Safer injection facilities for injection drug users: the debate continues
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* Gordon Brock
* Vydas Gurekas

Two recent articles asked for an evaluation of whether the European experience with safe injecting rooms can be replicated in Canada.1,2 We feel that before Canada's first “safe injection facility” opens its doors to the public, a number of questions should be answered:

What hours will service be available? 24/7? 9–5? Weekends? Holidays? Will there be age restrictions? What other services will be provided?

Will drugs be available for purchase on site or will users bring their own? 

Will medical and nursing personnel and sleeping facilities be available to users who become somnolent or comatose?

Will these facilities be held legally liable for criminal acts performed by those who have consumed drugs on the premises, as is the case for licensed bars?

In an era of declining government support, an aging population and expensive technology, who will pay for these facilities? We propose that the drug lords be approached because they will certainly be interested in providing comfortable and relaxing facilities for their user clients, and the costs can be readily passed on to consumers in the form of higher priced street drugs.

What evidence do Thomas Kerr and Anita Palepu have for their supposition that “staff ... better able to encourage people to seek help, to discuss health concerns with them and to provide them with immediate medical care, counselling or referrals” will be able to change significantly the behaviour of users?

Finally, in whose neighbourhood will these “safe injection facilities” be located? We submit that prospective neighbours will not be quite as open minded and optimistic as Kerr and Palepu.

## References

1.  1. Wood E, Tyndall MW, Spittal PM, Li K, Kerr T, Hogg RS, et al. Unsafe injection practices in a cohort of injection drug users in Vancouver: Could safer injection rooms help? CMAJ 2001; 165 (4):405-10.
    
    [Abstract/FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czo5OiIxNjUvNC80MDUiO3M6NDoiYXRvbSI7czoyMDoiL2NtYWovMTY2LzQvNDIwLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

2.  2. Kerr T, Palepu A. Safe injection facilities in Canada: Is it time? [editorial]. CMAJ 2001; 165 (4):436-7.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czo5OiIxNjUvNC80MzYiO3M6NDoiYXRvbSI7czoyMDoiL2NtYWovMTY2LzQvNDIwLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==)