Scientific and programmatic implications of safer injection facilities for persons who inject drugs illicitly

(2012)

Background: Persons who inject drugs (PWID), particularly those who inject in streets, alleys, and parks, use needles and syringes used by others, or use unclean drug-preparation equipment (cotton, cookers, or water) are at risk for HIV, HBV, and HCV infections. To reduce risk for infectious diseases and improve health outcomes, cities in Australia, Canada, Germany, Luxembourg, Netherlands, Norway, Spain, and Switzerland established safer injection facilities (SIFs) following establishment of legal support. SIFs provide clean injection environments, sterile injection equipment, and clean drug-preparation equipment at the time of injection.
Method: We reviewed and summarized the published scientific evidence (PubMed, EMBASE, PsychInfo) and appraised the programmatic implications of SIFs.
Results: At SIFs, persons can more safely inject drugs that they have purchased outside of the facility. SIF management and staff do not assist in
injection. SIFs safely dispose of used equipment and provide on-site counseling, referral to addiction treatment and health services, and overdose emergency assistance. SIFs limit transmission of HIV, viral hepatitis, and bacterial infections, reduce overdose mortality, prevent accidental needlestick injuries to community members, reduce public nuisance and litter, and improve health outcomes and public safety. As cost-saving and costeffective interventions, SIFs offer unique and complementary benefits, as compared to other effective interventions (prevention and treatment of drug abuse, syringe exchange programs, non-prescription pharmacy sale of sterile injection equipment, safe disposal programs for used equipment, community overdose prevention programs, prevention and treatment of infectious diseases) which often are not available to all persons who use drugs. Through collaboration with community members, law enforcement officers, persons who inject drugs, service providers, and public health scientists and practitioners, SIFs can meet needs of users and communities.
Conclusions: SIF services, within a multipronged intervention approach, address complex social and public health consequences of injection drug use and ameliorate the negative effects of injection drug use on users and communities.

Scientific and programmatic implications of safer injection facilities for persons who inject drugs illicitly

Scientific and programmatic implications of safer injection facilities for persons who inject drugs illicitly (485)

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