Benefits to the community
Reduced cost/burden on the health care system
SIFs are an effective and efficient use of public health care resources.30
Resources and money are saved by:
- less ambulances attending overdoses
- less emergency department admissions
- Fewer costs associated with new HIV/Hepatitis cases, and other health conditions related to injecting drug use.10, 11, 30-33
|Sydney||Ambulance call-outs to Kings Cross dropped by approximately 80% after the centre opened,(10) and the average monthly emergency department presentations that were opioid-related fell by 20%.(33)|
|Melbourne||Ambulance attendances involving naloxone (a drug that reverses opioid overdoses) have reduced by 25% within one km of the facility since it opened.(11)|
|Vancouver||Using conservative estimates, a study found that Vancouver's injecting centre prevents on average 35 new cases of HIV and almost three deaths each year. This provides a societal benefit in excess of $6 million per year.(30)|
No increase in drug-related crime
Opponents of SIFs argue that they will lead to increased crime and drug use in the neighbourhoods where they are located.
There has been no evidence of this.34
Systematic reviews of SIFs around the world have shown that:
- establishment of a facility does not increase drug consumption, drug dealing or crime in surrounding areas.35
- SIFs are associated with improvements in public order without increasing drug-related crime.36
Reduced evidence of drug use in public
SIFs give people a private – safer - space to inject drugs. This reduces public injecting and discarding of injecting equipment, such as needles or syringes, which can otherwise be left lying around in unsafe places.37-40
|Sydney||Six years from opening Sydney’s MSIC the number of discarded needles and syringes collected in the local area approximately halved.(33)|
|Melbourne||There was a decrease in the proportion of residents (24% down to 20%) and business respondents (27% down to 22%) who saw public injecting during the centre’s trial period.(11)|
“I remember the needles in the gutter and the constant ambulances before the Medically Supervised Injecting Centre opened.”13
Local Kings Cross resident and business owner (Sydney MSIC)
“I am very grateful that this facility will continue to operate just down the road from where I live. Long may it continue.”13
Local Kings Cross resident (Sydney MSIC)
Further information on the positive impacts of SIFs:
- What goes on inside a medically supervised injection facility?
- Uniting Medically Supervised Injecting Centre – Get to know our story
- Findings from the evaluation of Vancouver’s Pilot Medically Supervised Safer Injecting Facility – Insite
- North Richmond Community Health – Changing lives
- Reducing public injecting, improving amenity and saving lives
- International Network of Drug Consumption Rooms
- Uniting Medically Supervised Injecting Centre
- Jauncey M. What goes on inside a medically supervised injection facility? : The Conversation; 2017 [cited 2021 February 12].
- Kerr T, Tyndall MW, Lai C, Montaner JSG, Wood E. Drug-related overdoses within a medically supervised safer injection facility. International Journal of Drug Policy. 2006;17(5):436-41.
- Markwick N, Ti L, Callon C, Feng C, Wood E, Kerr T. Willingness to engage in peer-delivered HIV voluntary counselling and testing among people who inject drugs in a Canadian setting. Journal of Epidemiology and Community Health. 2014;68(7):675.
- Wood E, Tyndall MW, Stoltz J-A, Small W, Zhang R, O’Connell J, et al. Safer injecting education for HIV prevention within a medically supervised safer injecting facility. International Journal of Drug Policy. 2005;16(4):281-4.
- Kimber JO, Mattick RP, Kaldor J, Van Beek I, Gilmour S, Rance JA. Process and predictors of drug treatment referral and referral uptake at the Sydney Medically Supervised Injecting Centre. Drug and Alcohol Review. 2008;27(6):602-12.
- Tyndall MW, Kerr T, Zhang R, King E, Montaner JG, Wood E. Attendance, drug use patterns, and referrals made from North America's first supervised injection facility. Drug and Alcohol Dependence. 2006;83(3):193-8.
- Wood E, Tyndall MW, Zhang R, Montaner JSG, Kerr T. Rate of detoxification service use and its impact among a cohort of supervised injecting facility users. Addiction. 2007;102(6):916-9.
- Belackova V, Silins E, Salmon AM, Jauncey M, Day CA. “Beyond Safer Injecting”—Health and Social Needs and Acceptance of Support among Clients of a Supervised Injecting Facility. International Journal of Environmental Research and Public Health,. 2019;16(11).
- Clark J, Torrance, J. Drug Consumption Room: Could the provision of a drug consumption room bring significant benefit in reducing drug related deaths and other community harms in Bristol. Transform Drug Policy Foundation; 2018.
- Uniting. Uniting Medically Supervised Injecting Centre 2020 [cited 2020 June 16].
- Hamilton M. Review of the Medically Supervised Injecting Room. Melbourne: Medically Supervised Injecting Room Review Panel; 2020.
- Marshall BDL, Milloy MJ, Wood E, Montaner JSG, Kerr T. Reduction in overdose mortality after the opening of North America's first medically supervised safer injecting facility: a retrospective population-based study. The Lancet. 2011;377(9775):1429-37.
- Uniting. Uniting Medically Supervised Injecting Centre - Get to know our story. 2018.
- Bravo MJ, Royuela L, De la Fuente L, Brugal MT, Barrio G, Domingo-Salvany A, et al. Use of supervised injection facilities and injection risk behaviours among young drug injectors. Addiction. 2009;104(4):614-9.
- Kerr T, Tyndall M, Li K, Montaner J, Wood E. Safer injection facility use and syringe sharing in injection drug users. The Lancet. 2005;366(9482):316-8.
- Kinnard EN, Howe CJ, Kerr T, Skjødt Hass V, Marshall BDL. Self-reported changes in drug use behaviors and syringe disposal methods following the opening of a supervised injecting facility in Copenhagen, Denmark. Harm Reduction Journal. 2014;11(1):29.
- Stoltz J-A, Wood E, Small W, Li K, Tyndall M, Montaner J, et al. Changes in injecting practices associated with the use of a medically supervised safer injection facility. Journal of Public Health. 2007;29(1):35-9.
- North Richmond Community Health. Changing Lives. 2020 [cited 2021 February 11].
- Salmon A, Belackova V, Schwanz RS, Jauncey M, Hiley S, Demirkol A. Homelessness among clients of Sydney's supervised injecting facility. Drugs and alcohol today. 2017;17(4):258-68.
- Goodhew M, Salmon AM, Marel C, Mills KL, Jauncey M. Mental health among clients of the Sydney Medically Supervised Injecting Centre (MSIC). Harm Reduction Journal. 2016;13(1):29.
- Belackova V, Salmon A. Overview of international literature - supervised injecting facilities & drug consumption rooms - Issue 1. Sydney: Uniting Medically Supervised Injecting Centre; 2017.
- Scherbaum N, Specka M, Bombeck J, Marrziniak B. Drug consumption facility as part of a primary health care centre for problem drug users—Which clients are attracted? International Journal of Drug Policy. 2009;20(5):447-9.
- Biancarelli DL, Biello KB, Childs E, Drainoni M, Salhaney P, Edeza A, et al. Strategies used by people who inject drugs to avoid stigma in healthcare settings. Drug and Alcohol Dependence. 2019;198:80-6.
- Chan Carusone S, Guta A, Robinson S, Tan DH, Cooper C, O’Leary B, et al. “Maybe if I stop the drugs, then maybe they’d care?”—hospital care experiences of people who use drugs. Harm Reduction Journal. 2019;16(1):16.
- Paquette CE, Syvertsen JL, Pollini RA. Stigma at every turn: Health services experiences among people who inject drugs. International Journal of Drug Policy. 2018;57:104-10.
- Kerman N, Manoni-Millar S, Cormier L, Cahill T, Sylvestre J. “It’s not just injecting drugs”: Supervised consumption sites and the social determinants of health. Drug and Alcohol Dependence. 2020;213:108078.
- Fairbairn N, Small W, Shannon K, Wood E, Kerr T. Seeking refuge from violence in street-based drug scenes: Women's experiences in North America's first supervised injection facility. Social Science & Medicine. 2008;67(5):817-23.
- Boyd J, Lavalley J, Czechaczek S, Mayer S, Kerr T, Maher L, et al. “Bed Bugs and Beyond”: An ethnographic analysis of North America's first women-only supervised drug consumption site. International Journal of Drug Policy. 2020;78:102733.
- British Columbia Centre for Excellence in HIV/AIDS. Findings from the evaluation of Vancouver’s Pilot Medically Supervised Safer Injecting Facility – Insite. 2009.
- Andresen MA, Boyd N. A cost-benefit and cost-effectiveness analysis of Vancouver's supervised injection facility. International Journal of Drug Policy. 2010;21(1):70-6.
- Bayoumi AM, Zaric GS. The cost-effectiveness of Vancouver's supervised injection facility. Canadian Medical Association Journal. 2008;179(11):1143.
- Pinkerton SD. Is Vancouver Canada's supervised injection facility cost-saving? Addiction. 2010;105(8):1429-36.
- KPMG. Further evaluation of the Medically Supervised Injecting Centre during its extended Trial period (2007-2011). NSW Health; 2010.
- Barry CL, Sherman SG, Stone E, Kennedy-Hendricks A, Niederdeppe J, Linden S, et al. Arguments supporting and opposing legalization of safe consumption sites in the U.S. International Journal of Drug Policy. 2019;63:18-22.
- Potier C, Laprévote V, Dubois-Arber F, Cottencin O, Rolland B. Supervised injection services: What has been demonstrated? A systematic literature review. Drug and Alcohol Dependence. 2014;145:48-68.
- Kennedy MC, Karamouzian M, Kerr T. Public Health and Public Order Outcomes Associated with Supervised Drug Consumption Facilities: a Systematic Review. Current HIV/AIDS Reports. 2017;14(5):161-83.
- McKnight I, Maas B, Wood E, Tyndall MW, Small W, Lai C, et al. Factors Associated with Public Injecting Among Users of Vancouver's Supervised Injection Facility. The American Journal of Drug and Alcohol Abuse. 2007;33(2):319-25.
- Salmon AM, Thein H-H, Kimber J, Kaldor JM, Maher L. Five years on: What are the community perceptions of drug-related public amenity following the establishment of the Sydney Medically Supervised Injecting Centre? International Journal of Drug Policy. 2007;18(1):46-53.
- Thein H-H, Kimber J, Maher L, MacDonald M, Kaldor JM. Public opinion towards supervised injecting centres and the Sydney Medically Supervised Injecting Centre. International Journal of Drug Policy. 2005;16(4):275-80.
- Wood E, Kerr T, Small W, Li K, Marsh DC, Montaner JSG, et al. Changes in public order after the opening of a medically supervised safer injecting facility for illicit injection drug users. Canadian Medical Association Journal. 2004;171(7):731.