A systematic review of economic evaluations of supervised injection and consumption facilities for people who use drugs: A study protocol

Abstract Background : There are now more than 100 supervised injection facilities (SIFs) operating in numerous jurisdictions, including Australia, Canada and Western Europe. However, despite the increasing prevalence of people who use or abuse illegal drugs, including those who inject drugs, there are currently no operating SIFs in Africa, Asia, Central and South America and Eastern Europe. With the exception of Canada in North America, no sanctioned facility currently operates in the United Mexican States or the United States of America. This is the first study to systematically synthetizes the overall benefits and cost-effective ratios associated with operating SIFs, hypothetical SIFs, or drug consumption sites in different jurisdictions. Methods and Analysis : In this systematic review, through relying on five electronic scientific data bases, the peer-reviewed studies, reports, and theses that have evaluated the cost and benefits of supervised injection or consumption facilities will be identified. Based on the inclusion criteria, all initial articles will be identified and screened via title and abstract. All the articles collected through the initial search will be additionally screened to extract further information and data related to costs, benefits, programs, or services. The final data analysis will include the average cumulative benefits, costs, and ratios associated with operating SIFs. Discussion: This review has the potential to provide evidence-based knowledge related to the cost-savings of public health interventions implemented via harm reduction approaches for marginalized populations. However, it is important to emphasize that SIFs are an integral part of health care system for the marginalized populations and their establishments should not be based on health care costs, rather based on human rights. Systematic review registration: PROPSERO CRD42018100324