users (IDUs) have included only urban IDUs; information about rural IDUs is scarce. Recognizing this, the Victorian Injecting Drug Users Cohort Study (VICS) recruited IDUs from rural Victoria as well as Melbourne (population 3.2 million in 1995), capital city of the state of Victoria, Australia. Examination of data collected from IDUs living in M elbourne and the Western District (largest city: Warrnambool, pop. 27 734) revealed numerous differences in behaviour and serology. The primary drug for most Western District IDUs was amphetamines while Melbourne IDUs preferred heroin. Injecting and sharing frequencies were much lower in the rural sample. Hepatitis C antibody prevalence at first test was significantly higher in M elbourne IDUs, although this was clearly related to the difference in primary drugs; conversely, incidence among Western District amphetamine injectors was 16.2 per 100 person-years (py) (during 18.5 py), yet no conversions occurred in metropolitan amphetamine injectors in 29.8 py. Western District IDUs were less educated and more likely to be unemployed and of aboriginal descent than metropolitan IDUs. Variation between populations of Victorian IDUs has implications for the delivery of IDU-related health services; of particular concern is the possibility that hepatitis C has been spreading relatively rapidly among rural IDUs. \[Aitken C, Brough R, Crofts N. Injecting drug use and blood-borne viruses: a comparison of rural and urban Victoria, 1990-95. Drug alcohol Rev 1999;18:47-52]. [ABSTRACT FROM AUTHOR]