TDNet Discover

Background: Supervised injection facilities (SIF) have established use in several countries with
the aim to combat increasing overdose rates, spread of infection, and facilitate enrollment in
addiction treatment facilities for people who inject drugs. While use of these sites is currently
utilized in other countries, their use has not been established in the United States due to poor
public perception and the federal legality of these substances.
Objective: To conduct an extensive review of available literature to determine potential benefits
of SIF in the United States, focusing specifically on the role of SIF in facilitating enrollment in
addiction treatment programs in people who inject drugs.
Methods: A systematic review of the literature regarding use of SIF was performed by searching
all available abstracts from the following databases: Google Scholar, MEDLINE Complete,
CINAHL Complete, Health Source Nursing/Academic, and PubMed. After agreement by the
three researchers, full text article reviews, and in accordance with inclusion and exclusion
criteria, six final articles were selected. The National Heart, Lung and Blood Institute quality
assessment tool was used to analyze the quality of these articles. Data was qualitatively analyzed
using a data extraction tool, which investigated the relationship of SIF and factors, such as all
cause mortality, accessing withdrawal management services, and impact on local communities.
Results: Database research produced six viable studies pertaining to SIF use and potential
benefits, two of which were systematic reviews and four of which were prospective cohort
studies. In total, these studies examined a combined 93,988 people, ranging from 811 to 65,832
participants. This study shows that implementation of SIF reduces rates of morbidity and
mortality, decreases rates of disease transmission and instances of needle sharing among IV drug
iv
users, encourages uptake into drug treatment facilities, and increases the utilization of health and
social services.
Conclusion: Significant evidence was found to support the use of SIF, with limited evidence
found to support the negative public perception of SIF that have prevented their use in the United
States. Research shows that many of the public perceptions used as rationale against
establishment of SIF are unfounded. Studies researching community impacts of SIF found no
increase in crime, violence, drug use, or drug trafficking in surrounding areas. Additionally,
studies regarding the financial effects of SIF found that establishment of these facilities would
result in long term economic gain in the order of millions of dollars via prevention of disease and
premature death. Overall, these six studies resulted in similar conclusions regarding varying
outcomes involving SIF use, with evidence to support their implementation in the U.S. Due to
the current legal status of SIF in the United States, additional research and a shift in public
perception is required before implementation in the U.S. can be advanced.