Table 2.
Valuing outcomes experienced by SCS service users.
| Outcome | Financial valuation or proxy | Value ($CAD) | Source | Notes on value included and sensitivity test conducted (if applicable) |
|---|---|---|---|---|
| # of avoided overdoses that might otherwise have resulted in death or serious harm. | Quality Adjusted Life Year (QALY) valuation. | $22,229 | Lebenbaum et al. (52) | Adjusted for inflation from $18,853 in 2020. Selected for Canadian applicability, recentness of publication, and alignment with outcome. Sensitivity tested against higher value of a Statistical Life (VSL; Canada): 2009 article with 2007 cost estimates, $3.5–9.5 million (in 2025 = $5.1–13.9 million CAD adjusted for inflation) (53) |
| # of reversed overdoses resulting in avoided death or serious harm | Quality Adjusted Life Year (QALY) valuation | $22,229 | Lebenbaum et al. (52) | As above. |
| # of substance use-related infections avoided (e.g., cellulitis, osteomyelitis) | Revealed preference valuation: Personal cost of being treated for cellulitis | $47 | Cannon (54) | Direct cost of treating cellulitis at a hospital per person calculated as $50NZD in 2021. Converted to CAD and adjusted for inflation = $47.46 CAD in 2025. Selected based on comparability with Canadian context in the absence of Canadian valuation of this specific condition related to substance use |
| # of HIV infections avoided (minimum estimate of 1) | Quality Adjusted Life Year valuation | $22,229 | Lebenbaum et al. (52) | As above |
| # of contaminated samples found | Cost of drug checking using Fourier-transform infrared spectroscopy and drug testing strips | $23,414 | ScienceTech Shop online (55) | Based on the total number of substances checked with spectrometer (345) and the cost (in CAD) of spectroscopy machine, at the lower end are $13,799. UofT reports that hourly rates of use/testing at the university cost $17–22/h (CAD) while externally it can cost $29–66 CAD/h (https://analest.chem.utoronto.ca/rates), so we have got a range we can work with. Drug checking can be completed in about 10 min: https://www.fraserhealth.ca/Service-Directory/Services/mental-health-and-substance-use/drug-checking---Fourier-transform-infrared-spectrometers-ftir Other sources—Simple analyses can take a few hours to a day (https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2025.1565888/full), but more complex ones can take several days: https://rockymountainlabs.com/how-long-does-ftir-analysis-take/ |
| # of people avoiding physical harm (incl. death) due to weather-related dangers (e.g., frostbite, hypothermia, heat stroke, dehydration, etc.) | Revealed preference valuation: Cost of physiotherapy to address weather-related health issues | $110 | Longevity Saskatoon Blog (56) | Value of physiotherapy to address weather-related health issues in 2025 specifically in Saskatoon. This is a revealed preference valuation financial proxy, indicating that the market value of the outcome can be represented by the cost others might pay to achieve the outcome (not implying that the service users in the study would pay for this outcome directly). |
| # of service users experiencing reduced stigma associated with substance use, increased self-acceptance/ decreased internalized stigma | Revealed preference valuation: cost of counseling to address internalized stigma (estimated at minimum, 2 sessions per month for 6 months) | $2,400 | McCarty Counseling Individual Therapy Session Cost (57) | Value of counseling to address internalized stigma estimated at 2 sessions per month for 6 months at $200 per session specifically in Saskatoon in 2025. This is a revealed preference valuation financial proxy, indicating that the market value of the outcome can be represented by the cost others might pay to achieve the outcome (not implying that the service users in the study would pay for this outcome directly). |
| # of service users experiencing improved mental health and personal identity (e.g., Increased sense of pride, self-worth, purpose, autonomy, hope, personal growth, empowerment, trust, and feeling valued, accepted, validated, understood, not judged, welcome, dignified, treated with compassion, respected, decreased stress and worry); Decreased mental health disorder symptoms (e.g., decreased anxiety and depression) | Revealed preference valuation: cost of a life coach (minimum 3 sessions) | $150 | Superprof Blog on Life Coaching (58) | Value of using a life coach (min 3 sessions) to work on personal identity issues, specifically in Saskatoon in 2025. This is a revealed preference valuation financial proxy, indicating that the market value of the outcome can be represented by the cost others might pay to achieve the outcome (not implying that the service users in the study would pay for this outcome directly). |
| # of service users experiencing improved cultural health | Revealed preference valuation: Cost of one-night at cultural experience resort | $159 | Dakota Du nes Resort Rate (47) | Value of a cultural experience to advance cultural health near Saskatoon in 2025. Estimated at 1 room for 1 adult for 1 night = $159 CAD. This is a revealed preference valuation financial proxy, indicating that the market value of the outcome can be represented by the cost others might pay to achieve the outcome (not implying that the service users in the study would pay for this outcome directly). |
| # of service users experiencing improved relationships (e.g., increased sense of home, family, community and increased relationship building/maintenance) | Revealed preference valuation: cost of counseling to work on relationships (estimated at minimum, 2 sessions per month for 6 months) | $2,400 | McCarty Counseling Individual Therapy Session Cost (57) | As above. |
| # of service users experiencing increased disconnection with loved ones (e.g., service users accessing SCS when loved ones prefer they enter a treatment center or work toward sobriety) | Revealed preference valuation: cost of counseling (estimated at minimum, 2 sessions per month for 6 months) | −$2,400 | McCarty Counseling Individual Therapy Session Cost (57) | As above. |
| # of service users experiencing increased sense of safety and protection | Personal cost of pain and suffering due to assault |
$13,773 | Zhang and Department of Justice Canada (59). | Adjusted for inflation from $9,547 CAD in 2008. While this is an older source, no more recent estimations of the cost to victims of pain and suffering in Canada were found. |
| # of service users experiencing decreased suicide risk | Quality Adjusted Life Year (QALY) valuation | $22,229 | Lebenbaum et al. (52) | As above. |
| # of service users with reduced or altered substance use | Personal cost of supporting an addiction | $18,783 | DeRiviere (60) | Adjusted for inflation from $12,617 in 2006. While this is an older source, no more recent estimations of the comprehensive personal cost of supporting an addiction in Canada were found. |
| # of service users with increased or altered substance use due to exposure and access to other service users and substances | Personal cost of supporting an addiction | −$18,783 | DeRiviere (60) | As above. |
Reported values were adjusted for inflation.