Supervised injection facilities reduce all causes of premature death among people who inject drugs, new research finds
published on December 19, 2019
Supervised injection facilities are not only effective at reducing overdose deaths – they help reduce the risk of premature death from other causes, according to a new study from researchers at the BC Centre on Substance Use (BCCSU) and University of British Columbia (UBC).
Researchers interviewed 811 people who inject drugs in Vancouver between December 2006 and June 2017, following them for an average of six years. The researchers found that people who reported using supervised injection facilities on at least a weekly basis were 54% less likely to die compared to individuals who reported less than weekly or no use of supervised injection services.
“We know that injection drug use is associated with many different health risks and social harms, which ultimately contribute to premature death,” says lead author Dr. Mary Clare Kennedy, a Postdoctoral Research Fellow at UBC and the BCCSU. “These findings suggest that many of those premature deaths may be preventable, and that supervised injection facilities are a critical part of the response to the harms of injection drug use.”
Overdose deaths have risen dramatically in North America in recent years. More than 70,000 people died of an overdose in the US in 2017 and more than 4,000 Canadians died in 2018.* The impact of supervised injection facilities on reducing overdose death risk has been well established in scientific research.
However, this study is the first to demonstrate an association between frequent use of supervised injection facilities and a lower risk of all-cause mortality. Although the underlying explanations for this finding were not examined in this new study, past studies have found a number of health benefits associated with supervised injection facilities that may account for this. Specifically, in addition to reducing deaths from overdoses, supervised injection facilities have been found to be effective in linking people to care early for complex health conditions through on-site nursing care and referrals to services like addiction treatment. By providing sterile injection supplies and education on safe injection practices, supervised injection facilities have also been found to reduce high-risk injection behaviours, such as needle sharing, that increase risk of HIV, Hepatitis C and bacterial infections.
“Supervised injection facilities bring people into a health care environment where they can get the help they need,” says Dr. Thomas Kerr, senior author of the study and a professor of medicine at UBC and BCCSU. “Given the ongoing health-related harms experienced by people who inject drugs, and the current overdose epidemic, we have a moral imperative and good reasons for the sake of public health to increase access to these facilities.”
The people who use injectable drugs who participated in the study experienced a higher-than-average death rate than the general population, underscoring the continued need for programming that reduces health risks in this group. A total of 112 (14%) of the 811 study participants died during the 11-year study period. These individuals died an average of 34 years earlier than the average British Columbian. The most common causes of death were non-accidental causes (including circulatory and respiratory infections), ill-defined or unknown factors, accidental overdose, and HIV-related causes.
Read the full study here:
- Supervised injection facility use and all-cause mortality among people who inject drugs in Vancouver, Canada: A cohort study
* the most recent data available for both countries