A new report assessing nearly 50 studies on safe consumption sites (SCS) worldwide adds to the growing body of evidence that they not only save lives, but save money. The data show that, when coupled with syringe exchange services, SCS could save major US cities around $4 million each per year.
The evidence report was released on November 13 by the Institute for Clinical and Economic Review (ICER). While research into the economic impact of SCS invariably finds that such sites, do, in fact, save money for the cities that would implement them, “the magnitude of the cost savings [is what] I was startled by here,” said ICER Chief Medical Officer David Rind. “You don’t usually imagine that putting in something like this would save $4 million in Boston. It’s an enormous amount of money.”
The primary way the report found SCS to save on costs was by cutting down the number of 911 calls made—and therefore the number of emergency services teams dispatched—followed by a reduction in the number of Emergency Department visits and hospitalizations. In Boston, Philadelphia, San Francisco, Atlanta, Baltimore and Seattle, the report found that SCS would save each city between $3,623,000 and $4,199,000—in addition to three to four lives—each year.
ICER analyzed the findings of 48 studies on SCS and granted them an overall rating of B+, which corresponds to a “high certainty” that they provide a small to substantial net health benefit, and a “moderate certainty” that they provide a substantial benefit.
Around a dozen countries around the world have operational SCS in one form or another. The studies collectively analyzed in ICER’s report showed no increase in crime associated with SCS. It found that SCS are, however, associated with a 69 percent reduction in likelihood of syringe sharing; an overall higher likelihood of clients entering drug treatment or recovery services; and in some locations a reduction of public drug use and of littered syringes. The report also confirmed a fact widely known among harm reductionists and ignored by policymakers—that there are no known cases of someone ever dying at a safe consumption site.
“If it were costing $4 million to save [three to four] lives, a city might not want to spend that. But to save $4 million, to save that number of lives, you’d imagine a city would want to spend that.”
“Going into this, I don’t think we realized how much that would be in terms of cost savings,” Rind told Filter. “If it were costing $4 million to save [three to four] lives, we recognize that a city might well not want to spend that. But to save $4 million, to save that number of lives, you’d imagine that a city would want to spend that.”
As safe consumption sites in face closures in Canada, they’ve been stonewalled from ever getting off the ground in US cities like Philadelphia, New York City and Baltimore. Opponents of SCSs often claim, without evidence, that the sites will increase drug use and overall crime.
“There’s been a whole lot of NIMBYism,” ICER Communications and Outreach Director David Whitrap told Filter. But that $4 million saved per city, per year, “could be directed to other public health initiatives. That’s not only harm reduction; it’s cost reduction, too.”
ICER will host a virtual public meeting on December 3 to assess the report’s findings. The researchers hope that policymakers would take advantage of that opportunity to discuss at least the cost savings, if not the benefit to human life, but have so far been “relatively unsuccessful” in getting any opponents of safe consumption sites to RSVP.
“At a policy roundtable usually there’s multiple sides represented,” Rind said, “but as far as I can tell virtually everybody we have speaking is a proponent. We’ve had trouble getting anyone else to participate.”