The impact of supervised consumption sites on acute care health services: A literature review

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Mastromonaco, Carly
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People who use illicit drugs (PWUD) have higher rates of health care utilization compared to the general population. Additionally, PWUD are more than four times as likely to leave hospital against medical advice, contributing to costly readmissions for incompletely treated medical issues. Addressing this issue and providing efficacious care to PWUD requires the integration of adequate harm reduction strategies in the community and in acute care facilities. Supervised consumption sites are legally sanctioned facilities with trained staff that supervise the use of pre-obtained drugs and provide clean and safe drug equipment to PWUD. The aim of these sites is to prevent accidental overdose and reduce the spread of infectious diseases, while providing a safe environment and community for PWUD to have access to addictions resources, health services and other social supports. The purpose of this literature review is to identify the degree to which supervised consumption sites can impact health care utilization amongst PWUD. Specifically, this review aims to identify the impact that community-based SCS have on overdose-related ambulance attendance, emergency department visits, and hospitalization, as well as the impact that hospital-based SCS have on reducing patientdirected discharges for PWUD and contributing to medical retention of patients. This literature review identifies that the implementation of community-based SCS significantly reduces the use of emergency medical services for PWUD and is associated with decreased healthcare costs. The literature identifies a clear demand for access to SCS for hospitalized PWUD, however more research is needed to understand the efficacy of hospital-based SCS at reducing harm and decreasing the rates of patient-directed discharge and costly readmissions in this population.