Background People who inject drugs (PWID) have worse health than non-injectors and are at heightened risk of incidents that necessitate hospital emergency department (ED) visits.

Study objectives To describe ED visits by PWIDs in Melbourne, Australia, and compare reasons with those given in Vancouver, Canada.

Methods In 2008–2010, 688 Melbourne PWIDs were interviewed about their ED visits; these data were contrasted with published data about ED visits by PWIDs in Vancouver.

Results Participants reported 132 ED visits in the month preceding interview—27.3% drug-related, 20.5% trauma-related (principally physical assault), 13.6% for psychiatric problems. Melbourne PWIDs are less likely to attend ED for soft-tissue injuries, and more likely to attend after physical assault than PWIDs in Vancouver.

Conclusion PWID in Melbourne and Vancouver attend EDs for different reasons; information about PWID visits can help EDs cater for them and provide insights for prevention.