The impact of supervised consumption sites on acute care health services: A literature review
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Date
2023-05-15
Authors
Mastromonaco, Carly
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Abstract
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.