Supervised injection sites in Ottawa make financial sense, researcher says

Opening two supervised injection sites in Ottawa would save the health system money, new analysis suggests.

Ahmed Bayoumi, a medical researcher with St. Michael’s Hospital in Toronto, called supervised injection sites a “good investment in health dollars.”

He is among authors of a report looking at the potential cost-effectiveness of supervised injection facilities in Toronto and Ottawa. The study was published Monday in the journal Addiction.

Bayoumi and others updated analysis they conducted in 2012 in light of dramatic new treatment for hepatitis C. Drugs that treat and even cure hepatitis C are now available, but they are costly, which means strategies to reduce the spread of hepatitis C by injection drug users could save the health system substantial money, said Bayoumi.

That is a key issue in Ottawa where transmission rates of hepatitis C and HIV among injection drug users are higher than Toronto.

The research found that over 20 years, one supervised injection facility in Ottawa would avert 358 HIV infections and 323 hepatitis C infections. One facility would cost $31.5 million in operating costs and save $32.3 million in health care costs, the analysis found.

In fact the cost benefits in Ottawa would likely be even higher, said Rob Boyd, program director at Oasis, which provides health and social services to injection drug users and is working on a proposal to become the site of Ottawa’s first supervised injection site.

Boyd said the 2012 analysis and its updated version based the costs of supervised injection sites on Vancouver’s Insite, which is a large, stand-alone site.

At Oasis, plans are to set up a supervised injection area in an existing site, which already offers harm reduction, including a methadone clinic and a needle and pipe exchange. Costs would be significantly lower than suggested in the cost analysis study, he said.

Such a program would offer a “tremendous benefit” for injection drug users, Boyd said, and it is unlikely people in the surrounding community would notice much difference.

Ottawa is estimated to have between 1,200 and 2,000 injection drug users. Between 40 and 50 of them die every year from overdoses.

Boyd said there is optimism that, with the election of a Liberal federal government, new sites will eventually open in Ottawa and other cities across Canada. The Conservative government opposed supervised injection sites and tried to close Insite in Vancouver.

The Liberal government has said it supports supervised injection and other harm reduction programs. Still, there are significant hurdles to overcome for any group interested in applying to open one — including needing wide-ranging support from the community and officials. Both Mayor Jim Watson and police Chief Charles Bordeleau have said they oppose the opening of such a site in Ottawa.

Researchers said it would make more sense to have two smaller locations in Ottawa because the injection drug population is spread across the city. But they noted that the decision to allow such sites to open is based on more than cost-effectiveness.

“Although economic analyses are necessary inputs to such debates, the final decision will also reflect the decision-makers social and political agendas.”

By Elizabeth Payne
Source: Ottawa Citizen