Injecting drug use in Melbourne: SuperMIX cohort study

Open to students

SuperMIX is the largest and longest-running active cohort study of people who inject drugs in Australia, with over 1500 participants.

Since 2008, we have surveyed people who inject drugs in the Melbourne and the Greater Geelong region to:

understand rates of mortality, poor mental health, overdose, bloodborne virus (BBV) infections, injecting-related injuries and diseases (IRIDs), and chronic diseases such as chronic obstructive pulmonary disease (COPD)
determine the effectiveness of existing and new health programs like drug treatment, take-home naloxone (THN) and supervised injecting facilities (SIFs). The goal is to improve health and help people stop usings drugs in the long-term
evaluate the impacts of structural factors (like homelessness and imprisonment) on health outcomes.

A cohort study is a research method where scientists follow a group of people over time to see how certain things, like habits or exposures, affect their health.

SuperMIX provides important information on how injecting drug use evolves over time. People in the study complete follow-up interviews once a year. They also consent to linking their past and future data to administrative health and social datasets.

SuperMIX is part of a broader study called MIXMAX. This combines SuperMIX with VMAX—a study collecting data on methamphetamine use over time—to become the largest active cohort study of people who use drugs in Australia.

Our impact

SuperMIX has informed state government alcohol and other drug treatment services, including reviews of the Medically Supervised Injecting Room Trial. The project has also contributed to systematic reviews and international collaborative studies:

About the study

The SuperMIX study runs from a mobile van which visits different health services around Melbourne. Participants usually complete an interview in person with a researcher and have blood taken to test for blood borne viruses. Between 2020 and 2022, researchers switched to phone interviews due to the COVID-19 pandemic.

In August 2022:

5,530 surveys were completed
1,328 participants completed a baseline interview
28 was the average age of participants at baseline interview
participants were involved in the study for 8.6 years on average
the average number of follow up surveys was 4.2.

Participant location

Participants are located all around Victoria. The following chart provides a breakdown of participant locations as at August 2022.

Accessible Pie Chart

The pie chart shows the percentage of study participants located in different areas of Victoria. Footscray has the highest percentage (38%), while Geelong has the lowest (1%). Other regions are represented as follows: North Richmond (19%), Frankston (16%), Central Business District (10%), Inner north (7%), St Kilda (6%), and Dandenong (5%).

Student opportunities

View 56 more

Social networks of people who use drugs

Help us understand the characteristics study participant social networks. Investigate the influence of these characteristics on drug-related risk behaviours and harms, including cessation from and relapse into drug use, and overdose.

Open to

Masters by research
PhD
Honours
Masters by coursework

Supervisors

Contact

Tobacco/nicotine harm reduction among people with a history of illicit drug use

Quantitative research including:

analysis of trends in prevalence of daily tobacco use, quantity of cigarettes smoked daily, and/or vape use
analysis of longitudinal changes in individual smoking behaviours
estimation of incidence of tobacco-related chronic disease hospital admissions.

Open to

Masters by research
Honours

Vacancies

Supervisors

Contact

Measuring risk and health outcomes among women who use drugs

Qualitative and quantitative research, including:

conducting in-depth interviews with study participants to better understand their experiences as people who inject drugs
analysis of longitudinal survey data, characterising and assessing its suitability to understand behavioural risk and health outcomes among women.

Open to

Honours
Masters by research

Vacancies

Supervisors

Contact

Understanding the needs of women who inject drugs

Qualitative and quantitative research, or mixed methods research including:

conducting in-depth interviews with women of the SuperMIX study, to better understand their gendered experiences as people who inject drugs
analysis of longitudinal SuperMIX survey data to characterise the qualitative research sample and/or understand and compare differences between selected variables (experiences) of men/women.

Open to

Honours
Masters by research

Supervisors

Contact

Key publications

20 Oct 2021

Cohort Profile: The Melbourne Injecting Drug User Cohort Study (SuperMIX)

International Journal of Epidemiology

Daniel O’Keefe, Wijnand van den Boom, Maria del Mar Quiroga, Dhanya Kumar, Penny Hill, Nick Scott, Paul A. Agius, Peter Higgs, Lisa Maher, Matthew Hickman

17 Jun 2022

Mortality in the SuperMIX cohort of people who inject drugs in Melbourne, Australia: a prospective observational study

Addiction

Penny Hill, Mark Stoové, Paul A. Agius, Lisa Maher, Paul Dietze

30 Jan 2023

Comprehensive needle and syringe program and opioid agonist therapy reduce HIV and hepatitis c virus acquisition among people who inject drugs in different settings: A pooled analysis of emulated trials

Addiction

Daniela K van Santen, Paul Dietze, Wijnand van den Boom

Other publications

01 Jun 2023

Incidence of HIV and hepatitis C virus among people who inject drugs, and associations with age and sex or gender: a global systematic review and meta-analysis.

The Lancet Gastroenterology and Hepatology

Artenie A, Stone J, Fraser H, Stewart D, Arum C, Lim AG, McNaughton AL, Trickey A, Ward Z, Abramovitz D

29 Jan 2023

Comprehensive needle and syringe program and opioid agonist therapy reduce HIV and hepatitis c virus acquisition among people who inject drugs in different settings: a pooled analysis of emulated trials.

Addiction

van Santen DK, Lodi S, Dietze P, van den Boom W, Hayashi K, Dong H, Cui Z, Maher L, Hickman M, Boyd A

23 Jan 2023

Does sexuality matter? A cross-sectional study of drug use, social injecting, and access to injection-specific care among men who inject drugs in Melbourne, Australia.

Harm reduction journal

Schroeder SE, Wilkinson AL, O'Keefe D, Bourne A, Doyle JS, Hellard M, Dietze P, Pedrana A

14 Dec 2022

Trust and service engagement among people who inject drugs after release from prison.

The International journal on drug policy

Lafferty L, Schroeder S, Marshall AD, Drysdale K, Higgs P, Stoové M, Baldry E, Dietze P, Treloar C

24 Jun 2022

Mortality in the SuperMIX cohort of people who inject drugs in Melbourne, Australia: a prospective observational study.

Addiction (Abingdon, England)

Hill PL, Stoové M, Agius PA, Maher L, Hickman M, Crawford S, Dietze P

14 Jun 2022

Cohort Profile: The Melbourne Injecting Drug User Cohort Study (SuperMIX).

International journal of epidemiology

Van Den Boom W, Quiroga MDM, O'Keefe D, Kumar D, Hill PL, Scott N, Agius PA, Higgs P, Kerr T, Maher L

07 Jan 2022

"It's a revolving door": Ego-depletion among prisoners with injecting drug use histories as a barrier to post-release success.

The International journal on drug policy

Schroeder SE, Drysdale K, Lafferty L, Baldry E, Marshall AD, Higgs P, Dietze P, Stoove M, Treloar C

27 Dec 2021

Barriers to women's disclosure of and treatment for substance use during pregnancy: A qualitative study.

Women and birth : journal of the Australian College of Midwives

Oni HT, Drake JA, Dietze P, Higgs P, Islam MM

10 Oct 2021

The association between depression and oral health related quality of life in people who inject drugs.

Drug and alcohol dependence

Abdelsalam S, Van Den Boom W, Higgs P, Dietze P, Erbas B

26 Mar 2021

Homelessness, unstable housing, and risk of HIV and hepatitis C virus acquisition among people who inject drugs: a systematic review and meta-analysis.

The Lancet. Public health

Arum C, Fraser H, Artenie AA, Bivegete S, Trickey A, Alary M, Astemborski J, Iversen J, Lim AG, MacGregor L

06 Jan 2021

Sex Discrepancies in the Protective Effect of Opioid Agonist Therapy on Incident Hepatitis C Infection.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Geddes L, Iversen J, Wand H, Esmaeili A, Tsui J, Hellard M, Dore G, Grebely J, Dietze P, Bruneau J

17 May 2021

The Melbourne Safe Injecting Room Attracted People Most in Need of Its Service.

American journal of preventive medicine

Van Den Boom W, Del Mar Quiroga M, Fetene DM, Agius PA, Higgs PG, Maher L, Hickman M, Stoové MA, Dietze PM

18 Feb 2021

The impact of Victoria's real time prescription monitoring system (SafeScript) in a cohort of people who inject drugs.

The Medical journal of Australia

Fetene DM, Higgs P, Nielsen S, Djordjevic F, Dietze P

27 Aug 2020

Prevalence and correlates of simultaneous, multiple substance injection (co-injection) among people who inject drugs in Melbourne, Australia.

Addiction (Abingdon, England)

Palmer A, Higgs P, Scott N, Agius P, Maher L, Dietze P

05 Feb 2020

Blood donation amongst people who inject drugs in Australia: research supporting policy change.

Vox sanguinis

Quinn B, Pearson R, Cutts J, Seed C, Scott N, Hoad V, Dietze P, Wilson D, Maher L, Thompson A

06 Nov 2019

Assessing individual-level needle and syringe coverage parameters and the measurement of coverage in Melbourne, Australia: methods and impacts.

Journal of public health (Oxford, England)

O'Keefe D, Scott N, Aitken C, Dietze P

30 Sep 2019

The Effect of Female Sex on Hepatitis C Incidence Among People Who Inject Drugs: Results From the International Multicohort InC3 Collaborative.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Esmaeili A, Mirzazadeh A, Morris MD, Hajarizadeh B, Sacks HS, Maher L, Grebely J, Kim AY, Lauer G, Cox AL

14 Dec 2018

Geo-spatial analysis of individual-level needle and syringe coverage in Melbourne, Australia.

PloS one

O'Keefe D, Wilkinson A, Aitken C, Dietze P

05 Dec 2018

Drug overdose in the ED: a record linkage study examining emergency department ICD-10 coding practices in a cohort of people who inject drugs.

BMC health services research

Di Rico R, Nambiar D, Stoové M, Dietze P

28 Nov 2018

"I'm obviously not dying so it's not something I need to sort out today": Considering hepatitis C treatment in the era of direct acting antivirals.

Infection, disease & health

Wright C, Cogger S, Hsieh K, Goutzamanis S, Hellard M, Higgs P

29 Oct 2018

Incarceration history and risk of HIV and hepatitis C virus acquisition among people who inject drugs: a systematic review and meta-analysis.

The Lancet. Infectious diseases

Stone J, Fraser H, Lim AG, Walker JG, Ward Z, MacGregor L, Trickey A, Abbott S, Strathdee SA, Abramovitz D

22 Aug 2018

Analysis of time of drug use according to needle and syringe program operating hours in Melbourne, Australia: Effects on individual-level needle and syringe coverage.

Drug and alcohol dependence

O'Keefe D, Aitken C, Scott N, Dietze P

02 Aug 2018

Should sterile needle and syringe wastage be included within individual-level needle and syringe coverage measures?

The International journal on drug policy

Daniel O, Campbell A, Paul D

02 Apr 2018

Experiences of liver health related uncertainty and self-reported stress among people who inject drugs living with hepatitis C virus: a qualitative study.

BMC infectious diseases

Goutzamanis S, Doyle JS, Thompson A, Dietze P, Hellard M, Higgs P, TAP study group

16 Oct 2017

Are People Who Inject Drugs Frequent Users of Emergency Department Services? A Cohort Study (2008-2013).

Substance use & misuse

Nambiar D, Spelman T, Stoové M, Dietze P

29 Sep 2017

The Association between Intentional Overdose and Same-Sex Sexual Intercourse in a Cohort of People who Inject Drugs in Melbourne, Australia.

Substance use & misuse

O'Keefe D, Bowring A, Aitken C, Dietze P

18 Aug 2017

A prospective cohort study of hospital separations among people who inject drugs in Australia: 2008-2013.

BMJ open

Nambiar D, Stoové M, Hickman M, Dietze P

13 May 2017

Frequent emergency department presentations among people who inject drugs: A record linkage study.

The International journal on drug policy

Nambiar D, Stoové M, Dietze P

08 Dec 2016

The effects of needle-sharing and opioid substitution therapy on incidence of hepatitis C virus infection and reinfection in people who inject drugs.

Epidemiology and infection

Aitken CK, Agius PA, Higgs PG, Stoové MA, Bowden DS, Dietze PM

11 Sep 2016

Longitudinal changes in psychological distress in a cohort of people who inject drugs in Melbourne, Australia.

Drug and alcohol dependence

Scott N, Carrotte ER, Higgs P, Cogger S, Stoové MA, Aitken CK, Dietze PM

09 Dec 2015

Mortality in the Melbourne injecting drug user cohort study (MIX).

Harm reduction journal

Nambiar D, Agius PA, Stoové M, Hickman M, Dietze P

23 Nov 2015

From initiating injecting drug use to regular injecting: Retrospective survival analysis of injecting progression within a sample of people who inject drugs regularly.

Drug and alcohol dependence

O'Keefe D, Horyniak D, Dietze P

17 Nov 2015

Patterns of, and Factors Associated With, Illicit Pharmaceutical Opioid Analgesic Use in a Prospective Cohort of People Who Inject Drugs in Melbourne, Australia.

Substance use & misuse

Horyniak D, Agius PA, Degenhardt L, Reddel S, Higgs P, Aitken C, Stoové M, Dietze P

15 Jul 2015

Experiences of and attitudes toward injecting drug use among marginalized African migrant and refugee youth in Melbourne, Australia.

Journal of ethnicity in substance abuse

Horyniak D, Higgs P, Cogger S, Dietze P, Bofu T, Seid G

30 Jun 2015

Cessation of injecting drug use: The effects of health service utilisation, drug use and demographic factors.

Drug and alcohol dependence

Nambiar D, Agius PA, Stoové M, Hickman M, Dietze P

23 Oct 2014

High-frequency drug purity and price series as tools for explaining drug trends and harms in Victoria, Australia.

Addiction (Abingdon, England)

Scott N, Caulkins JP, Ritter A, Quinn C, Dietze P

17 Sep 2014

How do drug market changes affect characteristics of injecting initiation and subsequent patterns of drug use? Findings from a cohort of regular heroin and methamphetamine injectors in Melbourne, Australia.

The International journal on drug policy

Horyniak D, Stoové M, Degenhardt L, Aitken C, Kerr T, Dietze P

16 Jul 2014

A cross-sectional study describing factors associated with utilisation of GP services by a cohort of people who inject drugs.

BMC health services research

Nambiar D, Stoové M, Dietze P

23 Jun 2014

Are users' most recent drug purchases representative?

Drug and alcohol dependence

Bond B, Caulkins JP, Scott N, Kilmer B, Dietze P

21 Jun 2013

Establishing the Melbourne Injecting Drug User Cohort Study (MIX): rationale, methods, and baseline and twelve-month follow-up results.

Harm reduction journal

Horyniak D, Higgs P, Jenkinson R, Degenhardt L, Stoové M, Kerr T, Hickman M, Aitken C, Dietze P

01 Nov 2012

A response to: Self-reported and actual hepatitis C virus infection status.

Drug and alcohol review

O'Keefe D, Aitken C, Higgs P, Dietze P

16 Sep 2012

The relationship between alcohol use and injecting drug use: impacts on health, crime and wellbeing.

Drug and alcohol dependence

Dietze P, Jenkinson R, Aitken C, Stoové M, Jolley D, Hickman M, Kerr T

03 Sep 2012

Concordance between self-reported and actual hepatitis C virus infection status in a cohort of people who inject drugs.

Drug and alcohol review

O'Keefe D, Aitken C, Higgs P, Dietze P

16 Jul 2012

A cross-sectional study of emergency department visits by people who inject drugs.

Emergency medicine journal : EMJ

Aitken C, Kerr T, Hickman M, Stoové M, Higgs P, Dietze P

Partners

Funding partners

Colonial Foundation Trust
National Health and Medical Research Council (NHMRC). Grant IDs: 545891, 1126090, 2023690

Collaborators

Monash Rural Health
British Columbia Centre on Substance Use
Curtin University
Deakin University
University of Bristol
School of Public Health and Preventive Medicine, Monash University
Kirby Institute
UNSW Sydney
Alfred Health
Harm Reduction Victoria
Royal Melbourne Hospital

Project contacts

Main contacts

Group mailbox

SuperMIX team

supermix@burnet.edu.au +611800650299

Student supervisor contacts

Stephanie Curtis

Surveillance Officer / Master of Philosophy (Applied Epidemiology) Scholar

Adjunct Research Fellow

View profile

Collaborator

Royal Melbourne Hospital

View profile

Health themes

Projects

Published research

Careers

Study at Burnet

About us

Where we work

Injecting drug use in Melbourne: SuperMIX cohort study

Our impact

About the study

Participant location

Student opportunities

Social networks of people who use drugs

Open to

Supervisors

Contact

Tobacco/nicotine harm reduction among people with a history of illicit drug use

Open to

Vacancies

Supervisors

Contact

Measuring risk and health outcomes among women who use drugs

Open to

Vacancies

Supervisors

Contact

Understanding the needs of women who inject drugs

Open to

Supervisors

Contact

Key publications

Cohort Profile: The Melbourne Injecting Drug User Cohort Study (SuperMIX)

Mortality in the SuperMIX cohort of people who inject drugs in Melbourne, Australia: a prospective observational study

Comprehensive needle and syringe program and opioid agonist therapy reduce HIV and hepatitis c virus acquisition among people who inject drugs in different settings: A pooled analysis of emulated trials

Other publications

Incidence of HIV and hepatitis C virus among people who inject drugs, and associations with age and sex or gender: a global systematic review and meta-analysis.

Comprehensive needle and syringe program and opioid agonist therapy reduce HIV and hepatitis c virus acquisition among people who inject drugs in different settings: a pooled analysis of emulated trials.

Does sexuality matter? A cross-sectional study of drug use, social injecting, and access to injection-specific care among men who inject drugs in Melbourne, Australia.

Trust and service engagement among people who inject drugs after release from prison.

Mortality in the SuperMIX cohort of people who inject drugs in Melbourne, Australia: a prospective observational study.

Cohort Profile: The Melbourne Injecting Drug User Cohort Study (SuperMIX).

"It's a revolving door": Ego-depletion among prisoners with injecting drug use histories as a barrier to post-release success.

Barriers to women's disclosure of and treatment for substance use during pregnancy: A qualitative study.

The association between depression and oral health related quality of life in people who inject drugs.

Homelessness, unstable housing, and risk of HIV and hepatitis C virus acquisition among people who inject drugs: a systematic review and meta-analysis.

Sex Discrepancies in the Protective Effect of Opioid Agonist Therapy on Incident Hepatitis C Infection.

The Melbourne Safe Injecting Room Attracted People Most in Need of Its Service.

The impact of Victoria's real time prescription monitoring system (SafeScript) in a cohort of people who inject drugs.

Prevalence and correlates of simultaneous, multiple substance injection (co-injection) among people who inject drugs in Melbourne, Australia.

Blood donation amongst people who inject drugs in Australia: research supporting policy change.

Assessing individual-level needle and syringe coverage parameters and the measurement of coverage in Melbourne, Australia: methods and impacts.

The Effect of Female Sex on Hepatitis C Incidence Among People Who Inject Drugs: Results From the International Multicohort InC3 Collaborative.

Geo-spatial analysis of individual-level needle and syringe coverage in Melbourne, Australia.

Drug overdose in the ED: a record linkage study examining emergency department ICD-10 coding practices in a cohort of people who inject drugs.

"I'm obviously not dying so it's not something I need to sort out today": Considering hepatitis C treatment in the era of direct acting antivirals.

Incarceration history and risk of HIV and hepatitis C virus acquisition among people who inject drugs: a systematic review and meta-analysis.

Analysis of time of drug use according to needle and syringe program operating hours in Melbourne, Australia: Effects on individual-level needle and syringe coverage.

Should sterile needle and syringe wastage be included within individual-level needle and syringe coverage measures?

Experiences of liver health related uncertainty and self-reported stress among people who inject drugs living with hepatitis C virus: a qualitative study.

Are People Who Inject Drugs Frequent Users of Emergency Department Services? A Cohort Study (2008-2013).

The Association between Intentional Overdose and Same-Sex Sexual Intercourse in a Cohort of People who Inject Drugs in Melbourne, Australia.

A prospective cohort study of hospital separations among people who inject drugs in Australia: 2008-2013.

Frequent emergency department presentations among people who inject drugs: A record linkage study.

The effects of needle-sharing and opioid substitution therapy on incidence of hepatitis C virus infection and reinfection in people who inject drugs.

Longitudinal changes in psychological distress in a cohort of people who inject drugs in Melbourne, Australia.

Mortality in the Melbourne injecting drug user cohort study (MIX).

From initiating injecting drug use to regular injecting: Retrospective survival analysis of injecting progression within a sample of people who inject drugs regularly.

Patterns of, and Factors Associated With, Illicit Pharmaceutical Opioid Analgesic Use in a Prospective Cohort of People Who Inject Drugs in Melbourne, Australia.

Experiences of and attitudes toward injecting drug use among marginalized African migrant and refugee youth in Melbourne, Australia.

Cessation of injecting drug use: The effects of health service utilisation, drug use and demographic factors.

High-frequency drug purity and price series as tools for explaining drug trends and harms in Victoria, Australia.

How do drug market changes affect characteristics of injecting initiation and subsequent patterns of drug use? Findings from a cohort of regular heroin and methamphetamine injectors in Melbourne, Australia.

A cross-sectional study describing factors associated with utilisation of GP services by a cohort of people who inject drugs.

Are users' most recent drug purchases representative?

Establishing the Melbourne Injecting Drug User Cohort Study (MIX): rationale, methods, and baseline and twelve-month follow-up results.

A response to: Self-reported and actual hepatitis C virus infection status.

The relationship between alcohol use and injecting drug use: impacts on health, crime and wellbeing.

Concordance between self-reported and actual hepatitis C virus infection status in a cohort of people who inject drugs.

A cross-sectional study of emergency department visits by people who inject drugs.

Partners