Pubdate: Tue, 18 Nov 2008
Source: Vancouver Sun (CN BC)
Copyright: 2008 The Vancouver Sun
Contact: http://www.canada.com/vancouversun/letters.html
Website: http://www.canada.com/vancouversun/
Details: http://www.mapinc.org/media/477
Author: Linda Nguyen,  Canwest News Service
Cited: The cost-effectiveness of Vancouver's supervised injection facility
http://www.cmaj.ca/cgi/content/full/179/11/1143
Bookmark: http://www.mapinc.org/find?142 (Supervised Injection Sites)
Bookmark: http://www.mapinc.org/topics/insite

INSITE CAN SAVE HEALTH CARE SYSTEM $20 MILLION, STUDY SAYS

Just Reducing Needle Sharing Could Save $14 Million In 10 Years,
Research Suggests

Vancouver's supervised drug injection site can save the Canadian
health-care system as much as $20 million and substantially increase a
population's lifespan over a 10-year period, according to a study to
be published today in the Canadian Medical Association Journal.

The study, which used a computer simulation, measured the projected
impacts on Vancouver in the next decade with and without its
controversial Insite facility, the only such facility in Canada. It
found that, when the only impact of such a facility is assumed to be a
reduction in the prevalence of needle-sharing by drug users, there is
a projected net saving of nearly $14 million over 10 years.

The facility would also increase the drug-using population's life
span, resulting in what the study calls a gain of 920 life years
compared with a model that had no supervised injection site.

When additional factors such as overdose survival rates, the incidence
of HIV and hepatitis C infections, and the frequency of referrals to
social services were included, the financial savings rose to as much
as $20 million, with the number of life years gained rising to 1,070.

A total of 1,191 cases of HIV infection and 54 cases of hepatitis C
infection could be averted over a decade with the operation of the
facility, according to the study, by Dr. Ahmed Bayoumi of St.
Michael's Hospital in Toronto and the University of Toronto, along
with Gregory Zaric of the University of Western Ontario in London.

"The conclusion that my co-author and I would want to put forward is
that we believe that Insite does provide good value for money, if you
were to look at the cost-effectiveness," Zaric said. "This study
ultimately brings one more piece of information when deciding the fate
of Insite."

The study quoted a number of other studies over the years that have
observed the impact of the safe injection site. The report said Insite
had other positive impacts on the community, including "a decrease in
needle sharing and reuse of syringes, fewer people injecting drugs in
public, an increase in referrals to social services and addiction
counselling, a decrease in the number of publicly discarded syringes,
no apparent increase in police reports of drug-dealing or crime, and
no observed increase in new initiates into drug use."

The study's authors say the findings can be applied only to Vancouver,
since the simulation was tailored to the city's population figures,
including drug users who went to Insite and those who did not and the
number of downtown residents. The findings are also sensitive to the
assumption of a number of factors, including how often the facility is
used, the risk of HIV transmission by sharing needles and the
frequency of safe infection practices among users at the clinic.

Insite has operated in Vancouver's Downtown Eastside since 2003 under
a federal exemption of the Controlled Drugs and Substances Act.

Last May, a B.C. Supreme Court judge ruled that Insite should be
allowed to operate for another year, even if it does not have a
specific exemption from the federal government.

The court ruled that it was unconstitutional to impose ordinary drug
laws on addicts using a supervised injection site.

The federal government appealed the ruling and the appeal is scheduled
to be heard next April.

Insite provides a "safe, health-focused place" where drug addicts can
go to inject drugs and connect to other health-care and social
services, according to its website.

It serves about 600 to 1,100 users daily and is funded by the B.C.
government.
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MAP posted-by: Larry Seguin