A new study explores the cost-benefits of supervised injection facilities. Researchers estimate that providing one safe drug site in Baltimore will save the City $6 million in medical costs and potentially prevent overdose deaths.
“Safe consumption spaces are physical environments where people bring previously purchased drugs. There's no sharing, there's nothing passed between people,” said Susan Sherman, professor of health behavior and society at Johns Hopkins Bloomberg School of Public Health.
Sherman is one of the authors of the report published in the Harm Reduction Journal. The study was conducted by researchers at Johns Hopkins University, the Law Enforcement Action Partnership, the Criminal Justice Policy Foundation, and the University of British Columbia.
Supervised injection facilities are a controversial concept being discussed in several major U.S. cities. Tackling the opioid epidemic by providing addicts with a safe space to shoot up may seem counterintuitive, but the study uses data to show the opposite.
“The facility itself would cost $1.8 million and the savings would be a gross of $7.8 million dollars per year,” Sherman said. “Having a single site in Baltimore would save the city $6 million, estimating of course, as cost effectiveness and benefit studies do.”
Supervised injection facilities (SIF) are already being used throughout the world.
“In the hundred injection facilities throughout the world, in over 66 cities, mostly in Europe, 11 countries as well as Canada, there's never been one fatal overdose,” Sherman said.
Major Neill Franklin (Ret.) spent 34 years with the Baltimore and Maryland State Police Departments. He’s currently the executive director of the Law Enforcement Action Partnership (LEAP).
“Police have to deal with people who inject drugs on a daily basis for overdoses, ambulance calls, and public drug use. A SIF would put this issue into the capable hands of public health experts and let officers focus on finding and arresting dangerous criminals and helping victims,” Franklin said.
The most recent study not only looked at the efficacy of the idea but also the areas of for health care cost-savings.
“Hepatitis cases averted, HIV cases averted, ambulatory care because of all the time ambulances come to overdose that's kind of expensive. Hospital stays from soft tissue infections, overdoses themselves, health care utilization,” Sherman said.
The savings stem from offering addicts a clean environment, sterile needles, and a medical professional who can intervene with Narcan, when needed.
Professor Sherman knows there are critics but points to the data and the success of a facility in Canada called Insite.
“A third of people are more likely to enter treatment after being involved, being a client for Insite after a year. So, it's not just directly saving people when they're sitting there but it's also saving them by treating them with dignity and respect, offering them a range of opportunities, offering them a way to stabilize their lives to the point where when they're ready to quit they have a place to go and they're more successful with treatment,” said Sherman.
The paper makes a strong case but building the single 13-booth facility is far-off.
In the 2016 and 2017 legislative sessions, Baltimore County Delegate Dan Morhaim introduced bills that would allow the facilities in the state but they both failed.
And when Maryland Governor Larry Hogan was asked in March what he thinks of Morhaim's bill, he shot it down.
“I think it's absolutely insane,” said Hogan. “His proposal is idiotic.”
Governor Hogan’s Office did not respond to ABC2’s request for comment on Thursday.
The facilities could also face a legal challenge. Heroin use is against federal law and creating a place that allows consumption could violate federal regulations.
Baltimore City Health Commissioner Leana Wen called safe injection sites a potential tool to reduce overdose deaths but sad legal guidance would before determining the feasibility of the approach. “As we understand, federal regulations would preempt city rules or health codes about safe injection facilities, so assurance from the Department of Justice is a necessary first step,” Wen wrote in a statement.
There are currently no supervised injection facilities in the United States. Other cities looking at the approach include Seattle, San Francisco, New York City, and Boston.