Medically Supervised Drug Injection Facilities Safer for Users

Facilities that provide medical supervision for illicit drug injections could reduce syringe sharing among users, concludes a Canadian study published online by The Lancet.

Public health officials in Vancouver opened North Americas first medically supervised safer injection facility in September 2003. Injection drug users in the facility can access sterile injecting equipment, inject pre-obtained illicit drugs under the supervision of nurses, and access nursing care and addictions counseling. Although such facilities exist in several European settings and in Sydney, Australia, few statistical analyses of their effects syringe sharing have been done.

Thomas Kerr, of the British Colombia Centre for Excellence in HIV/AIDS in Vancouver, Canada, and colleagues examined the behavior of 431 active injection drug users seen between December 2003 and June 2004 as part of a separate study on injection drug users in Vancouver. Ninety reported that all, most, or some of their injections were at the safer injection facility. 49 reported syringe sharing during this same period. Binge drug taking and frequent heroin or cocaine injection were associated with syringe sharing, whereas younger age and use of safer injection facility reduced the incidence of syringe sharing. The investigators found that rates of syringe sharing were similar in the study group before the opening of the facility and the difference only emerged during follow-up after the facility had opened.

Kerr concludes, We have shown that use of a medically supervised safer injection facility was independently associated with reduced syringe sharing in a community-recruited sample of injection drug users who had similar rates of syringe sharing before the facilitys opening. Our findings could help inform discussions in the UK and elsewhere, where potential public health benefits of such facilities are growing interest.

In an accompanying commentary, Wayne Hall, of the University of Queensland in Australia, concludes, Research to date has shown that supervised injecting facilities can operate safely and to the benefit of the health and well-being of the socially marginalized injecting drug users that use them. These facilities do not seem to increase crime or public nuisance, and they reduce the public visibility of injecting drug use, the most probable reason for public tolerance of supervised injecting facilities in Europe. An important step in persuading the community that supervised injecting facilities have a role to play in reducing the harms caused by injecting drug use is to encourage more realistic expectations in the community about their likely benefits given the constraints under which these facilities often have to operate.

Source: The Lancet