Supervised Consumption Services

Insite, North America’s first legal supervised injection site, in Vancouver. (Photo courtesy of Vancouver Coastal Health)

Supervised consumption services (SCS) are provided in legally sanctioned facilities that allow people to consume pre-obtained drugs under the supervision of trained staff and are designed to reduce the health and public order issues often associated with public drug consumption. They are also called overdose prevention centers, safe or supervised injection facilities (SIFs), and drug consumption rooms (DCRs).

Facility staff members do not directly assist in consumption or handle any drugs brought in by clients, but are present to provide sterile injection supplies, answer questions on safe injection practices, administer first aid if needed, and monitor for overdose. This is particularly pertinent to fentanyl because the onset of overdose is rapid and waiting for an ambulance may mean death or permanent brain damage due to lack of oxygen. SCS staff also offer general medical advice and referrals to drug treatment, medical treatment, and other social support programs. 

There are approximately 120 SCS currently operating in ten countries around the world (Australia, Canada, Denmark, France, Germany, Luxembourg, the Netherlands, Norway, Spain and Switzerland). In July 2021, Rhode Island became the first state in the nation to authorize a two-year pilot program to establish "harm reduction centers" where people can consume pre-obtained substances under the supervision of trained staff. We hope other states will follow Rhode Island’s example. SCSs can play a vital role as part of a larger public health approach to drug policy. They are intended to complement – not replace – existing prevention, harm reduction, and treatment interventions.

Benefits of SCS

Over 100 evidence-based, peer-reviewed studies have consistently proven the positive impacts of supervised consumption services, including: 

  • Increasing entry into substance use disorder treatment
  • Reducing the amount and frequency that clients use drugs
  • Reducing public disorder and public injecting while increasing public safety
  • Reducing HIV and Hepatitis C risk behavior (i.e. syringe sharing, unsafe sex)
  • Successfully managing frequent on-site overdoses and reducing drug-related overdose death rates (there has not been a single overdose fatality at any SCS worldwide)
  • Saving costs due to a reduction in disease, overdose deaths, and need for emergency medical services
  • Increasing the delivery of medical and social services

Barriers to SCS in the U.S.

No SCS currently exist in the United States due to a host of legal and ideological barriers. SCS arguably violate various state and federal drug laws, including laws that make it illegal to use, open, or maintain property where any controlled substance is consumed. 

July 2021 UpdateRhode Island became the first state in the nation to authorize a two-year pilot program to establish "harm reduction centers" where people can consume pre-obtained substances under the supervision of trained staff.

Beyond legal obstacles (which can be overcome), there can be a lack of community support based on fears that SCS will cause an increase in drug use and crime. These fears are unfounded, however. In areas surrounding existing SCS, there has been no evidence of increased community drug use, initiation of injection drug use, or drug-related crime.

“Studies from other countries have shown that supervised injection facilities reduce the number of overdose deaths, reduce transmission rates of infectious disease, and increase the number of individuals initiating treatment for substance use disorders without increasing drug trafficking or crime in the areas where the facilities are located.” – American Medical Association

See our fentanyl report to learn about more health-centered solutions to the overdose crisis.

Our Work

The Drug Policy Alliance has been advocating for SCS pilot programs in California, Washington, Colorado, Vermont, New York, and Maryland, among other states. San Francisco and New York City are moving forward with plans to open SCSs over the next year.

While gaining acceptance for a U.S. facility will be an uphill battle, we are committed to challenging the stigma surrounding drug use and introducing political leaders and the public to the health and societal benefits that SCSs bring to local communities.

Learn more about our efforts to establish SCS in California.

Supervised Consumption Services