DPA Releases New Report: The Costs and Benefits of a Supervised Use Site in Denver, Colorado

Today the Drug Policy Alliance is releasing a new report, The Costs and Benefits of a Supervised Use Site in Denver, Colorado. Produced in collaboration with Colorado Fiscal Institute, Law Enforcement Action Partnership and Harm Reduction Action Center, the report marshals the best available data from Denver and from existing facilities in Canada and Europe to analyze the cost effectiveness of a prospective supervised use site in Denver. 

Facilities providing supervised consumption services (SCS) are legally sanctioned to allow people to consume pre-obtained drugs under the supervision of trained staff while providing access to sterile equipment, health care, counseling, and referrals to medical and social services, including drug treatment. Such facilities are also referred to as supervised use sites (SUS), the terminology adopted most commonly in Denver, as well as overdose prevention centers, safe or supervised injection facilities (SIFs) and drug consumptions rooms (DCRs). 

Report findings include:

• A full capacity SUS in Denver could generate $8.6 million in health benefits for a total cost of under $1.8 million, yielding a cost-benefit ratio of $4.89 saved for every dollar spent.
• The net savings associated with a full capacity SUS in Denver is projected to be $6.9 million per year.
• Health benefits and associated fiscal savings projected for a Denver-based SUS include:
  • $300,000 in savings through HIV prevention
  • $3.8 million in annual savings through HCV prevention 
  • $2.8 million in annual savings through SSTI prevention
  • Multiple lives saved and reduced ambulance, emergency room and hospital costs through overdose prevention
  • $320,000 in reduced annual drug-related health care and crime costs

Recent cost-benefit analyses have reached similar conclusions in San Francisco and Baltimore.

Advocates are lauding this report as confirmation that the Colorado General Assembly should move forward without delay with legislation to allow a supervised use site. In November of 2018, Denver City Council nearly unanimously passed an ordinance authorizing establishment of a supervised use site pilot program contingent upon approval of corresponding state legislation that is pending introduction. The new report shows that the legislature has an urgent opportunity to save money and lives by introducing and approving this bill.

Several state legislators, including Senator Brittany Pettersen (D – District 22), Senator Kevin Priola (R – District 25), and Representative Leslie Herod (D – District 8) have been involved in plans to introduce a bill that would allow Denver to implement the supervised use site pilot program ordinance, but Senator Pettersen announced today that those efforts are stalling. Local experts from the public health, medical, faith and legal communities, as well as families impacted by overdose, insist on the urgent need to move forward.

“The legislature has a duty to pursue fiscally responsible and evidence-based public health policy. We need to face the fact that opposition to Denver’s supervised use site pilot program is based solely in bias, stigma and misinformation,” says Amanda Bent, Policy Manager for the Colorado office of the Drug Policy Alliance. “Extensive studies prove that supervised use sites save money and resources while preventing disease and death. This cost-benefit analysis report shows how an initiative that will funded by private foundations, grants and individual donors will benefit the entire Denver community. It’s irresponsible and unconscionable for the legislature to stop Denver from implementing this ordinance.”

The coalition to establish a supervised use site in Denver is publicly supported by over fifty local businesses and officially endorsed by over fifty medical, public health, social service and faith organizations. Supporters include Colorado Medical Society, Denver Medical Society, the American Medical Association and the American College of Emergency Physicians.

“We need to act swiftly to bring new, scientifically proven tactics to address the opioid epidemic, which is why physicians and physician organizations overwhelmingly support pilot supervised injection facilities or supervised use sites,” says Dr. Donald Stader, MD, FACEP and President of the Colorado American College of Emergency Physicians. “Backed by significant and compelling scientific data, these are a key component of our response to the opioid epidemic. A supervised use site in Colorado will save lives, prevent disease, facilitate patients getting into treatment and save our medical system millions of dollars. This represents not only a logical, scientific solution to problems around injection drug use, but also a moral response to a public health crisis.”

Colorado Governor Jared Polis has suggested that supervised use sites may represent innovative, cost-effective access to treatment under the appropriate purview of local control. The Colorado Office of the Attorney General, previously under Republican Cynthia Coffman, endorsed the supervised use site coalition and current Democratic Attorney General Phil Weiser, who assumed office this year, is also supportive. The findings of this report only bolster the existing backing from diverse stakeholders and buy-in from bipartisan officials. 

Approximately 120 SCS facilities are currently operating in twelve countries around the world including Australia, Canada, Denmark, France, Germany, Luxembourg, the Netherlands, Norway, Spain and Switzerland. Over 100 evidence-based, peer-reviewed studies have consistently proven the positive impacts of supervised consumption services, including increasing entry into substance use disorder treatment, reducing public disorder and public injecting, reducing HIV and Hepatitis C risk behavior, and saving costs due to a reduction in disease, overdose deaths, and need for emergency medical services.