Supervised injection facilities in the United States: How close are we to making that a reality?

Issue: Supervised injection facilities (SIFs) are recognized around the world as effective public health interventions: reducing HIV and hepatitis, overdose, and public drug use, and increasing entrance to substance use treatment. As of yet, there are no SIFs in the United States, and there are legal and political barriers to opening one, despite the clear evidence of their effectiveness. Description: Current organizing efforts are underway in San Francisco, CA, New York, NY, and New Mexico to frame SIFs for an American audience and build support for this evidence-based. A community coalition in San Francisco has been working to build political support for a SIF. In New Mexico, the state Senate passed a resolution requesting research on how to better address their overdose problem, including how SIFs could operate in the rural state. In The Bronx, a community organization is building a model SIF to educate community stakeholders. Lessons Learned: Each of these campaigns has learned how to present the public health research on SIFs to their audience, address community concerns, and how to build alliances with unlikely partners, such as law enforcement. All of them look to Canada for inspiration and data. In each locality, drug users have come to the fore as leaders and voices for change. Recommendations: Next steps include generating more interest and support among public health practitioners and policy makers for this evidence-based intervention; addressing the legal challenges; finding organizations and researchers interested in starting a SIF; and continuing to build the political will.