Not Yet Ready for Prime Time? Safe Injection Facilities in the Overall Prevention Scheme

Abstract

One of the many trips that I have been privileged to make this year as a representative of the Association of Nurses in AIDS Care (ANAC) was to the annual conference of the Canadian Association of Nurses in AIDS Care in Vancouver. There, I heard Fiona Gold talk about the safe injection facility (SIF): so simple, so pragmatic, and so obvious (once the “duh!” moment passed) that I wondered at my initial inability to appreciate the concept. What I eventually had was a flash of recognition: SIFs are, quite frankly, just the next logical step in the harm-reduction journey that I have been set on as a result of my association with HIV infection. We all know that injection drug use (IDU) is a direct link to the transmission of a variety of blood-borne diseases and that it contributes to physical and mental health problems, increased violence and criminal behavior, gridlock in courts and corrections settings, decreased property values, and unsafe neighborhoods. SIFs, as one of a broad spectrum of harm-reduction measures, provide one more option to help alleviate these problems. SIFs (also referred to as safer injection rooms and drug consumption rooms) are legally sanctioned facilities that provide for supervised injection (The Lindesmith Center, 1999). The goals (and proven abilities) of SIFs are to