More medically-supervised injecting centres are needed across Australia to help prevent drug overdose deaths, safety advocates say.
Action is overdue and urgently required as dangerous synthetic opioids continue to be detected, Alcohol and Drug Foundation chief executive Erin Lalor says.
"Governments need to act now to stop future harms, including better access to the life-saving opioid overdose reversal drug, naloxone, as well as increased public drug checking services and overdose prevention services," Dr Lalor said.
Her calls come after Victoria recorded 547 fatal overdoses in 2023 - three fewer than the state's deadliest year on record in 2022 - according to an annual report released on Thursday by the Coroners Court.
About three quarters of overdose deaths occurred in metropolitan Melbourne, with a majority involving multiple drugs.
Diazepam, a sedative often used to treat anxiety, was the deadliest drug contributing to overdose deaths.
Heroin accounted for the second-highest number of deaths, but overall numbers decreased from 230 in 2022 to 204.
Methamphetamines were the third-highest contributor.
The City of Yarra, which hosts a medically supervised injecting room in North Richmond, recorded 19 deaths - five more than the previous year.
From July 2023 to June, the injecting facility had more than 98,000 visits and safely managed 1750 overdoses with no loss of life.
The Victorian Drugs and Alcohol Association said the data showed a clear need for more medically-supervised injecting centres in high-risk areas.
Chief executive Chris Christoforou said the growing adulteration of traditional illicit drugs with fentanyl and synthetic opioids "only increases the risk that fatal overdose numbers will grow".
Victorian State Coroner John Cain called for public health responses to be strengthened.
"Drug-related harms are complex and are driven by a variety of factors including changes in drug use, availability and regulation," he said.
The report found men were twice as likely to die from overdoses, and people aged 35 to 54 were most at risk.
More than 35,000 injections were administered at Sydney's medically supervised injecting centre in 2023/24, which recorded almost 400 overdoses and no deaths.
But overdose deaths continue to occur across NSW, the facility's medical director Marianne Jauncey said.
She called for supervised drug injection to be co-located at needle syringe services across the state.
“If some of these existing services had the resources and capacity for a small space that could supervise drug use, and thus prevent overdose death, they should be allowed to try it out," Dr Jauncey said.
Victorian Premier Jacinta Allan in April ruled out a second injecting centre in Melbourne, instead investing $95 million in health measures, a position she reiterated on Thursday.
Victorian festival-goers will be able to test drugs for potentially deadly chemicals as soon as this summer during an 18-month pill-testing trial.
NSW has been urged to adopt pill-testing after two people recently died and two others were hospitalised from heroin overdoses after using what they believed was cocaine at a Sydney party.
Overdose deaths will be discussed at a NSW drug summit in December, modelled a 1999 event that was critical to the nation's first supervised injecting room.
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