Summary

In Australia, between 2012 and 2016 unintentional heroin deaths increased by more than 107%, far outstripping other opioid deaths that increased 20% over the same time period. Increased overdoses at Supervised Injecting Facilities were observed in recent years. Yet, it is not clear what is driving changes in opioid-related harms.

To understand rising opioid-related harms, there is a need for systems to gather timely information on changing opioid overdose patterns and risk factors, including the involvement of emerging drugs. This project will establish fixed-site drug checking and data monitoring to form a rapid overdose warning system that can feed into the emerging Prompt Response Network, and local communication networks.

Methods:

The proposed study will extend our established fentanyl surveillance study to:

  1. Co-design and embed procedures for monitoring for emerging substances into routine practice at supervised injecting facilities (SIFs)

  2. Extend existing urine monitoring to include laboratory confirmation for 234 novel psychoactive substances

  3. Conduct novel analysis to identify novel psychoactive substance implicated in overdoses from testing injecting equipment

  4. Analyse overdose trends and correlates

  5. Combine these data sources to feed into a co-designed protocol for rapid responses

Research questions:

  1. How can SIFs implement drug checking and contribute to early warning systems?

  2. Are there specific opioids and/or other emerging drugs that are contributing to overdoses, and if so, which?

Benefits:

We will establish and test timely information sharing systems with clinicians and end-users. The program will leverage the unique data that can be collected within supervised injecting facilities, with different approaches tested in practice to provide important feasibility data to support ongoing use so the benefits of this study extend beyond the life of the project.

Publications:
Infrequent detection of unintentional fentanyl use via urinalysis among people who regularly inject opioids in Sydney and Melbourne, Australia Read it here

Investigators

A/Prof Suzanne Nielsen, Principal Investigator

Monash University, UNSW Sydney, Burnet Institute and Turning Point

Ms Sarah Hiley, Chief Investigator Site coordinator for Melbourne MSIR

North Richmond Community Health

Ms Julie Latimer, Chief Investigator, Site coordinator for Sydney MSIC

Uniting Medically Supervised Injecting Centre

Dr Nico Clark, Chief Investigator

North Richmond Community Health, Melbourne University, Royal Melbourne Hospital

Dr Marianne Jauncey, Chief Investigator

Uniting Medically Supervised Injecting Centre, Conjoint Senior Lecturer, NDARC UNSW

Dr Monica Barratt, Chief Investigator

RMIT University

Dr Emma Tay, Chief Investigator

Western Sydney Local Health District

A/Prof Dimitri Gerostamoulos, Chief investigator

Victorian Institute of Forensic Medicine, Department of Forensic Medicine, Monash University

Ms Linda Glowacki, Chief Investigator

Victorian Institute of Forensic Medicine

Prof Claude Roux, Chief Investigator, Leading UTS team

University of Technology Sydney, UTS Centre for Forensic Science (Research Strength)

Dr Marie Morelato, Chief Investigator

University of Technology Sydney, UTS Centre for Forensic Science (Research Strength)

Ms Elodie Lefrancois, Chief investigator

University of Lausanne, Switzerland, Adjunct member of the UTS Centre for Forensic Science

Ms Tina Lam, Chief investigator

Monash University, National Drug Research Institute, Curtin University

Mr Michael Gilbert, Chief investigator

Independent consultant