Supervised Consumption Sites and Overdose Mortality

"In this population-based analysis, we showed that overdose mortality was reduced after the opening of a SIF. Reductions in overdose rates were most evident within the close vicinity of the facility—a 35% reduction in mortality was noted within 500 m of the facility after its opening. By contrast, overdose deaths in other areas of the city during the same period declined by only 9%. Consistent with earlier evidence showing that SIFs are not associated with increased drug injecting (panel),^38,39 these findings indicate that such facilities are safe and effective public-health interventions, and should therefore be considered in settings with a high burden of overdose related to injection drug use.

"In both the primary and sensitivity analyses, we saw no significant reductions in overdose mortality further than 500 m from the SIF. This finding is not surprising, since over 70% of frequent SIF users reported living within four blocks of the facility. Although the facility operates at capacity with over 500 supervised injections per day on average,²³ it is a pilot programme with only 12 injection seats in a neighbourhood with about 5000 injection drug users.⁴⁰ Therefore, and since previous studies have shown that waiting times and travel distance to the facility are barriers to SIF use,⁴¹ larger reductions in community overdose mortality would probably require an expansion of SIF coverage."