5 Years, No Fatal ODs: Study Finds 'Safe Injection Sites' Can Save Lives

THURSDAY, July 9, 2020 (HealthDay News) -- Safe injection sites for users of illicit drugs such as heroin: They've been tried and legalized in countries such as Canada and the Netherlands, and a new study suggests they might save American lives, too.

In the study, published online July 8 in the New England Journal of Medicine, researchers analyzed five years of data (2014 to 2019) from an unsanctioned safe drug consumption site in the United States. It's location was not disclosed for privacy reasons.

At the site, people were able to inject illicit drugs, such as heroin, under the supervision of staff who were trained to provide counseling, drug overdose intervention, and to also contact emergency medical services, if needed.

People using the safe drug site had to be invited, be 18 years of age or older, have a history of prior illicit drug use and come to the site with their own drugs.

Once there, they were provided with sterile syringes and injection equipment, and a staff member assisted with the injection if requested.

During the study period, more than 10,500 injections took place, according to the researchers at RTI International, a nonprofit research institute, and the University of California, San Diego.

Of those, 33 resulted in opioid overdoses, all of which were reversed by staff trained to inject the user with the opioid OD treatment drug naloxone.

None of the overdoses required a call to 911, and there were no deaths at the injection site over the five years of the study.

"We know that nearly 70,000 people die each year from drug overdoses in the U.S.," study author Alex Kral, an epidemiologist at RTI, said in a news release from the group.

"Implementing safe consumption sites could lead to a reduction in deaths, and studies from other countries with sanctioned injection sites have shown reductions in the risk of infectious disease, drug use, and increased access to health and social services," Kral said.

Over the five years, the number of injections and the number of overdoses both increased, in line with the burgeoning opioid addiction epidemic in the United States. The type of drugs used at the site also changed significantly, the researchers said, with a 55% increase observed in the use of a combination of opioid and stimulant drugs.

"Sanctioning these sites could help allow linkages to other medical and social services including substance use treatment," Kral said. "The sites could also help reduce problems that we see across communities, such as public drug use and improperly discarded syringes."

Dr. Roopali Parikh is a psychiatrist specializing in substance use disorders at the Northwell Health Physician Partners' Behavioral Health Group Practice in Manhasset, N.Y. Reading over the new report, she agreed that "safe consumption sites have great potential in reducing deaths from opioid overdose in the United States.

"Multiple studies have demonstrated that individuals with opioid use disorder value these safe consumption sites for the shelter and protection that they provide, the creation of a sense of belonging to individuals who are often discriminated against, and of course, safety from overdoses and communicable diseases given the clean needles and syringes," Parikh said.

But legal and staffing issues often stand in the way of establishing safe injection sites, she added.

Those issues involve "funding for supplies, rent, meals, and salaries for trained professionals, as well as the potential lawsuits for assisted injections leading to morbidity and even mortality," Parikh said.

More information

The Canadian Centre for Addictions has more on safe injection sites.

SOURCES: Roopali Parikh, MD, psychiatrist specializing in substance use disorder, Northwell Health Physician Partners' Behavioral Health Group Practice, Manhasset, N.Y.; RTI International, news release, July 8, 2020

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