Expand Number of Safe Injection Sites

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Introductory Paragraph

In the United States there is still much debate on the use of safe injection sites and whether states and the federal government should allow these sites to exist. A safe injection site is a specific location where people can safely inject an illicit drug under a medical professional's supervision. Everyday there are more than 100 people who overdose. The objective of these sites is to provide a safe and clean environment to decrease the number of overdoses. These sites can also help to stop the spread of life-threatening infections, such as HIV or Hepatitis C. Although they have been in use in Europe, Australia, and Canada for decades, the use of these sites is relatively new to the United States. [1]

Key Information

A key part for communities to be able to expand safe injection sites in the United States is to continue to remove the stigma of addiction. Many individuals still believe that those with substance abuse disorders can just stop. We do not expect people with autoimmune disorders or other diseases to stop or figure it out on their own, and we should provide the same care and understanding to those with substance abuse disorders. Educating individuals on substance abuse disorders and how this disease can affect people is an important part of being able to get more legislation to open sites nationwide. [2]

Safe injection sites are important because they can lower the rate of overdoses in a community by having trained individuals at the site to assist and monitor those with substance abuse disorder while they inject. Safe injection sites also provide clean needles and other supplies to reduce risks. These sites are also important because they can provide a safe and sterile environment for substance abuse users to learn about proper injection and hygienic methods, which may lower infections that can easily be transmitted among those with this disorder. Further, these sites may be the first place that someone with substance abuse disorder decides that they want help, and having individuals working at these sites who are trained in knowing the resources available can help a person get the help they need. [3]

Safe injection sites are more than just a place for individuals to inject illicit drugs safely. These sites can provide classes, resources, therapy options, and programs. Some of the classes offered can simply be on proper hygiene use to proper product preparation. Having these classes and programs available can also help to reduce overdose and the spread of infectious diseases among those that are using. Other resources that these sites can provide are therapy options and resources on where to go to help get control of the disorder. [4]

Individuals who want to get involved and have a say on these programs can:

  • Contact their local, state and federal legislature
  • Watch for and vote on legislation that will allow these sites to operate
  • Educate individuals on substance abuse disorder to remove stigma
  • Once sites are opened, individuals can help to support the site and get word out that these programs are available in the community

Relevant Research

  • This report indicates that best evidence from cohort and modeling studies suggests that safe injection sites s are associated with lower overdose mortality, 67% fewer ambulance calls for treating overdoses, and a decrease in HIV infections. [5]
  • This report provides a literature review on safe consumption facilities. [6]
  • A report made by Kral and Davidson documents the benefit of an unsanctioned supervised injection site in the U.S. [7]
  • A longitudinal study done in France on the practice of community-based safe injection sites had promising results. This study focused on providing education on safely injecting and safe hygiene practices at the sites. Using proper methods can help to reduce the risk of overdose and the risk of spreading infectious diseases. [8]

Impactful Federal, State, and Local Policies

  • In January of 2021, the Third Circuit Appellate Court in the United States Department of Justice ruled that safe injection sites were illegal under federal law. [9] This overturned a decision by the district court on the matter.[10] However, in February of 2022 the Department of Justice released a statement stating that they are evaluating such facilities. [11]
  • In November of 2021, New York began operating two safe injection sites in Manhattan. New York currently has a proposal for the Safer Consumption Services Act. If this act passes into law it would allow New York to open more sites statewide. [12] As of 10/27/23, this bill is still in committee.

Available Tools and Resources

  • The British Columbia Ministry of Health has published a Community guidebook that provides an overview of harm reduction and various actions that can be taken at the municipal level to develop a strategy for mobilizing communities around harm reduction. It focuses on supporting the development of a community response using the traditional authority of municipal jurisdictions. [13]
  • The Canadian Centre on Substance Abuse provides a FAQ-sheet on supervised injection facilities.[14]

Promising Practices

  • The Transform Drug Policy Foundation documents that there are almost 200 safe injection sites in operation across the world in fourteen countries including Canada, Germany, Switzerland, France, Portugal, Ukraine, Norway, the Netherlands, Australia, Belgium, Spain, Denmark, Iceland and the US. [15]
  • United States. A grant of more than $5 million over 4 years will go to New York University and Brown University in Providence, RI, to study 1,000 people at New York’s two sites, along with one set to open in Providence next year. [16]


  1. https://nursing.usc.edu/blog/supervised-injection-sites/
  2. https://www.nytimes.com/2021/11/30/nyregion/supervised-injection-sites-nyc.html
  3. https://www.infectiousdiseaseadvisor.com/home/advisor-channels/hiv-aids-advisor/supervised-injection-sites-pros-and-cons/
  4. https://www.health.harvard.edu/blog/safe-injection-sites-reducing-stigma-addiction-2017060211826
  5. Ng J, Sutherland C, Kolber MR. Does evidence support supervised injection sites? Can Fam Physician. 2017 Nov;63(11):866. Retrieved at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685449/
  6. https://dbhids.org/wp-content/uploads/2018/01/OTF_LarsonS_PHLReportOnSCF_Dec2017.pdf
  7. Kral AH, Davidson PJ. Addressing the nation’s opioid epidemic: lessons from an unsanctioned supervised injection site in the U.S. Am J Prev Med 2017;53:919-922.
  8. https://www.sciencedirect.com/science/article/abs/pii/S0376871618305003
  9. https://www.justice.gov/opa/pr/appellate-court-agrees-government-supervised-injection-sites-are-illegal-under-federal-law
  10. https://www.boston25news.com/news/local/federal-development-safe-injection-sites-leaves-massachusetts-advocates-optimistic/YFZWESC22JDRRHWBYPWX7U6HKA/
  11. https://www.justice.gov/opa/pr/appellate-court-agrees-government-supervised-injection-sites-are-illegal-under-federal-law
  12. https://www.nytimes.com/2021/11/30/nyregion/supervised-injection-sites-nyc.html
  13. https://www.health.gov.bc.ca/library/publications/year/2005/hrcommunityguide.pdf
  14. https://www.ccsa.ca/sites/default/files/2019-04/ccsa-010657-2004.pdf
  15. https://transformdrugs.org/drug-policy/uk-drug-policy/overdose-prevention-centres
  16. https://www.webmd.com/mental-health/addiction/news/20230517/us-will-fund-study-of-safe-injection-sites-despite-pushback