The Case for SIFs
Supervised injection facilities (SIFs) are controlled health care settings where people can more safely inject drugs under clinical supervision and receive health care, counseling, and referrals to health and social services, including drug treatment. SIFs have been rigorously studied and found to reduce the spread of infectious disease, overdose deaths, and improperly discarded injection equipment, and to increase public order, access to drug treatment and other services, and to save taxpayer money.
Also called safer injection sites, drug consumption rooms, and supervised injecting centers, SIFs are designed to reduce the health and public order issues often associated with public injection by providing a space for people to inject pre-obtained drugs in a hygienic environment with access to sterile injecting equipment and under the supervision of trained medical staff.
There are at least 98 SIFs operating in 66 cities around the world in ten countries (Switzerland, Germany, the Netherlands, Norway, Luxembourg, Spain, Denmark, Greece, Australia and Canada)– but none in the United States. France recently approved the development of four SIFs.
Numerous peer-reviewed scientific studies have proven the positive impacts of SIFs. These benefits include:
- Increased access to drug treatment, especially among people who distrust the treatment system and are unlikely to seek treatment on their own.
- Reduced public disorder, reduced public injecting, and increased public safety.
- Attracting and retaining a high risk population of people who inject drugs, who are at heightened risk for infectious disease and overdose.
- Reduced HIV and Hepatitis C risk behavior (e.g. syringe and other injection equipment sharing, unsafe sex).
- Reducing the prevalence and harms of bacterial infections (e.g. staph infection, endocarditis).
- Successfully managing overdoses and reducing overdose death rates.
- Cost savings resulting from reduced disease, overdoses, and need for emergency medical services, and increased preventive healthcare and drug treatment utilization.
- Not increasing community drug use.
- Not increasing initiation into injection drug use.
- Not increasing drug-related crime.
Why NYC Needs SIFs
New York City has been the epicenter of injection drug use in the U.S. for decades. Coupled with an exploding homelessness crisis in recent years – when for the first time the city’s shelter system exceeded 60,000 people on any given night – public injection drug use is an increasing problem.
Through a recent survey by the Injection Drug Users Health Alliance (IDUHA), nearly half of syringe exchange participants reported having to inject in a public place like a park or building stairwell. Moreover, 60% had recently injected in semi-public locations, often restaurant and other public restrooms. Homeless people were more than 9 times more likely to report public injecting than those who were stably housed.
Public injection drug use in NYC is leading to many negative consequences. The IDUHA study found that public injectors are twice as likely to have overdosed in the past year compared to injection drug users who do not inject publicly. They are twice as likely to not have a consistent supply of new, sterile injection equipment and more than 4 times more likely to re-use injection equipment, which can lead to permanent vein damage and HIV, viral hepatitis, and other infectious disease transmission.
These factors and others, including public safety and order and the high cost of providing preventable medical care to people harmed through public injection drug use, are what led scores of other cities to adopt SIFs as a solution.