Mitigating the heroin crisis in Baltimore, MD, USA: a cost-benefit analysis of a hypothetical supervised injection facility

Autor: Andrew Lindsay, Sean T. Allen, Susan G. Sherman, Brian W. Weir, Ehsan Jozaghi, Amos Irwin
Rok vydání: 2017
Předmět:
Gerontology
medicine.medical_specialty
Cost effectiveness
Cost-Benefit Analysis
Supervised injection facility
030508 substance abuse
Medicine (miscellaneous)
HIV Infections
Cost-benefit
Heroin
03 medical and health sciences
0302 clinical medicine
Environmental health
Opiate Substitution Treatment
medicine
Humans
Baltimore
Maryland
030212 general & internal medicine
Harm reduction
Cost–benefit analysis
Heroin Dependence
business.industry
Transmission (medicine)
Research
lcsh:Public aspects of medicine
Public health
1. No poverty
Public Health
Environmental and Occupational Health
lcsh:RA1-1270
Opiate overdose
Hepatitis C
medicine.disease
3. Good health
Needle-Exchange Programs
Supervised consumption rooms
Psychiatry and Mental health
Health psychology
Models
Organizational
Baltimore
Cost-effectiveness
Public Health
Drug Overdose
0305 other medical science
business
People who inject drugs
medicine.drug
Zdroj: Harm Reduction Journal, Vol 14, Iss 1, Pp 1-14 (2017)
Harm Reduction Journal
ISSN: 1477-7517
DOI: 10.1186/s12954-017-0153-2
Popis: 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.
Databáze: OpenAIRE
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