For the first time, researchers have determined the potential cost and benefits of opening a supervised injection facility for people who inject drugs in the United States. The study found that a single facility in San Francisco could generate $3.5 million in savings.
According to the Centers for Disease Control and Prevention, the opioid epidemic costs the United States 75 billion dollars each year -- 55 billion in health and social costs and 20 billion for emergency department and inpatient care. People who inject drugs comprise less than one percent of the U.S. population, however they experience roughly 56 percent of new hepatitis C virus infections, 11 percent of new HIV infections, and nearly one-third suffer from skin and soft tissue infections.
Currently, 97 supervised injection facilities exist in 66 cities across 11 countries, however the United States is not among these countries. Supervised injection facilities provide a safe, clean place and injection equipment so that people can bring in previously obtained drugs and inject while being observed by medical staff.
"Supervised injection facilities have been shown to improve the health and safety of both the people who use them and the surrounding neighborhoods," said Alex Kral, Ph.D., senior author and director of the Behavioral and Urban Health Program at RTI International. "Our study looked specifically at San Francisco where there's a large opioid problem and assessed whether opening a safe injection facility would result in a net benefit to society."
Published in the Journal of Drug Issues, the team of researchers -- from RTI, the Criminal Justice Policy Foundation, Law Enforcement Against Prohibition, the University of British Columbia's Centre for Disease Control, and the University of Southern California -- found that the supervised injection facility would prevent 3.3 cases of HIV and 19 cases of hepatitis C virus per year, reduce skin and soft tissue infection hospital stays by 415 days annually, save an average of 0.24 lives per year, and facilitate 110 people to enter medication-assisted treatment.
"While the predicted results may sound small, they are substantial for a single facility," Kral said. "Three HIV infections is roughly 6 percent of the city's total annual injection-related HIV infections, and we estimate that 19 HCV infections comprises roughly 3 to 5 percent of the city's total annual injection-related HCV infections."
The associated outcomes of the supervised injection facility would result in about $6.1 million in health savings per year. With facility operations estimated at $2.6 million per year, net savings would be roughly $3.5 million annually.
"Our analysis shows that a supervised injection facility will not only keep San Franciscans who inject drugs alive and out of the hospital, but it will encourage them to seek help and save taxpayer money," said Amos Irwin, the first author of the study as chief of staff at the Criminal Justice Policy Foundation.
"This important study adds to the large body of research clearly demonstrating the benefits of supervised consumption services," said Laura Thomas, deputy state director of the Drug Policy Alliance. "It shows that San Francisco would experience cost savings as well as saving lives and getting public drug use off the streets if we offer these services here."
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Amos Irwin, Ehsan Jozaghi, Ricky N. Bluthenthal, Alex H. Kral. A Cost-Benefit Analysis of a Potential Supervised Injection Facility in San Francisco, California, USA. Journal of Drug Issues, December 2016 DOI: 10.1177/0022042616679829