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Training Guide

Alternatives to Public Injections

The first session of the meeting was focused on providing an overview of different models of supervised injection facilities, including their origins, operations, and oversight. Several commonalities emerged in core services: 

• Medical supervision of injections, including emergency response to drug overdoses; 
• Injection-related first aid (such as wound and abscess care); 
• Assessment and referral to primary health care, drug treatment and social services; 
• Harm reduction education and counseling; 
• Access to syringes and other injecting equipment. 

All of the established programs confronted initial opposition, which sometimes recurred periodically after they began operating. The SIFs present at the consultation have decades of combined experience; Frankfurt, Germany’s program was established in 1992, while Insite in Vancouver, Canada launched in 2003. All of the presenters emphasized the importance of buy-in from stakeholders, including local community, media, and law enforcement. The challenges and results of their innovations and perseverance were shared and are summarized below.