The impact of supervised drug consumption services (SCS)

Key take-home messages

• Three systematic reviews (1–3) and one scoping review (4) published in peer-reviewed journals have found evidence that SCS can provide individual- and community-level benefits. Some of the individual-level benefits include reducing infections related to drug use, reducing the risk of non-fatal overdose, and facilitating access to health services (4). Community-level benefits include reduction in public disorder (e.g. less use of drugs in public spaces and less public disposal of syringes) and a decrease in the use of other public services (e.g. ambulance transport to hospital) (4). SCS have not been found to be associated with an increase in drug-related crime (4).
• Peer-reviewed primary studies published in recent years continue to demonstrate that SCS meet their overall objectives such as: management of drug overdose and decreased mortality (5), enhancement of safer injecting practices (6), receipt of services by the most high-risk, marginalized people who use drugs (7), less improper syringe disposal in public places (8), decreased public drug use (9), increased uptake of addiction treatment and other healthcare and social services (10), and prevention of transmission of blood-borne diseases (11–13), without increases in crime (14), drug use, or overdose rates (9).
• Evaluations of SCS have mostly relied upon ecological, modelling, cross-sectional, and cohort study designs to draw conclusions about the impact of SCS (2, 15, 16). Although these evaluation methodologies have been established in the literature and are appropriate given the context, further research could involve systematic inclusion of a control group who are eligible but do not access SCS (15). While some study cohorts include individuals who use SCS as well as those who do not (17), the body of evidence for SCS in general could be strengthened by inclusion of randomized controlled trials (1, 4, 18) and by a broader range of settings and jurisdictions to enhance generalizability (1, 18).

• Epidemiology and Determinants of Health
  • Determinants of Health
• Determinants of Health
  • Health services
• Population(s)
  • People who use drugs
  • General HIV- population
• Substance Use
  • Nonmedicinal drugs
• Health Systems
  • Delivery arrangements