Safe and clean syringe service programs that distribute the opioid antagonist naloxone can help save lives if combined with cost-effective pre-exposure prophylaxis (PrEP) to prevent the spread of HIV, a new study from the Lancet Journal of Public Health determined.
Prophylaxis is defined as an action taken to prevent disease. The combination of these tactics is the most productive way to both treat addiction and prevent further deaths from opioid use, the study suggested.
The researchers studied five strategies to estimate the outcomes and cost-effectiveness of each method. The strategies analyzed were no additional intervention other than standard addiction treatment; naloxone distribution; naloxone distribution with addiction treatment; naloxone distribution with PrEP for HIV prevention; and a combination of the three methods of naloxone distribution.
The study simulated overdoses from opioids and heroin, other opioid-related deaths, HIV incidences and deaths in people who took drugs intravenously in the state of Connecticut by using probability charts with the data from heroin users in the United States contrasted with the population in the state. Each strategy was analyzed regarding outcomes such as survival, life expectancy, quality-adjusted life-years, percentage and number of overdose deaths avoided, the number of HIV deaths avoided, the total cost of each strategy, and the incremental cost of quality-adjusted years of life.
The addiction treatment surveyed by researchers was an opioid treatment that used methadone. Compared with no additional intervention, distributing naloxone yielded an incremental cost-effectiveness of $323 for the years of life adjusted to quality.
The most effective strategies were naloxone distribution combined with addiction treatment, and distribution combined with both addiction treatment and pre-exposure prophylaxis. But the combination of all three methods was the most beneficial strategy. Syringe programs, the study says, are more cost-effective when you combine them with naloxone distribution.
The study states that naloxone distribution is useful and economical, but comprehensive strategies are needed to optimize the health, recovery, and transmission of diseases like HIV and hepatitis C. The cost-effectiveness ranges from $50,000 to $350,000 in quality assessments when PrEP is included.
Researchers concluded that… (continue reading)