Victorian Premier Daniel Andrews has said he changed his mind about supporting a safe injecting room trial in inner Melbourne because a jump in the number of overdoses showed the current approach was failing.

The Government has confirmed it will hold a two-year trial a centre at the heroin hotspot North Richmond under a bold plan that includes tougher penalties for drug traffickers.

The medically supervised service will be run at North Richmond Community Health, which is already handing out a million syringes every month.

Thirty-four people have died from heroin overdoses in a four block area near Victoria St in one 12-month period, which prompted the state coroner to call for a trial earlier this year.

"There can be no rehabilitation if you are dead. If you are lying in a laneway in a gutter with a syringe that you got through the needle and syringe exchange program just here, there can be no pathway to treatment for you," Mr Andrews said.

Paramedics were called to a suspected drug overdose while Daniel Andrews was speaking to the media nearby. ( AAP: Joe Castro )

"If, however, you can be supervised, if you can get, in the event you need, the urgent health care that saves lives… that surely, on any measure, is a better outcome than seeing that death toll go up and up."

Harsher sentencing for heroin trafficking

Under the trial, the health centre on Lennox St will be exclusively written into legislation to give it legal amnesty.

Illegal drugs will not be provided at the address and only adults can use the site.

New legislation will need to be introduced to Parliament but the Government has enough support from the Upper House crossbench.

There will also be provision to extend the trial for three years.

The trial is part of a $87 million drug rehabilitation plan, which includes 100 more residential rehabilitation beds to tackle soaring ice and heroin use.

No-one has died at the Kings Cross injecting room despite thousands of overdoses. ( ABC News: Philippa McDonald )

Mr Andrews has for a long time resisted calls for an injecting room, and has recently met with families who have lost loved ones to heroin.

Today conceded it was a change in policy, but said with skyrocketing overdose action was needed.

"We have the highest heroin overdose death toll since 2000, circumstances are different," he said.

"To stubbornly continue with a policy that's just not working, then that's the wrong thing to do when there is an alternative, one that can save lives.

"I think leadership is about being prepared to say a different way is worth trialling."

As the Premier's press conference wrapped up, paramedics were called to a suspected overdose just 50 metres from the centre.

There will also be changes to sentences for people trafficking commercial quantities of heroin, with the punishable quantity to drop from 250 grams to 50g.

The Premier acknowledged the lobbying and work of Reason Party MP Fiona Patten to convince him of the need, as well as local Labor MP Richard Wynne.

Ms Patten said she was thrilled for all involved and congratulated the Government for getting on board.

She hoped it was a move towards treating drugs as a health issue rather than a law and order matter.

Primary school backs injecting centre on its doorstep

Mr Wynne said it was an important day for his community after years of advocacy.

Loading

Ms Patten currently has a bill before Parliament for a trial of a safe injecting room and much of that has been adopted by the Government.

An expert panel will oversee the trial, with former Liberal premier Jeff Kennett as chair.

Heroin deaths hit 190 in Victoria last year, the highest since the crisis that hit Melbourne at the end of the 1990s.

Mr Andrews said Victoria Police Chief Commissioner Graham Ashton was "100 per cent" behind the plan.

The Australian Medical Association and Ambulance Victoria were also consulted.

The Government hopes the centre will be open within the next six months, operating seven days a week and at least 12 hours a day.

It is modelled on the King's Cross centre in Sydney, where no one has died despite more than 6,000 serious overdoses.

Mental Health Minister Martin Foley said the Government expected hundreds of people would use the centre every month.

It will be next to West Richmond Primary School but Mr Foley said the school was supportive, with people already overdosing in the grounds.

Used needles are a common sight in gutters and backyards around Richmond. ( ABC News: Chris Le Page )

Ambulance Victoria said the centre would free up paramedics for other emergencies and reduce the burden on staff.

Victoria Police Assistant Commissioner Rick Nugent said the experience of Sydney showed police co-existed well and operated as normal with dealers apprehended and prosecuted.

Opposition Leader Matthew Guy said he would look closely at the legislation but the Coalition was unlikely to support it.

"I'm happy to look at some of the details of this, but in principle our position hasn't changed," he said.

"I accept if there's deaths and drug overdoses we need to do something."

Mr Guy questioned whether a recent "flurry of social policy announcements" from the Government was linked to the upcoming Northcote by-election, where Labor is in a battle with the Greens.