The Economic Consequences of Opioid Addiction in America

In addition to being underfunded, MAT is blocked by our medical and criminal justice
systems. Concerned about doctors dealing drugs, the federal government
requires doctors to get specially certified for MAT and caps their allowed number of
Suboxone patients. In rural areas, many patients cannot find an open MAT slot. MAT
patients also suffer in the criminal justice system. If arrested, most jails refuse to allow
patients to continue their Suboxone treatment, sending them into withdrawal. Many drug
courts, which are designed to divert drug users out of the criminal justice system,
require patients to quit MAT. Fortunately, the Obama administration has threatened to
cut off funding for drug courts hostile to MAT. Access to MAT programs needs to be
expanded, particularly in rural areas and within the criminal justice system.
Supervised Injection Facilities
What can be done to help the most marginalized and depressed heroin users, who are
not seeking treatment? Many of these people are homeless, unemployed, suffering from
disease and chronic skin infections, cut off from family and friends, and branded with a
criminal record. Heroin is their solution to this situation. They need a place where they
can avoid overdose and disease. In order to successfully quit their painkiller, they need
comprehensive support to tackle their housing, employment, medical, criminal and
personal problems.
In 92 locations across Europe, Canada, and Australia, injection drug users bring their
own drugs into supervised injection facilities (SIFs) and inject in the presence of medical
staff. SIF staff provide sterile injection equipment, medical advice and treatment
referrals, and they intervene in case of overdose. All 92 SIFs have demonstrated a track
record of success—millions of injections and tens of thousands of overdoses have not
killed a single person. The difference is stark. A year ago in Pittsburgh, a batch of heroin
mixed with fentanyl killed 22 people. Nine months later in Vancouver, a similar batch
caused 32 people to overdose. Thirty-one of them overdosed at Insite, the city's SIF,
where the medical staff saved their lives. The 32nd, a woman in her 20s, was found
dead in a downtown hostel.
SIFs also save millions of dollars by reducing disease transmission. Since users can be
arrested for possessing needles, many share syringes with other drug users, spreading
blood-borne diseases. As a result, when compared to the general U.S. population,
people who inject drugs are 35 times more likely to have Hepatitis C and 23 times more
likely to be HIV positive. A single new infection carries lifetime costs of $68,000 for
Hepatitis C and $408,000 for HIV/AIDS. Researchers estimate that over the past
decade alone, the Vancouver SIF has saved millions of dollars and dozens of lives for
the local population.
SIFs have a number of other benefits. Medical staff spot skin infections early on and
intervene before they develop into expensive, life-threatening conditions. Studies show
that SIFs also reduce syringe littering and the frequency of drug use in public places.
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