Do supervised injecting facilities attract higher-risk injection drug users?

@article{Wood2005DoSI,
  title={Do supervised injecting facilities attract higher-risk injection drug users?},
  author={Evan Wood and Mark Tyndall and Kathy Li and Elisa Lloyd-Smith and Will Small and Julio S. G. Montaner and Thomas Kerr},
  journal={American journal of preventive medicine},
  year={2005},
  volume={29 2},
  pages={
          126-30
        }
}
BACKGROUND In Western Europe and elsewhere, medically supervised safer injection facilities (SIFs) are increasingly being implemented for the prevention of health- and community-related harms among injection drug users (IDUs), although few evaluations have been conducted, and there have been questions regarding SIFs' ability to attract high-risk IDUs. [...] Key MethodMETHODS We examined data from a community-recruited cohort study of IDUs.Expand
Characteristics of young illicit drug injectors who use North America's first medically supervised safer injecting facility
TLDR
Data from the 6-month period prior to the SIF's opening showed that youth initiating SIF use were significantly more likely to have been in jail, to use heroin daily, to have overdosed, and to have binged on drugs.
Injection drug users' perceptions regarding use of a medically supervised safer injecting facility.
TLDR
Many IDU reported changes in their injecting behaviors that have important implications for community and public health, and addressing a number of programmatic issues related to operating hours and waiting times, and the provision of additional amenities within SIF, may help to further improve their impact.
Use of supervised injection facilities and injection risk behaviours among young drug injectors.
TLDR
SIFs attract highly disadvantaged drug injectors who engage none the less in less borrowing of used syringes than non-users of these facilities, and the risks of indirect sharing should be emphasized when counselling SIF attendees.
The Validity of Reporting Willingness to Use a Supervised Injecting Facility on Subsequent Program Use among People Who Use Injection Drugs
TLDR
It is indicated that reported willingness measures collected from IDUs regarding potential SIF program participation prior to its opening independently predicted later attendance even when variables that were likely determinants of willingness were adjusted for.
Injection drug use cessation and use of North America's first medically supervised safer injecting facility.
TLDR
The finding that Aboriginal persons were less likely to enroll in addiction treatment is consistent with prior reports and demonstrates the need for novel and culturally appropriate drug treatment approaches for this population.
Use of a medically supervised injection facility among street youth.
TLDR
This study, the first to examine SIF use among street youth in North America, demonstrated that the facility attracted high-frequency young drug users most at risk of blood-borne infection and overdose and those who otherwise inject in public spaces.
Summary of findings from the evaluation of a pilot medically supervised safer injecting facility
TLDR
Vancouver's safer injecting facility has been associated with an array of community and public health benefits without evidence of adverse impacts, and should be useful to other cities considering supervised injecting facilities and to governments considering regulating their use.
The Melbourne Safe Injecting Room Attracted People Most in Need of Its Service.
TLDR
The Melbourne Medically Supervised Injecting Room attracted socially marginalized people who inject drugs who are most at risk of harms related to injecting drug use and therefore who is most in need of the service.
Supervised injection facility use and exposure to violence among a cohort of people who inject drugs: A gender-based analysis.
TLDR
The finding of a protective association between exclusive SIF use and exposure to violence among men is encouraging and highlights the need for social-structural interventions that are more responsive to the specific needs of women PWID in relation to violence prevention.
M Program and Evaluation Methods
overdose epidemics as a result of illicit injection drug use, an activity that is also associated with a number of negative community impacts, including public drug use. Despite these harms,
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References

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The Potential Public Health and Community Impacts of Safer Injecting Facilities: Evidence From a Cohort of Injection Drug Users
TLDR
Data indicate a high potential for immediate community and public health benefits if SIFs were presently available, and several variables that have recently been associated with overdose, syringe sharing, HIV and HCV incidence, and community impact of illicit drug use in this setting were associated with willingness to attend medically supervised Sifs.
Responding to an Explosive HIV Epidemic Driven by Frequent Cocaine Injection: Is There a Role for Safe Injecting Facilities?
TLDR
It appears that an SIF pilot could result in significant and immediate benefits in terms of public health and community safety, and several modifications could be made to conventional SIF service design and delivery.
Changes in public order after the opening of a medically supervised safer injecting facility for illicit injection drug users
TLDR
The opening of the safer injecting facility in Vancouver was independently associated with improvements in several measures of public order, including reduced public injection drug use and public syringe disposal.
Methodology for evaluating Insite: Canada's first medically supervised safer injection facility for injection drug users
TLDR
Preliminary observations suggest that the SIF in Vancouver, Canada has been successful in attracting IDUs into its programs and in turn helped to reduce public drug use, but it will take several years before the site's impacts can be appropriately examined.
Rationale for evaluating North America's first medically supervised safer-injecting facility.
TLDR
The evidence and rationale in support of the Canadian SIF initiative are outlined, which involves limitations in conventionally applied drug-control efforts, and gaps in current public-health policies in controlling the spread of infectious diseases, and the incidence of overdose among IDUs.
Unsafe injection practices in a cohort of injection drug users in Vancouver: could safer injecting rooms help?
  • E. Wood, M. Tyndall, +6 authors M. Schechter
  • Medicine
    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
  • 2001
TLDR
A number of risk behaviours--difficulty getting sterile needles, needle sharing and reuse, injection of drugs in public and injecting alone (one of the main contributing causes of overdose)--that may be alleviated by the establishment of supervised safer injecting rooms are identified.
Intensive injection cocaine use as the primary risk factor in the Vancouver HIV-1 epidemic
TLDR
Injection cocaine use was a strong, dose-dependent predictor of HIV seroconversion in this poly-drug using population, and participants who averaged more than three injections per day were seven times more likely to contract HIV.
Maintaining low HIV seroprevalence in populations of injecting drug users.
TLDR
In low-seroprevalence areas, it appears possible to severely limit transmission of HIV among populations of IDUs, despite continuing risk behavior among a substantial proportion of the population.
Needle exchange is not enough: lessons from the Vancouver injecting drug use study
TLDR
Despite having the largest NEP in North America, Vancouver has been experiencing an ongoing HIV epidemic and NEP are crucial for sterile syringe provision, they should be considered one component of a comprehensive programme including counselling, support and education.
Supervised injecting centres
TLDR
The Home Secretary rejected this recommendation, stating that medically supervised injecting centres would be supported only as part of a heroin prescribing programme, suggesting that this decision should be overturned.
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