Physicians who establish policy positions for the Massachusetts Medical Society are set to vote on a recommendation that the society support a pilot supervised injection facility program in the state.
If the recommendation is approved, MMS would be the first state physician group to support a SIF program, according to an article from WBUR, Boston’s public radio station. The measure was unanimously approved by MMS’ board of trustees. At a SIF, patients addicted to heroin or other opioids would be able to inject the drugs in the presence of clinicians who would monitor them and treat overdoses. The model is gaining steam as possible way to take on the nation’s opioid addiction crisis.
Dennis Dimitri, M.D., past president of the society and the head of its task force on opioid addiction, told WBUR that the ethical concerns of allowing patients to take illegal drugs in their presence is outweighed by the benefits of treating people with substance abuse disorder.
“It's about trying to get individuals into an environment, where they have a much better chance of surviving their substance use disorder, to a point in time where they actually are able to make progress in recovery,” Dimitri said.
Though politicians and law enforcement agencies may approach SIFs with skepticism, studies have found that safe injection sites in other countries help more patients enter treatment programs and save lives, according to an article from JAMA Forum. In Vancouver, for instance, researchers found that the SIF did not lead to increased injectable drug use. In a random sampling of more than 1,000 users who went to the facility, just one injected there for the first time.
Researchers also estimated that Vancouver’s SIF saved $20 million in healthcare costs, and annually prevented at least three deaths and upwards of 30 HIV infections, according to the article.
The opioid crisis forces doctors to strike a delicate balance between the needs of patients with chronic pain and calls to reduce the number of painkiller prescriptions they offer. Some states are considering laws that would allow patients to put a “nonopioid directive” on file to prevent doctors from issuing scripts for the drugs. Other strategies that providers are putting increased emphasis on e-prescribing and training that help clinicians spot signs of addiction faster.