{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:18:38Z","timestamp":1790032718182,"version":"4.0.1"},"reference-count":85,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Harm reduction interventions aim to reduce negative consequences of drug use. We aimed to estimate the cost, health impact and economic benefits of current, expanded and new harm reduction interventions for people who use drugs in the Australian Capital Territory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We conducted a cost\u2013benefit analysis of existing and new harm reduction interventions in the Australian Capital Territory. Independent decision tree models captured health outcomes [opioid\/non\u2010opioid overdose; overdose\u2010related deaths; injection\u2010related skin\/soft tissue\/vascular infections (IRIs); hepatitis C incidence] for 2026\u20132030 according to intervention coverage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Australian Capital Territory, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants\/cases<\/jats:title>\n                    <jats:p>\n                      People who use drugs through injecting (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091500) or non\u2010injecting (\n                      <jats:italic>n\u2009<\/jats:italic>\n                      =\u200933\u2009600) routes differentiated by drug class (opioid\/non\u2010opioid).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions and comparator<\/jats:title>\n                    <jats:p>A baseline scenario (current intervention coverage maintained) was compared with a counterfactual no interventions scenario, as well as scenarios with interventions linearly scaled up to the assumed maximum proportion of the target population that could be reached given geographical, social and implementation constraints. Interventions included in the analysis were: drug consumption rooms, needle\u2010syringe programs, take\u2010home naloxone, opioid agonist treatment, safer opioid supply, drug checking services and technological interventions (i.e. overdose monitoring \u2018apps\u2019\/hotlines).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Economic benefits were estimated from health costs averted (emergency response; shorter hospitalisation for IRI; hepatitis C treatment) and societal costs from years of life lost. Benefit\u2013cost ratios were calculated compared to the baseline. A sensitivity analysis considered a changed illicit drug market with increased probability of overdose and overdose\u2010related death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Compared with no coverage, the current package of harm reduction interventions was estimated to cost $24.6 million over 2026\u20132030 and avert 454 (24%) opioid and 20 (0.2%) non\u2010opioid overdoses, 70 (28%) overdose\u2010related deaths, 215 (17%) emergency responses, 552 (117%) hepatitis C infections and 199 (9%) IRIs. This corresponds to $250.1 million in economic benefits [benefit\u2013cost ratio\u2009=\u200910.1, 95% confidence interval (CI)\u2009=\u20097.9\u201312.4].<\/jats:p>\n                    <jats:p>Benefit\u2013cost ratios for scaling up take\u2010home naloxone [16.4 (5.0\u201327.9)], opioid agonist treatment [10.2 (5.6\u201315.3)], technological interventions [3.5 (0.0\u201315.7)], drug consumption room\/s using medialised [1.9 (0.6\u20133.9)] or nurse\/peer\u2010led model [2.7 (1.2\u20134.4)], safer opioid supply [1.5 (0.8\u20132.6)]\u00a0and needle\u2010syringe programs [1.4 (0.7\u20132.6)] were favourable. The benefit\u2013cost ratio for drug checking was 0.3 (0.0\u20136.2) but increased to 14.0 (0.1\u201329.6) under changed drug market conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Modelled expanded and new harm reduction interventions for people who use drugs in the Australian Capital Territory appear to be likely to be cost saving from a societal perspective. If circulation of drugs with higher overdose risks was greater in this region, this would increase the impacts of interventions to prevent overdose and associated harms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70276","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T20:03:22Z","timestamp":1769544202000},"page":"1272-1289","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A cost\u2013benefit analysis of the implementation and scale\u2010up of harm reduction interventions in the Australian Capital Territory"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2192-9260","authenticated-orcid":false,"given":"Anna L.","family":"Bowring","sequence":"first","affiliation":[{"name":"Burnet Institute  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Tidhar","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Olsen","sequence":"additional","affiliation":[{"name":"School of Medicine and Psychology Australian National University, College of Health and Medicine  Canberra Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Bailie","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin","family":"Burke","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rowan","family":"Martin\u2010Hughes","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Keane","sequence":"additional","affiliation":[{"name":"School of Sociology Australian National University, College of Arts and Social Sciences  Canberra Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Dietze","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Scott","sequence":"additional","affiliation":[{"name":"Burnet Institute  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Harm Reduction International.What is harm reduction?[cited 2025 Apr 24]. 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