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Safe injection sites receive support in face of opioid epidemic

On Jan. 23, 2017, Philadelphia city officials announced their support for supervised drug injection sites to combat the ongoing opioid epidemic, which has led to increased rates of infectious disease transmissions such as hepatitis C and HIV.

Additionally, there has been a marked increase in overdose fatalities related to opioid use, according to a recently published editorial by Jessie M. Gaeta, MD, and Melanie Racine, MPH, from the Boston Health Care for the Homeless Program.

“With the explosion of highly potent fentanyl and its analogs in the illicit drug supply, overdose fatalities are occurring with alarming frequency and speed — often within minutes or even seconds of injection, leaving little time for first responders to find and resuscitate victims,” Gaeta and Racine wrote.

“We now support a strategy that other countries around the world have been adopting since as early as 1984 — supervised injection facilities, or SIFs,” Gaeta and Racine continued. “Approximately 100 SIFs in 11 countries across Europe, North America and Australia have been studied for decades. SIFs offer sterile injecting equipment and a hygienic environment for medically supervised injection of drugs obtained off-site. SIFs also offer education about reducing harms, access to life-saving naloxone and connection to primary health care services, counseling and treatment for [substance use disorder (SUD)].”

According to Gaeta and Racine, over 100 peer-reviewed studies on safe injection sites have been published that report reduced cases of overdose and mortality and increased safer injection behaviors, which were then linked to reduced infectious disease transmission. The studies also showed that implementation of safe injection sites did not increase public disorder, attract drug-related crime to the area of the site, or increase relapse rates.

Gaeta and Racine noted that the Massachusetts Medical Society and American Medical Association have announced support for the development of pilot safe injection sites to study their impact on the opioid epidemic, provide an additional strategy to mitigate overdose, and connect injection drug users with treatment.

“If the opioid overdose epidemic continues at anywhere near its current rate, over half a million more deaths will occur in America in the next 10 years,” Gaeta and Racine concluded. “As health care practitioners, we have a duty to advocate for the development and study of interventions that have shown promise in promoting health and saving lives. We endorse SIFs as one piece of a comprehensive continuum of care for this chronic, relapsing disease.” – by Talitha Bennett

Disclosure: Healio.com/Hepatology was unable to determine relevant financial disclosures at the time of publication.