Supervised Consumption Sites: Efficacy & How to Find Them

October 10, 2022

Table of Contents

The opioid epidemic is at an all-time high. More than 100,000 people died from a drug overdose during the one-year period ending April 2021, three-quarters of which involved an opioid drug.[1] 

Supervised consumption sites are sites where patients are able to go to use opioids (either ingesting orally or injecting) and be medically supervised while doing so.

The need for treatment programs and measures to help reduce opioid use and prevent overdose deaths continues to rise. Harm reduction methods, which include supervised consumption sites, have shown incredible promise in European countries. Unfortunately, due to governmental regulations and unfortunate stigma around drug use, they are only available in a very limited capacity in certain states, and are not currently available in most parts of the country. 

What Are Supervised Consumption Sites?

Supervised consumption sites are sites where patients are able to go to use opioids (either ingesting orally or injecting) and be medically supervised while doing so. A supervised consumption site is a safe space where people can bring their own drugs that they have already obtained to use under the supervision of trained professionals. 

In a safe consumption site, individuals are able to use drugs without stigma or fear of being judged. They also have access to medical and mental health care. Support staff are on site to watch for signs of overdose. They also offer support services and behavioral services for patients if and when they are ready to decrease or even discontinue their drug use. 

What is Harm Reduction?

The concept of supervised injection sites started in European countries as a way of reducing the harms associated with opioid use. They are based on a principle of “harm reduction”. 

In a “harm reduction” model, if an individual is going to use drugs, instead of insisting on abstinence, we can provide safe places for them to inject or use drugs under medical supervision to prevent the harms or risks associated with that drug use. For example, under supervision they are much less likely to overdose. The idea of a supervised consumption site is not to encourage abstinence, but instead focus on reducing the harms associated with drug use. [2] 

Supervised Consumption Site vs. an Injection Site

Supervised consumption sites are places where people can use drugs under the supervision of medical professionals. This can mean either consuming orally or injecting. The use of the term “consumption” is broader than simply “injecting” and makes it clear that patients can come to these sites to consume their drugs whether they are ingesting them orally or if they are injecting them. 

Injection sites specifically allow individuals to use drugs via injection. They may often offer needle exchange programs or clean needles as well as a safe space to inject drugs in the presence of medical personnel. 

Supervised consumption sites can also be injection sites, and the terms are often used interchangeably. 

Injection sites are also called overdose prevention centers (OPCs). The first legal site in the United States opened in late 2021 in New York City.[3] Others are being considered in additional major cities as well, such as Philadelphia, San Francisco, and Seattle.

Unfortunately the availability of these sites in the US is still extremely rare and limited. 

Benefits of Supervised Consumption Sites

Almost all of the research on the benefits and efficacy of SCS come out of european studies where these facilities are much more common. Research on the benefits and efficacy of SCS is extremely positive. 

Supervised consumption sites and overdose prevention centers can have numerous positive impacts, including these:

  • Lowered fear of criminalization and reduced stigma surrounding drug use
  • Fewer incidences of transmission of infectious diseases, such as hepatitis C and HIV
  • Less risk for overdose death
  • Reduction in the amount and frequency of drug use
  • Lower rates of crime 
  • Ability to test drugs for the presence of fentanyl
  • Cleaner streets with less public drug consumption or drug-related litter
  • Cost savings related to the need for emergency medical services, disease, and overdose deaths
  • Increased entry into substance misuse treatment services and elevated access to social, medical, and mental health services and support

Overdose prevention centers and harm reduction services lower the risk for fatal overdose, reduce the rate of infectious disease transmission, and minimize public nuisance crimes while reducing health care costs and effectively connecting people to lifesaving treatment for substance use disorder.[4] 

How to Find Them

While there are currently more than 100 safe consumption sites in over 60 cities  and 11 countries around the world, there is only currently one organization operating legal and sanctioned overdose prevention centers in the United States, and it is in New York City at OnPoint.[5]

Safe Consumption Sites: The Bottom Line 

Harm reduction is a strategy that does not call for complete abstinence from drugs. Instead, it focuses on permitting drug use but reducing the harms associated with that use. It can reduce the likelihood of overdose-related death and other harms, as has been extensively proven by research in other countries that have wider availability of these types of programs. 

Hopefully as we continue to look more at the overwhelming success of these programs in European countries, we can continue to advocate for their continued expansion here in the US to help us better care for persons who use drugs.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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Citations

  1. Drug Overdose Deaths in the U.S. Top 100,000 Annually. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm. November 2021. Accessed August 2021.
  2. How Supervised Drug Consumption Sites Could Help Solve the Opioid Crisis. NPR. https://www.npr.org/2022/02/03/1078010868/how-supervised-drug-consumption-sites-could-help-solve-the-opioid-crisis. February 2022. Accessed August 2022.
  3. A Look Inside the 1https://www.nbcnewyork.com/news/local/a-look-inside-the-1st-safe-injection-sites-in-the-us/3591018/. March 2022. August 2022.
  4. The Case for Supervised Injection Sites in the United States. American Family Physician. https://www.aafp.org/pubs/afp/issues/2022/0500/p454.html. May 2022. Accessed August 2022.
  5. OnPoint. Facebook. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiEtqi6yeL5AhViLzQIHRwoBVwQFnoECCsQAQ&url=https%3A%2F%2Fwww.facebook.com%2Fonpointnyc.org%2F&usg=AOvVaw3J7nxTmPW7H_G1bTqZbr_f. Accessed August 2022.

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