Supervised drug injection sites help prevent opioid overdoses, safely dispose of syringes

Commentary shares lessons learned from an unsanctioned supervised injection site in the United States

assortment of syringes

RESEARCH TRIANGLE PARK, NC— The U.S. opioid epidemic has sparked an increase in morbidity and mortality, calling policy makers and public health practitioners to find innovative solutions. Supervised drug injection sites offer a strategy for potential life-saving benefits for people who use drugs and surrounding communities, a commentary by researchers at RTI International and the University of California San Diego explains.

Researchers evaluated an unsanctioned supervised injection site in an undisclosed urban area to understand the impact of these sites. Supervised injection facilities provide a safe, clean place and injection equipment so that people can bring in previously obtained drugs and inject while being observed by medical staff.

“Supervised injection sites are an important evidence-based harm reduction strategy that should be considered for implementation in the United States,” said Alex Kral, Ph.D., director of the Behavioral and Urban Health Program at RTI. “These sterile, clinical settings have been shown to improve individual health and reduce the risk of HIV and viral hepatitis, and increase enrollment in drug treatment and access to health and social services.”

The commentary, published in the American Journal of Preventive Medicine, describes research that found that more than 90 percent of people using the unsanctioned supervised injection site reported that if it were not for the site, they would have injected in a park, public restroom, street or parking lot. During a two-year period, this site prevented more than 2,300 instances of drug injection in public.

The researchers observed that all syringes at the supervised injection site were safely disposed, totaling an estimated 1,725 prevented cases of public disposal of injection equipment, including needles. 

Heroin was the most commonly injected drug at this site with most visitors identified as white, male and homeless. There have only been two overdoses at the site, both which were reversed by staff trained to use naloxone, a medication used to block the effects of opioids, especially during an overdose.

“By supervising injections, trained staff ensure that overdoses are identified and responded to immediately,” Kral said. “It also provides opportunities for medical staff to educate people in real-time about safer injection practices, which could reduce future infections and other injection-related injuries.”

Sanctioning supervised injection sites would allow more people to be served, licensed clinicians to provide on-site health services, and provide more options for funding site activities and extending operating hours. Currently, there are nearly 100 supervised injection sites in 11 countries including Canada.

A previous RTI study found opening a supervised injection facility for people who inject drugs would generate $3.5 million in annual savings.

“Research has found that supervised injection sites also help the neighborhoods in which they are located by reducing crime, publicly discarded syringes, and the need for ambulances to respond to overdoses,” said co-author Peter Davidson of the University of California San Diego.

RTI has an extensive portfolio of research that helps policymakers make informed decisions about the prevention and treatment of opioid-use disorders. To learn more, visit RTI’s Opioid Research webpage.