Supervised Injection Facilities and Other Supervised Consumption Sites: Effectiveness and Value

ICER - Institute for Clinical and Economic Review (2020)

The opioid overdose epidemic is devastating families and communities across the United States (US). Epidemiological studies from the US Centers for Disease Control and Prevention (CDC) have found that overall life expectancy of Americans has declined, and this decline was largely attributed to drug-related overdose deaths.1-3 Today in the US, overdoses are classified as the leading cause of injury-related death. The public health approach to addressing the overdose epidemic is multi-faceted, involving a combination of policy, education, and community interventions. A framework developed by the Association of State and Territorial Health Organizations (ASTHO) describes a cross-sectoral response with four key strategy areas: (1) training and education; (2) monitoring and surveillance; (3) primary and overdose prevention; and (4) treatment, and harm reduction. Harm reduction strategies seek to mitigate the harms of behaviors.4 Harm reduction strategies include improved access to the antidote naloxone, syringe service programs (SSPs) that allow people who inject drugs (PWID) to obtain or exchange equipment for injections, and drug checking services that screen for risky drugs such as fentanyl. These implement an alternative to the criminalization and disease treatment models of drug use and addiction. Supervised injection facilities (SIFs) are an additional method of harm reduction. While proponents of harm reduction theory recognize abstinence may be the ideal goal for some people, they accept alternatives which reduce the risk for death and disability even if they do not promote abstinence.5 Opponents of such strategies often focus on their potential to enable activities that are criminal or perceived as immoral.6

Supervised Injection Facilities and Other Supervised Consumption Sites: Effectiveness and Value

Supervised Injection Facilities and Other Supervised Consumption Sites: Effectiveness and Value (569)

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