Safe-injection sites are cost-effective to health system: study

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A new Canadian study about safe-injection sites for intravenous drug users concludes that they are cost-effective to the health-care system — an argument that is likely to be advanced as Montreal takes steps to open four such facilities in the city.

Researchers at St. Michael’s Hospital in Toronto carried out an analysis that compared the projected costs of maintaining supervised injection sites over a period of 20 years with the potential savings to the health system in averted HIV and hepatitis C infections. The researchers’ estimates were conservative, as they did not include other infections associated with intravenous drug use and the costs involved in treating and hospitalizing patients suffering from overdoses.

Still, despite their conservative approach, the researchers found that one facility in Toronto would incur $33.1 million in direct operating expenses over 20 years, but save $42.7 million in health-care costs because of an anticipated reduction in HIV and hepatitis C infections. This represented a net savings of $9.6 million.

The researchers predicted that a single site Toronto would spare 164 people from contracting HIV (because they wouldn’t be using dirty needles) and prevent 459 hepatitis C infections.

“I would say that having supervised injection sites in Ottawa and Toronto are a good investment in health dollars because we get considerable health benefits at a reasonable cost,” Ahmed Bayoumi, the study’s senior author, said in an interview.

The study, published on Monday in the journal Addiction, focused exclusively on Toronto and Ottawa. But Bayoumi suggested that setting up safe-injection sites in Montreal might also be beneficial.

“I think it’s a reasonable hypothesis that it would be cost-effective to do this in Montreal, but I really hesitate to say anything definitive without further study,” he added.

In June, Mayor Denis Coderre vowed to establish three safe-injection sites and one mobile unit in the fall despite former prime minister Stephen Harper’s resistance to the plan.

“This is urgent in Montreal,” Coderre said after Montreal applied formally to Health Canada for an exemption that would permit the sites to open in the city.

However, the mayor has since been mum on the subject as he focused on the city’s sewage problems and then the municipal budget.

In 2011, the Supreme Court ruled that Ottawa’s refusal to renew the exemption for Canada’s sole safe-injection site — Insite in Vancouver — was unconstitutional because it deprived people of access to potentially life-saving medical care. Montreal plans to open its sites downtown, in the Plateau and Hochelaga districts and run a mobile unit in the city’s northern and southwest neighbourhoods.

The St. Michael’s study found that running as many as three sites in Toronto and two in Ottawa would be cost-effective.

Although former Conservative Health Minister Rona Ambrose has described the sites as “drug-injection houses,” Prime Minister Justin Trudeau has supported the principle behind the facilities. In June, Trudeau praised Coderre’s plans to open the sites in Montreal as helping to “make people’s lives better, to keep them safe, and I applaud him for moving forward on this.”

Story by Aaron Derfel.

Montreal Gazette, November 30, 2015.

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