Injecting room will cost $5.6 million per life saved

A proposed Melbourne injecting room will inevitably present similar costs to the Sydney facility, which saved the lives of only 4 opiate users in its first 9 years of operation while referring a tiny percentage to recovery.

In Australia there is one opiate overdose fatality for every 110,000 injections, but the Kings Cross injecting room supervises only 58,000 opiate injections each year.[i]  These 58,000 injections fall well short of the 110,000 injections that must be supervised before the facility can claim it saved the one life that would otherwise have been lost.  It takes the Sydney facility almost two years and $5.6 million[ii] to save a single life.

The ratio of deaths to injections is well documented in this country where up to 85% of Australia’s opiate overdose deaths occur amongst long-term dependent users[iii] who inject multiple times daily, rather than amongst casual users.  The many studies of overdose deaths amongst Australian opiate users strongly agree that one out of every 100 dependent opiate users die each year from overdose.[iv],[v],[vi],[vii]  This means that if 100 dependent opiate users were all housed in the one charity-run housing facility, each injecting an average 3 times daily,[viii],[ix] one would likely die each year.  This group of 100 users would between them inject around 110,000 times each year,[x] with only one injection in that 110,000 being fatal.  The Sydney injecting room supervises 160 opiate injections per day despite having capacity for more than 300.  This under-utilisation only adds to its inordinately high costs for little benefit.

Alternately, the $5.6 million spent to save a single life in Kings Cross will fund 950 Naltrexone implants per year.  The Western Australian government has funded implants in that State for the last 19 years, presently contributing $3 million annually.  Implant Naltrexone constantly resident in the blood works like Naloxone which nullifies any effect of opiates.  Of those 950 implant patients, 9-10 (1 in every 100) would have otherwise died.  Furthermore, the person whose life was saved in the Sydney facility today may die tomorrow injecting at home, while the same does not occur with active implants.[xi] 

For the cost of just one life saved in a proposed North Richmond injecting room, implants will save at least nine times as many, something Victorian coroners need to consider.  Ultimately there is no contest between the two when compassion for the lives of Melbourne’s opiate users is uppermost.  A Victorian injecting room will be a waste of public money.

Gary Christian­­­­­

Secretary

Drug Free Australia

0422 163 141

www.drugfree.org.au

 

[i] [ix] https://uniting.org/who-we-help/for-adults/sydney-medically-supervised-injecting-centre/what-the-uniting-sydney-msic-does shows an average 180 injections per day and the last government-funded evaluation shows that more than 10% of injections are not opiates - http://www.health.nsw.gov.au/mentalhealth/programs/da/Documents/msic-kpmg.pdf p 112

[ii] The Sydney injecting room spends about $3 million annually on its operation, apart from other side-programs funded by the NSW Department of Health – see http://www.justicehealth.nsw.gov.au/publications/201516NSWHealthAnnualReport.pdf p 108

[iii] https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Mono.46.PDF p 14 This is a Federal Government Monograph reviewing the extant literature on heroin overdose

[iv] https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/NDARC%20monograph%2044.pdf  This was the study that calculated the number of heroin users in Australia for 1997, where one of its calculations estimated the number of users by multiplying deaths for that year by 100

[v] https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-015-0089-3 see Abstract

[vi] https://www.ncbi.nlm.nih.gov/labs/articles/27021806/

[vii] https://www.ncbi.nlm.nih.gov/pubmed/16735295

[viii] https://uniting.org/__data/assets/pdf_file/0007/136438/MSIC-final-evaluation-report-2003.pdf p 58 The first government-funded evaluation of the Sydney facility, done mostly by NSW University teaching faculty colleagues of its then medical Director, Dr Ingrid van Beek, noted that dependent users injected ‘at least’ 3 times daily

[ix] https://drugs-forum.com/threads/how-many-times-a-day-do-other-daily-addicts-use.90306/

[x] That is, 100 injectors injecting ‘at least’ 3 times daily for 365 days annually = 109,500 injections

[xi] http://www.journalofsubstanceabusetreatment.com/article/S0740-5472(07)00249-8/abstract) note no deaths during the active implant stage – Drug Free Australia thereby recommends Naltrexone implant maintenance as an alternative to injecting rooms, where users will become abstinent at their own pace

 

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