New research projects that over the next 10 years Vancouver's Insite supervised drug-injection program could save up to $20 million in health-care costs, significantly increase the lifespan of drug users, and avert more than 1,000 cases of HIV.

The Vancouver Sun reported Nov. 17 that researchers at the University of Toronto and the University of Western Ontario looked at projected effects of the Insite facility on Vancouver over the next decade by using a computer simulation. The researchers concluded that Insite would add 920 "life years" to the drug-using population's life span, compared to a model without the injection site.

When additional factors like overdose survival rates, incidence of HIV and hepatitis C, and frequency of social-service referrals were integrated into the model, the researchers saw a gain of 1,070 in life years. Financial savings were estimated to reach $20 million with these features added (compared to a projected net savings of $14 million based on the impact of Insite alone). Additionally, 1,191 cases of HIV and 54 cases of hepatitis C could be prevented because of the program, the authors said.

"We believe that Insite does provide good value for money, if you were to look at the cost-effectiveness," researcher Gregory Zaric of the University of Western Ontario in London said. "This study ultimately brings one more piece of information when deciding the fate of Insite."

Insite positively impacted the community in many ways, including "a decrease in needle sharing and reuse of syringes, fewer people injecting drugs in public, an increase in referrals to social services and addiction counseling, a decrease in the number of publicly discarded syringes, no apparent increase in police reports of drug-dealing or crime, and no observed increase in new initiates into drug use," Zaric and co-author Ahmed Bayoumi of St. Michael's Hospital in Toronto and the University of Toronto wrote in the report.

Canada's only supervised drug-injection site, Insite has operated in downtown Vancouver since 2003 through an exemption from Canada's Controlled Drugs and Substances Act and several permit extensions. However, the federal government has appealed a recent constitutional extension granted by the British Columbia Supreme Court, with the appeal scheduled for a hearing in April 2009.

The report's findings will be published in the Nov. 18, 2008 issue of the Canadian Medical Association Journal.