TY - JOUR
KW - Baltimore/epidemiology
KW - Cost-Benefit Analysis
KW - Drug Overdose/mortality/prevention & control
KW - HIV Infections/economics/prevention & control
KW - Harm Reduction
KW - Hepatitis C/economics/prevention & control
KW - Heroin Dependence/complications/economics/therapy
KW - Humans
KW - Models, Organizational
KW - Needle-Exchange Programs/economics/organization & administration
KW - Opiate Substitution Treatment/economics
KW - Public Health
KW - Baltimore, Maryland
KW - Cost-benefit
KW - cost-effectiveness
KW - Heroin
KW - Opiate Overdose
KW - People who inject drugs
KW - Supervised consumption rooms
KW - Supervised injection facility
AU - Amos Irwin
AU - Ehsan Jozaghi
AU - Brian W. Weir
AU - Sean T. Allen
AU - Andrew Lindsay
AU - Susan G. Sherman
A1 - 
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.
AD - Law Enforcement Action Partnership, Silver Spring, MD, USA. Amos@LawEnforcementAction.org.; Criminal Justice Policy Foundation, Silver Spring, MD, USA. Amos@LawEnforcementAction.org.; British Columbia Centre for Disease Control, University of British Columbia, Vancouver, Canada.; School of Population and Public Health, University of British Columbia, Baltimore, MD, USA.; Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.; Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.; Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.; Criminal Justice Policy Foundation, Amherst College, Silver Spring, MD, USA.
BT - Harm reduction journal
C5 - Financing & Sustainability; Healthcare Disparities; Opioids & Substance Use
CP - 1
CY - England
DO - 10.1186/s12954-017-0153-2
IS - 1
JF - Harm reduction journal
LA - eng
M1 - Journal Article
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.
PP - England
PY - 2017
SN - 1477-7517; 1477-7517
SP - 29
T1 - Mitigating the heroin crisis in Baltimore, MD, USA: a cost-benefit analysis of a hypothetical supervised injection facility
T2 - Harm reduction journal
TI - Mitigating the heroin crisis in Baltimore, MD, USA: a cost-benefit analysis of a hypothetical supervised injection facility
U1 - Financing & Sustainability; Healthcare Disparities; Opioids & Substance Use
U2 - 28532488
U3 - 10.1186/s12954-017-0153-2
VL - 14
VO - 1477-7517; 1477-7517
Y1 - 2017
Y2 - May 12
ER -