But critics object to enabling addicts to shoot illegal drugs in a
supervised injection facility in San Francisco – or anywhere in the
A new cost-benefit analysis in the Journal of Drug Issues makes the
financial case for a supervised injection site. A 13-booth facility
in San Francisco could save $3.5 million a year, mostly in reduced
medical costs, the report calculates.
The estimate assumes San Francisco would open a center exactly like
Insite – North America’s first legal supervised drug-injection site
built in Vancouver, Canada in 2003. Insite serves an estimated 1,700
people a month.
An injection facility in San Francisco would save the life of one
drug user who would otherwise die of an overdose every four years
and would assist in getting 110 drug addicts medication-assisted
treatment each year, the new study suggests.
In addition, it would prevent an average of 19 cases of hepatitis C
and three cases of HIV infection a year and would reduce hospital
stays for skin and soft-tissue infections related to needle use by
415 days a year.
“To me, it’s really a win-win for everyone,” senior author Alex Kral
said in a phone interview. “It’s a win for the community to get
people off the streets, and it’s a win for the people injecting
drugs to be sure they can be as safe as possible.”
An epidemiologist, Kral directs the behavioral and urban health
program at RTI International, a nonprofit research institute in San
Propelled by prescription painkiller and heroin abuse, U.S. deaths
from drug overdoses hit a record 47,055 in 2014, according to the
Centers for Disease Control and Prevention. The study authors
estimate the U.S. spends more than $6 billion a year covering the
medical expenses of people who inject drugs.
“This is one way to reduce what is one of the biggest sources of
mortality in the country,” Kral said.
“We’ve tried a lot of things in the last 50 years, and none of them
have succeeded,” he said. “So why not try an innovative,
evidence-based solution that’s working in upwards of a dozen
Since the first supervised injection facility opened in the Swiss
city of Berne in 1986, nearly 100 similar facilities have opened in
66 cities across 11 countries. U.S. cities from Seattle to New York
have considered installing drug-injection sites, but none have been
able to clear the hurdles.
Kral and his team assumed it would cost $2 million to buy and
renovate a site for a supervised injection facility in San Francisco
and $2.6 million a year to operate it. For every dollar spent, $2.33
would be saved as a result of averted overdose deaths, reduced
disease transmission and increased drug treatment, the researchers
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They expect the savings would be greater in other cities where the
number of overdose deaths is higher and real estate and operating
costs might be lower. San Francisco already slashed heroin overdose
deaths from 120 to 13 a year between 2000 and 2012 largely because
of widespread distribution of naloxone, a drug that can prevent
overdoses by blocking the effects of opioids.
A supervised injection facility would likely bring more financial
and life-saving benefits to a city like Baltimore, which has a
higher percentage of needle users dying of heroin overdoses, the
Susan Sherman is working on a similar cost-benefit analysis for an
injection facility in Baltimore. A professor of health, behavior and
society at Johns Hopkins University in Baltimore, Sherman was not
involved with the current study.
People fear supervised injection sites, she said, because they
believe the facilities could draw drug users to their neighborhoods.
But the sites would be located in areas where addicts already live.
“We have neighborhoods in Baltimore where heroin is the biggest
economy,” she said in a phone interview. “Having a place to go and
not being on a dirty street corner is foundational for dignity and
respect, which can transfer into other aspects of their lives.”
“Having a safe consumption space somewhere in the U.S. is going to
happen,” Sherman said. “It’s close to reality in New York, Ithaca
SOURCE: http://bit.ly/2iHEcYp Journal of Drug Issues, online
December 13, 2016.
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