Drug Overdose Surveillance Program, Rhode Island Department of Health, Providence, Rhode Island, USA; Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island, USA.
Drug Overdose Surveillance Program, Rhode Island Department of Health, Providence, Rhode Island, USA.
Int J Drug Policy. 2022 Oct;108:103820. doi: 10.1016/j.drugpo.2022.103820. Epub 2022 Aug 13.
Overdose deaths have increased dramatically in the United States, including in Rhode Island. In July 2021, the Rhode Island government passed legislation supporting a two-year pilot program authorizing supervised consumption sites (SCSs) in response to this crisis. We estimated the costs and benefits of a hypothetical SCS in Providence, Rhode Island.
We utilized a decision analytic mathematical model to compare costs and outcomes for people who inject drugs under two scenarios: (1) a SCS that includes syringe services provision, and (2) a syringe service program only (i.e., status quo). We assumed 0.95% of injections result in overdose, the SCS would serve 400 clients monthly and have a net cost of $783,899 annually, 46% of overdoses occurring outside of the SCS result in an ambulance run and 43% result in an emergency department (ED) visit, 0.79% of overdoses occurring within the SCS result in an ambulance run and ED visit, and the SCS would lead to a 25.7% reduction in fatal overdoses near the site. The model was developed from a modified societal perspective with a one-year time horizon.
A hypothetical SCS in Providence would prevent approximately 2 overdose deaths, 261 ambulance runs, 244 ED visits, and 117 inpatient hospitalizations for emergency overdose care annually compared to a scenario that includes a syringe service program only. The SCS would save $1,104,454 annually compared to the syringe service program only, accounting only for facility costs and short-term costs of emergency overdose care and ignoring savings associated with averted deaths. Influential parameters included the percentage of injections resulting in overdose, the total annual injections at the SCS, and the percentage of overdoses outside of the SCS that result in an ED visit.
A SCS in would result in substantial cost savings due to prevention of costly emergency overdose care.
在美国，包括罗得岛在内，过量死亡人数急剧增加。2021 年 7 月，罗得岛政府通过立法，支持为期两年的试点计划，授权在该州建立监督吸毒场所（SCS），以应对这一危机。我们估计了在罗得岛普罗维登斯建立一个假设的 SCS 的成本和效益。
我们利用决策分析数学模型，比较了两种情况下注射毒品者的成本和结果：（1）一个包括提供注射器服务的 SCS，（2）一个仅提供注射器服务的项目（即现状）。我们假设 0.95%的注射会导致过量，SCS 每月将服务 400 名客户，每年的净成本为 783899 美元，46%的过量发生在 SCS 之外，导致救护车出动，43%导致急诊部（ED）就诊，0.79%的过量发生在 SCS 内，导致救护车出动和 ED 就诊，SCS 将导致现场附近致命过量的减少 25.7%。该模型是从一个经过修改的社会视角出发，以一年的时间跨度开发的。
与仅提供注射器服务的方案相比，在普罗维登斯建立一个假设的 SCS，每年可预防约 2 例过量死亡、261 次救护车出动、244 次 ED 就诊和 117 次因紧急过量护理而住院。与仅提供注射器服务相比，SCS 每年可节省 1104454 美元，仅包括设施成本和紧急过量护理的短期成本，忽略了与避免死亡相关的节省。有影响力的参数包括导致过量的注射百分比、SCS 每年的总注射量以及 SCS 外导致 ED 就诊的过量百分比。
SCS 将导致大量的成本节约，因为它可以预防昂贵的紧急过量护理。
