Summary of findings from the evaluation of a pilot medically supervised safer injecting facility

Evan Wood, Mark W. Tyndall, Julio S. Montaner, Thomas Kerr (2006)

In many cities, infectious disease and overdose epidemics are occurring among illicit injection drug users (IDUs). To reduce these concerns, Vancouver opened a supervised safer injecting facility in September 2003. Within the facility, people inject pre-obtained illicit drugs under the supervision of medical staff. The program was granted a legal exemption by the Canadian government on the condition that a 3-year scientific evaluation of its impacts be conducted. In this review, we summarize the findings from evaluations in those 3 years, including characteristics of IDUs at the facility, public injection drug use and publicly discarded syringes, HIV risk behaviour, use of addiction treatment services and other community resources, and drug-related crime rates. Vancouver's safer injecting facility has been associated with an array of community and public health benefits without evidence of adverse impacts. These findings should be useful to other cities considering supervised injecting facilities and to governments considering regulating their use.
Many cities are experiencing infectious disease and overdose epidemics as a result of illicit injection drug use, an activity that is also associated with a number of negative community impacts, including public drug use. Despite these harms, innovative public health programs for reducing health and community concerns remain highly controversial in North America and other settings where HIV infection is spreading rapidly among injection drug users (IDUs).
In Canada, Vancouver has been an epicentre of drug-related harm during the last decade. In response, the affected community began advocating a medically supervised safer injecting facility where IDUs could inject pre-obtained drugs under the supervision of medical staff.11 Within the facility, IDUs are typically provided with sterile syringes and emergency care in the event of overdose, as well as primary care services and referral to addiction treatment. Such facilities exist in more than 2 dozen European cities and, more recently, in Sydney, Australia.
Vancouver's safer injecting facility was opened in September 2003 as a pilot study. The legal exemption by the federal government that allowed operation of the facility was limited to 3 years and was granted on the condition that an external 3-year scientific evaluation of its impacts be conducted. Given the controversial nature of the program, stakeholders agreed that all findings from the evaluation, including this report, should be externally peer-reviewed and published in the medical literature before dissemination. In this review we report on the 3 years' findings.

Summary of findings from the evaluation of a pilot medically supervised safer injecting facility

Summary of findings from the evaluation of a pilot medically supervised safer injecting facility (434)

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