Reduction in overdose mortality after the opening of North America's first medically supervised safer injecting facility: a retrospective population-based study

Marshall, Brandon D.L.; Milloy, M‐J; Wood, Evan; Montaner, Julio S. G.; Kerr, Thomas

doi:10.1016/s0140-6736(10)62353-7

Cited by 399 publications

(284 citation statements)

References 45 publications

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“…Theoretical possibilities of SIF expansion needs to be decided on by the local health authorities on the basis of scientific evidence supporting such expansion (17). Public awareness by the local health policy-makers and doctors regarding SIF will allow the community to be better educated about the benefits of these harm reduction programs and the role they play in reducing crime, drug dealing, public injection, and a host of other social maladies (9,(12)(13)(14)34,(46)(47)(48)(49)(50)(51). Community support is a fundamental part of sustaining the program and it will ultimately help in conceptualizing injection drug use as a health issue, rather than a moral one (11,16,53).…”

Section: Discussionmentioning

confidence: 99%

“…The first model was initially used in Edmonton, Alberta's evaluation of a needle exchange program in 1999. Later, the model was used in an economic evaluation of Insite (14)(15)(16)(17)(18)25,26). In addition, the model has been used to estimate the cost-benefit/cost-effectiveness of a SIF potential in Montreal, Quebec, and Ottawa, Ontario (10,19).…”

Section: Modelsmentioning

confidence: 99%

“…The procedural objectives of Insite have been assessed by more than 60 peer-reviewed studies offering promising results. Some of the noted effects are reduction in overdose deaths, needle sharing, public injection and public discarded needles (12)(13)(14). In addition, most empirical analysis have reported cost-effectiveness of Insite in reducing HIV, HCV and overdose cases (4,(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

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Examining the potential role of a supervised injection facility in Saskatoon, Saskatchewan, to avert HIV among people who inject drugs

Jozaghi

Jackson

2015

Int J Health Policy Manag

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Background: Research predicting the public health and fiscal impact of Supervised Injection Facilities (SIFs), across different cities in Canada, has reported positive results on the reduction of HIV cases among People Who Inject Drugs (PWID). Most of the existing studies have focused on the outcomes of Insite, located in the Vancouver Downtown Eastside (DTES). Previous attention has not been afforded to other affected areas of Canada. The current study seeks to address this deficiency by assessing the cost-effectiveness of opening a SIF in Saskatoon, Saskatchewan. Methods: We used two different mathematical models commonly used in the literature, including sensitivity analyses, to estimate the number of HIV infections averted due to the establishment of a SIF in the city of Saskatoon, Saskatchewan. Results: Based on cumulative cost-effectiveness results, SIF establishment is cost-effective. The benefit to cost ratio was conservatively estimated to be 1.35 for the first two potential facilities. The study relied on 34% and 14% needle sharing rates for sensitivity analyses. The result for both sensitivity analyses and the base line estimates indicated positive prospects for the establishment of a SIF in Saskatoon. Conclusion:The opening of a SIF in Saskatoon, Saskatchewan is financially prudent in the reduction of tax payers' expenses and averting HIV infection rates among PWID. Keywords: People Who Inject Drugs (PWID), HIV, Cost-Benefit Analysis, Canada Copyright: © 2015 by Kerman University of Medical Sciences Citation: Jozaghi E, Jackson A. Examining the potential role of a supervised injection facility in Saskatoon, Saskatchewan, to avert HIV among people who inject drugs.

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Section: Discussionmentioning

confidence: 99%

Section: Modelsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Examining the potential role of a supervised injection facility in Saskatoon, Saskatchewan, to avert HIV among people who inject drugs

Jozaghi

Jackson

2015

Int J Health Policy Manag

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“…2 These legal defeats did not stop ongoing attempts to prevent the opening of additional safe injection sites, despite new evidence continuing to support Insite (e.g., Andresen and Boyd 2010;Marshall et al 2011). Only a change in government in 2015 led to a change in policy surrounding safe injection sites in Canada.…”

Section: Marleau and Girlingmentioning

confidence: 99%

Keeping science’s seat at the decision-making table: Mechanisms to motivate policy-makers to keep using scientific information in the age of disinformation

Marleau

Girling

2017

FACETS

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Policy-makers are confronted with complex problems that require evaluating multiple streams of evidence and weighing competing interests to develop and implement solutions. However, the policy interventions available to resolve these problems have different levels of supporting scientific evidence. Decision-makers, who are not necessarily scientifically trained, may favour policies with limited scientific backing to obtain public support. We illustrate these tensions with two case studies where the scientific consensus went up against the governing parties' chosen policy. What mechanisms exist to keep the weight of scientific evidence at the forefront of decision-making at the highest levels of government? In this paper, we propose that Canada create "Departmental Chief Science Advisors" (DCSAs), based on a program in the UK, to help complement and extend the reach of the newly created Chief Science Advisor position. DCSAs would provide advice to ministers and senior civil servants, critically evaluate scientific work in their host department, and provide public outreach for the department's science. We show how the DCSAs could be integrated into their departments and illustrate their potential benefits to the policy making process and the scientific community.

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“…Although methadone maintenance treatment, needle exchange programs and safe injection sites have clearly been shown to prevent the harms of injection drug use [16,17], the body of research supporting their effectiveness has been conducted predominantly among largely street-based populations of heroin users. The implementation of evidence-based responses to the burgeoning epidemic of OPR use, and programming to prevent the initiation of injection drug use among OPR users, should be considered an urgent public health priority.…”

mentioning

confidence: 99%

Commentary on Bruneau et al. (2012): Injection of prescription opioid pain relievers and infectious disease risk

Hadland

Wood

2012

Addiction

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Reduction in overdose mortality after the opening of North America's first medically supervised safer injecting facility: a retrospective population-based study

Cited by 399 publications

References 45 publications

Examining the potential role of a supervised injection facility in Saskatoon, Saskatchewan, to avert HIV among people who inject drugs

Examining the potential role of a supervised injection facility in Saskatoon, Saskatchewan, to avert HIV among people who inject drugs

Keeping science’s seat at the decision-making table: Mechanisms to motivate policy-makers to keep using scientific information in the age of disinformation

Commentary on Bruneau et al. (2012): Injection of prescription opioid pain relievers and infectious disease risk

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