TY - JOUR
T1 - Mitigating the heroin crisis in Baltimore, MD, USA
T2 - A cost-benefit analysis of a hypothetical supervised injection facility
AU - Irwin, Amos
AU - Jozaghi, Ehsan
AU - Weir, Brian W.
AU - Allen, Sean T.
AU - Lindsay, Andrew
AU - Sherman, Susan G.
N1 - Funding Information:
The contribution by AI was supported by the Criminal Justice Policy Foundation and the Law Enforcement Action Partnership. The contribution by EJ was supported by the Canadian Institutes of Health Research (CIHR) Postdoctoral Fellowship (201511MFE-358449-223266).The contributions by SGS and BWW were supported by the Johns Hopkins University Center for AIDS Research (P30AI094189). The contribution by STA was supported by a grant from the National Institute on Drug Abuse (T32DA007292, PI: Renee M. Johnson). The contribution by AL was supported by the Criminal Justice Policy Foundation and by Amherst College.
Publisher Copyright:
© 2017 The Author(s).
PY - 2017/5/12
Y1 - 2017/5/12
N2 - Background: In Baltimore, MD, as in many cities throughout the USA, overdose rates are on the rise due to both the increase of prescription opioid abuse and that of fentanyl and other synthetic opioids in the drug market. Supervised injection facilities (SIFs) are a widely implemented public health intervention throughout the world, with 97 existing in 11 countries worldwide. Research has documented the public health, social, and economic benefits of SIFs, yet none exist in the USA. The purpose of this study is to model the health and financial costs and benefits of a hypothetical SIF in Baltimore. Methods: We estimate the benefits by utilizing local health data and data on the impact of existing SIFs in models for six outcomes: prevented human immunodeficiency virus transmission, Hepatitis C virus transmission, skin and soft-tissue infection, overdose mortality, and overdose-related medical care and increased medication-assisted treatment for opioid dependence. Results: We predict that for an annual cost of $1.8 million, a single SIF would generate $7.8 million in savings, preventing 3.7 HIV infections, 21 Hepatitis C infections, 374 days in the hospital for skin and soft-tissue infection, 5.9 overdose deaths, 108 overdose-related ambulance calls, 78 emergency room visits, and 27 hospitalizations, while bringing 121 additional people into treatment. Conclusions: We conclude that a SIF would be both extremely cost-effective and a significant public health and economic benefit to Baltimore City.
AB - Background: In Baltimore, MD, as in many cities throughout the USA, overdose rates are on the rise due to both the increase of prescription opioid abuse and that of fentanyl and other synthetic opioids in the drug market. Supervised injection facilities (SIFs) are a widely implemented public health intervention throughout the world, with 97 existing in 11 countries worldwide. Research has documented the public health, social, and economic benefits of SIFs, yet none exist in the USA. The purpose of this study is to model the health and financial costs and benefits of a hypothetical SIF in Baltimore. Methods: We estimate the benefits by utilizing local health data and data on the impact of existing SIFs in models for six outcomes: prevented human immunodeficiency virus transmission, Hepatitis C virus transmission, skin and soft-tissue infection, overdose mortality, and overdose-related medical care and increased medication-assisted treatment for opioid dependence. Results: We predict that for an annual cost of $1.8 million, a single SIF would generate $7.8 million in savings, preventing 3.7 HIV infections, 21 Hepatitis C infections, 374 days in the hospital for skin and soft-tissue infection, 5.9 overdose deaths, 108 overdose-related ambulance calls, 78 emergency room visits, and 27 hospitalizations, while bringing 121 additional people into treatment. Conclusions: We conclude that a SIF would be both extremely cost-effective and a significant public health and economic benefit to Baltimore City.
KW - Baltimore, Maryland
KW - Cost-benefit
KW - Cost-effectiveness
KW - Harm reduction
KW - Heroin
KW - Opiate overdose
KW - People who inject drugs
KW - Supervised consumption rooms
KW - Supervised injection facility
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U2 - 10.1186/s12954-017-0153-2
DO - 10.1186/s12954-017-0153-2
M3 - Article
C2 - 28532488
AN - SCOPUS:85019917386
VL - 14
JO - Harm Reduction Journal
JF - Harm Reduction Journal
SN - 1477-7517
IS - 1
M1 - 29
ER -