Reduction in overdose mortality with medically supervised safer injecting facility

January 01, 0001

Reduction in overdose mortality with medically supervised safer injecting facility

Overdose from illicit drugs is a leading cause of premature mortality in North America. Internationally, more than 65 supervised injecting facilities (SIFs), where drug users can inject pre-obtained illicit drugs, have been opened as part of various strategies to reduce the harms associated with drug use. The researchers sought to determine whether the opening of an SIF in Vancouver, BC, Canada, was associated with a reduction in overdose mortality. They examined population- based overdose mortality rates for the period before (Jan 1, 2001, to Sept 20, 2003) and after (Sept 21, 2003, to Dec 31, 2005) the opening of the Vancouver SIF. The location of death was determined from provincial coroner records. They compared overdose fatality rates within an a priori specified 500 m radius of the SIF and for the rest of the city.

Of 290 decedents, 79.0% were male, and the median age at death was 40 years. A third 30.7% of deaths occurred in city blocks within 500 m of the SIF. The fatal overdose rate in this area decreased by 35.0% after the opening of the SIF, from 253.8 to 165.1 deaths per 100,000 person-years (significant). By contrast, during the same period, the fatal overdose rate in the rest of the city decreased by only 9.3%, from 7.6 to 6.9 deaths per 100,000 person-years. There was a significant interaction of rate differences across strata.

The researchers concluded: "SIFs should be considered where injection drug use is prevalent, particularly in areas with high densities of overdose."

Interesting approach to harm reduction.

For the full abstract, click here.

The Lancet 377(9775):1429-1437, 23 April 2011
© 2011 Elsevier Limited
Reduction in overdose mortality after the opening of North America's first medically supervised safer injecting facility: a retrospective population-based study. Brandon DL Marshall, M-J Milloy, Evan Wood et al. Correspondence to Thomas Kerr: [email protected]

Category: HSR. Health Services Research Keywords: overdose, mortality, reduction, medically supervised, injecting facility, North America, retrospective population-based study, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 20 May 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.