Research

Research has consistently shown that Medically Supervised Injecting Facilities (MSIF)

  • Save lives
  • Reduce public injecting
  • Reduce drug related litter,
  • And save money.

Here, we briefly summarise some of the international research on Drug Consumption Rooms (DCRs) and MSIFs.

MSIF save lives

A major report in 2004 from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) found that MSIFs “contribute to a reduction in levels of risk-taking among their clients and increase access for specific ‘hard-to reach’ target populations of drug users to health, welfare and drug treatment services”.

A more recent report (2017), also from the EMCDDA, stated that “use of supervised drug consumption facilities is associated with self-reported reductions in injecting risk behaviour such as syringe sharing”. This report also cites the German Ministry of Health, who concluded, based on analyses of several years’ data across four sites, that “the work of consumption rooms is statistically significantly related to the reduction of drug-related deaths”.

Studies of facilities outside Europe have come to similar conclusions.

In 2011, KPMG undertook a review of the Sydney MSIF, and stated that, given there had been over 3,400 overdoses at the MSIF between 2001 and 2010 without a single fatality, it is “reasonable to assume that a proportion of these overdose-related events managed at the [MSIF] would have led to overdose injury or overdose death had they occurred in another location (public place or a private dwelling) that did not have accessible medical supervision and intervention”.

Research in Canada has also found the use of consumption facilities is associated with increased uptake both of detoxification and drug dependence treatment, including opioid substitution.

In 2017, a systematic review of literature investigating MSIFs found that “high-quality scientific evidence suggests that these effectively achieve their primary public health and order objectives with a lack of adverse impacts”.

MSIFs and their communities

As part of a series of evaluations of the Sydney Medically Supervised Injecting Centre (MSIC), in 2006 the National Centre in HIV Epidemiology and Clinical Research evaluated community attitudes towards the facility. The review found that:

  • Residents and business operators in the area of the MSIC perceived a decrease in the level of public drug use and publicly disposed syringes.
  • The Sydney MSIC has not been perceived as an inducement to inject drugs among those living locally.
  • Nearly three quarters of residents and business operators continued to support the Sydney MSIC establishment.

Another study focusing on community perceptions of the facility five years after it opened found that “local residents and business operators perceived significant improvements in public amenity indicators since the opening of the service”.

A study of the Vancouver facility found that: “the opening of the safer injecting facility was independently associated with improvements in several measures of public order, including reduced public injection drug use and public syringe disposal.”

The 2004 EMCCDA report found that “consumption rooms can reduce the level of drug use in public places and help to reduce public nuisance”, while their 2017 report stated that “evaluation studies have found an overall positive impact on the communities where these facilities are located”.

MSIFs are value for money

There is extensive evidence to suggest that MSIFs are an effective use of public money.

A report from the Transform Drug Policy Foundation have stated “given the high life-time cost of treating diseases like HIV (about £360,000 per person) and hepatitis, avoiding even a small number of infections from needle sharing can mean a DCR [Drug Consumption Room] pays for itself rapidly.”.

An assessment of a proposed DCR in San Francisco suggested savings of $2.33 for every $1 spent.

A cost-benefit analysis of the MSIF in Vancouver found that, when looking at HIV infection and overdose deaths, an MSIF “appears to be an effective and efficient use of public health care resources”.

Further reading

Ireland

Ana Liffey Drug Project: At the Dark End of the Street: a report on street-based injecting

HSE Supervised Injecting Facility FAQ

HSE National Drug Treatment Centre: Opiate-dependent service-users’ knowledge and attitudes towards Supervised Injecting Facilities-Poster Winter Conference 2017

Misuse of Drugs (Amendment) Act 2015

Europe

European Monitoring Centre on Drugs and Drug Addiction Drug Consumption Rooms: An Overview of Provision and Evidence (Perspectives on Drugs) (2017)

European Monitoring Centre on Drugs and Drug Addiction Preventing Overdose Deaths in Europe (Perspectives on Drugs) (2017)

European Monitoring Centre on Drugs and Drug Addiction Report on drug consumption rooms (2004)

NHS Greater Glasgow and Clyde: Safer Consumption Facility Could Provide Substantial Financial Gain for Services (2017)

The Joseph Rowntree Foundation: The Report of the Independent Working Group on Drug Consumption Rooms (2006)

North America

American Journal of Preventive Medicine: Addressing the Nation’s Opioid Epidemic: Lessons from an Unsanctioned Supervised Injection Site in the U.S (2017)

British Columbia Centre for Excellence in HIV/AIDS: Findings from the Evaluation of Vancouver’s Pilot Medically Supervised Safer Injection Facility – Insite (2009)

British Medical Journal: Supervised Injection Centers Could Save Millions of Dollars in Health Costs, US Study Finds (2016)

Expert Advisory Committee on Supervised Injection Site Research: Vancouver’s INSITE Service and Other Supervised Injection Sites: What Has Been Learned from Research? (2008)

International Journal of Drug Policy: A Cost-benefit and Cost-effectiveness Analysis of Vancouver’s Supervised Injection Facility (2009)

International Journal on Drug Policy: A cost–benefit and cost-effectiveness analysis of Vancouver’s supervised injection facility (2009)

Journal of Drug Issues: A Cost-Benefit Analysis of a Potential Supervised Injection Facility in San Francisco, California, USA (2017)

PloS ONE: Estimated Drug Overdose Deaths Averted by North America’s First Medically-Supervised Safer Injection Facility (2008)

The Lancet: Reduction in overdose mortality after the opening of North America’s first medically supervised safer injecting facility: a retrospective population-based study (2011)

Australia

KPMG International: Further Evaluation of the Medically Supervised Injecting Centre during its extended trial period (2007-2011)

MSIC Evaluation Committee: Final report on the evaluation of Sydney Medically Supervised Injecting Centre (2003)

National Centre in HIV Epidemiology and Clinical Research: Sydney Medically Supervised Injecting Centre Interim Report 1: operations and service delivery (2005)

National Centre in HIV Epidemiology and Clinical Research: Sydney Medically Supervised Injecting Centre Interim Report 2: Evaluation of Community Attitudes towards the Sydney MSIC (2006)

National Centre in HIV Epidemiology and Clinical Research: Sydney Medically Supervised Injecting Centre Interim Report 3: Evaluation of Client Referral and Health Issues (2007)

National Centre in HIV Epidemiology and Clinical Research: Sydney Medically Supervised Injecting Centre Interim Report 4: Evaluation of service operation and overdose-related events (2007)

SAHA International Final Report: Economic Evaluation of the Medically Supervised Injection Centre at Kings Cross (MSIC) (2008)

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