Supervised injection facilities (SIFs) are medically supervised facilities designed to provide a hygienic environment in which drug users can consume illicit drugs intravenously. SIFs can be cost saving, help to reduce transmission of disease, and decrease drug overdoses. There are no SIFs in the United States. In this study we used a multiple case study design to understand the stigma surrounding the use of a SIF and the feasibility of implementing the drug prevention strategy in Baltimore City by comparing experiences with opening a SIF in Sydney, Australia. We interviewed one healthcare worker at the Sydney SIF and ten community stakeholders in Baltimore City. Interviewees were asked about community stigma of SIFs, drug use, and feasibility of opening a SIF in Baltimore City. Six overarching themes were established including lack of trust, lack of public education, fear of police, concern about efficacy of harm reduction programs, drug user stigma, and concerns about implementation. Findings suggest that stigma surrounding drug use and drug users is the most important aspect in shaping the participant's varied perceptions of SIFs. Participants believed that for any change to occur, there must be multi-tiered collaboration at the level of government, healthcare, community, and law enforcement.


substance use, addiction, opioid, heroin, overdose, fatal overdose, dependence, Safe Injection Facility (SIFs), case study

Author Bio(s)

Timothy Dupree is an Adjunct Professor at Towson University. The focus of his research is harm reduction and drug use prevention in response to the opioid epidemic. He is also interested in community health by means of harm reduction initiatives. Correspondence can be addressed directly to 8000 York Rd. Towson, MD 21212. Phone: 410-704-4049. Email: tdupree@towson.edu.

Caroline Wood is an Assistant Professor of Health Sciences at Towson University. The focus of her research is bullying prevention, and protective factors that can help children avoid or reduce their risk of victimization. She is also interested in children with special healthcare needs, mixed-methods research, health literacy, and injury prevention. Correspondence can be addressed directly to: 8000 York Rd, 101 Linthicum, Towson, MD 21252. Phone: 410-704- 3865. Email: ciwood@towson.edu.

Andrea Brace is an Associate Professor of Health Sciences at Towson University and is a Certified Health Education Specialist. The focus of her research is food access and food equity. She is also interested in the relationship between place and health. Correspondence can be addressed directly to: 8000 York Rd, 101 Linthicum, Towson, MD 21252. Phone: 410-704-4218. Email: abrace@towson.edu.

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Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 International License.





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