Safe-injection sites make financial sense for Ontario, study says

Opening five safe-injection sites in Ontario makes financial sense, says a medical researcher who based his study on a Vancouver clinic where drug users shoot up under supervision.

Dr. Ahmed Bayoumi of St. Michael's Hospital in Toronto said establishing facilities such as Insite in that city and in Ottawa would save money and reduce the incidence of diseases such as HIV and hepatitis C.

"Three facilities for Toronto and two for Ottawa represent a good investment compared to other things that we ordinarily invest in in health care," he said in an interview Monday.

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The study follows up on earlier research that said safe injection sites in Toronto and Ottawa would improve the health of intravenous drug users. The latest information takes into account new treatments for hepatitis C which, though effective, are also much more expensive. 

A typical six-month course of hepatitis C treatment costs about $60,000, Bayoumi said. 

"So preventing hepatitis C becomes particularly important because it helps avert those costs that would otherwise be incurred by the health-care system," he said. 

Insite is North America's only supervised-injection site, where addicts shoot up their own drugs under the watchful eyes of a nurse to prevent overdoses.

The site provided a baseline for estimating the approximate cost of operating a safe-injection site as well its effectiveness at improving users' health, Bayoumi said.

Victoria and other cities across Canada have considered establishing similar facilities.

Montreal announced its intention to open a safe-injection site after a 2011 Supreme Court of Canada decision ruled against the former Conservative government's attempts to shut down Insite for violating federal drug laws.

Multiple facilities

Unlike in Vancouver's Downtown Eastside, Bayoumi said multiple facilities would be more appropriate in Ontario, where populations of drug users are more spread out.

He said the study's economic estimates are conservative because they're based on Insite being a freestanding clinic, compared to an approach that would incorporate safe-injection facilities into existing health centres.

While the study focused on needs in Toronto and Ottawa, Bayoumi said other Ontario cities could also benefit from such facilities.

"The next step is mostly a political decision rather than a research decision, as in, 'Is there an interest and a will to actually establish some facilities?"'

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Ontario's health minister said a national strategy to deal with intravenous drug users, rather than a piecemeal approach, would be most beneficial.

"I think that more than anything, this is an opportunity to bring together all jurisdictions and look at this in a uniform way," Eric Hoskins said.

"We, up until recently, had a federal government that made it clear they didn't support such sites. We now have a government that understands the science and is willing and prepared and wants to make decisions based on evidence."

The minister said any request for a safe-injection site would have to come from municipal governments.

Reducing deaths, disease

Insite opened in 2003 as part of a harm-reduction plan to tackle an epidemic of HIV-AIDS and drug overdose deaths in the Downtown Eastside.

The facility provides clean needles to addicts to stop the spread of infectious diseases before they inject drugs at one of 12 booths.

Studies in major medical journals have hailed the success of Insite, suggesting it has helped reduce overdose deaths, infectious diseases and crime in the 10-block area that draws addicts.

The former federal government was criticized for wanting Insite to be shut down over concerns it promotes drug use, but lost a series of legal battles that kept the clinic open.