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Heroin Addiction and Related Clinical Problems: 2018, 20, N4 (pages: 37 - 43)

The Cost-Effectiveness of Naloxone Programmes for the Treatment of Heroin Overdoses ‘on the Street': A 2-Year Data Collection by the Street Unit of the Villa Maraini Foundation

Barra M., Direnzo G.F.M., Patruno F.V., Patti M., Rodoquino G., Rossi E., Santoro R., and Badiani A.

Summary: Introduction: The mortality rate of opioid users is 5 to 10 times greater than that of the general population, and the most common cause of death in that case is an overdose. When treated in a timely fashion with the opioid antagonist naloxone, an opioid overdose is rarely lethal. Unfortunately, many opioid overdoses occur in isolated, hidden, inaccessible locations. To circumvent this problem, the Villa Maraini Foundation in Rome has created a rescue team called ‘the Street Unit' to provide basic life support and administer naloxone for the treatment of opioid overdose in urban environments. The aim of this paper is to review the cost-effectiveness of our Street Unit. Methods: We compared the cost of 90 overdose interventions provided by the Street Unit with the cost of those provided by the Accident & Emergency departments of the Italian National Health System. Results: The Street Unit not only successfully treated all overdoses, but also provided a dramatic reduction in costs, ranging from €123,367.05 (best-case scenario) to €203,377.05 (worst-case scenario). Conclusion: This finding suggests that the treatment of opioid overdose in the street context offers a safe, cost-effective strategy for the reduction of opioid overdose-related mortality.