UPDATED: Report offers financial argument in favor of safe injection sites

Research by the Institute for Clinical and Economic Review says Boston could save $4 million + in health care costs by opening a safe consumption site. The issue, though, is a thorny one.

A photo shows harm reduction materials, such as clean needles and alcohol prep pads, that are often distributed at existing foreign safe consumption sites. (Photo by Todd Huffman, used under Creative Commons license)


Boston could save more than $4 million by creating a safe consumption site for people who use IV drugs, a new draft report from the Institute for Clinical and Economic Review says. 

Released on September 24, the report details how such a site within city limits could save money by reducing ambulance trips, ER visits, hospitalizations and fatalities due to overdoses.

Previously released scientific work has further suggested these facilities increase participation in recovery treatment.

“This is an intervention that we can turn to that we know works and could address the rapid increases in overdose deaths that we’re seeing in Boston and across the region,” said Brown University associate professor of epidemiology Brandon Marshall in a recent interview with Boston 25 News.

Safe consumptions sites have existed since the 1980s in Europe. They came to Canada more recently, offering people with addictions opportunities to use substances while being cared for by medical professionals. 

No such facilities, however, exist in the US as efforts to bring them here have faced strong opposition. 

“These sites are a terrible idea and, more importantly, they are illegal,” US Attorney for Massachusetts Andrew Lelling argued in a Boston Globe op-ed last year.

While recognizing the severity of the opioid crisis, Lelling wrote that consumption sites are not the answer. He argued that scientific analysis of foreign efforts have often been poorly executed. He further discussed potential moral and ethical issues with such sites and echoed complaints of residents in areas like the South End and Roxbury, who say that already centralized addiction services have concentrated issues associated with drug use on their doorsteps.

“The City of Vancouver dropped the speed limit on the street next to [it’s safe consumption site] to about 20 miles per hour because addicts might wander into traffic,” Lelling wrote. “Do you want this in Boston? In Cambridge?”

Regardless, advocates press onward. And this new ICER report represents a fresh tool for them in that effort.

With ambulance rides costing $523 each, and hospitalizations racking up an average bill of $8,379, after all, the reduced burden offered by a safe consumption site would save Boston $4.09 million each year, ICER says.

However, the city can only save this money if the state legislature passes a pivotal bill simply identified as S.2717. 

Proposed by senator Joseph A. Boncore and representatives Jack Patrick Lewis and Lindsay Sabadosa, that bill would allow safe consumption sites in Massachusetts.

It has, however, been stuck in the Senate Ways and Means Committee since June 25. 

“It is an honor to join Senator Joe Boncore and Lindsay Sabadosa, State Representative, 1st Hampshire District on legislation to more fully treat substance use disorder from a public health perspective and not one of criminal prosecution,” Lewis wrote in a Facebook post, Thursday, sharing an earlier version of this article. “S.2717 would simply study what many other countries have already done by administering a safe consumption site pilot program here in the Commonwealth.”

As Lewis commented, Jim Stewart, who has advocated for safe consumption sites through his group SIFMA NOW, blasted senate inaction on S.2717.

“Public officials refuse to recognize the facts because they are unwilling to challenge their own and their constituents bigotry about who drug users are and what will actually help them,” he said, via text message. “Lives continue to be lost and degraded due to cowardice and ignorance.”

Follow S.2717 through the Mass.gov website…https://malegislature.gov/Bills/191/S2717

Read the September edition of our “Research Roundup” for more coverage of recent academic work on addiction in Boston…https://substantive.substack.com/p/research-roundup-september

Subscribe to Substantive to see more coverage of this issue and the broader world of addiction research in Boston…