The cost-effectiveness of naloxone programs for the treatment of heroin overdose in the ‘street’: a 2-years data collection by the Street Unit of the Villa Maraini Foundation

The mortality rate of opioid users is about 5 to 10 times greater than that of the general population, and the overdose represents the most common cause of death. When timely treated with the opioid antagonist naloxone, the opioid overdose is rarely lethal. Unfortunately, many opioid overdoses occur in isolated, hidden, hard to reach location. To circumvent this problem, Villa Maraini Foundation in Rome has created a rescue team, 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. We evaluated the cost of 90 overdose interventions provided by the Street Unit to that provided by the Accident & Emergency departments of the Italian National Health System. 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). This finding suggests that the treatment of opioid overdose in the street context represents a safe and cost-effective strategy to reduce opioid overdose related mortality.