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TORONTO — A new study published in Addiction Monday shows that opening supervised drug injection facilities for addicts could actually save our health care system money.
People have been hearing a lot about supervised injection sites, largely because they were a hot topic in the recent federal election.
What is a supervised injection site?
These are facilities that provide a safe and hygienic environment where addicts can inject illicit drugs.
They provide sterile needles which reduce transmission of infections like hepatitis C and HIV, trained medical staff who try to prevent and manage overdoses and counsellors who try to help people in recovery.
There are about 90 such facilities around the world, including a single Canadian facility that has been operating in Vancouver since 2003.
Why should taxpayers pay for people to safely inject IV drugs?
The philosophy behind supervised injection sites is that of “harm reduction.”
The idea is that in a perfect world, no one would use illicit intravenous drugs. While that remains our goal, we should do everything we can to reduce the harm caused by addiction until we can achieve that.
In addition, the benefits of these facilities extend not only to addicts, but likely also to society at large.
A Canadian study showed that in the three months after the opening of the Vancouver facility, the number of users injecting in public and the number of discarded syringes found in public dropped by nearly half.
At the same time, there were no increases in drug trafficking or crime in the area, and overall, the facility saved the healthcare system money.
This new study out of St. Michael’s Hospital tries to estimate whether similar benefits might be seen in Toronto and Ottawa, which also have large IV drug user populations.
Researchers created a model analyzing the effects of one or more new injection sites over 20 years of operation.
In Toronto, they found that a single site would prevent 164 HIV infections and 459 hepatitis C infections.
This would cost us $33 million to operate, but due to the high cost of treating these infections (especially hepatitis C, for which expensive new drugs were recently approved), it would also save us almost $43 million in healthcare costs (for a net savings of almost $10 million over 20 years).
They conclude that having three facilities in Toronto and two facilities in Ottawa would present a healthcare investment which is on par with the spending thresholds that we apply for most other treatments.
So will Toronto end up with a supervised injection site?
It bodes well that Prime Minister Justin Trudeau campaigned on a promise to support injection sites, and that our provincial health minister says that he’s willing to look at the scientific evidence to propose a multi-jurisdictional approach.
But the first and all important step will be to get the public and our local leaders to look past stigmas, and to buy-in to the benefits of harm reduction.