Impact of safe consumption facilities on individual and community outcomes: A scoping review of the past decade of research

Abstract

Globally, the rate of injection drug use has increased, leading to a rise in injection-related injuries, infections, disease transmission, and death. Safe consumption facilities (SCFs) were developed with the aim of reducing injection-related disease transmission and death. There is a rapidly growing body of literature related the individual and community level outcomes associated with SCFs that warrants a comprehensive review. Thus, this scoping review examined the impact and effectiveness of SCFs related to: (1) individual outcomes for people who inject drugs; (2) community outcomes associated with SCFs; and (3) the cost-effectiveness of SCFs. The search strategy, developed by the lead author and a social work librarian, followed the PRISMA scoping review extension guidelines. We searched eight databases for peer-reviewed qualitative and quantitative articles published in English over the past decade, returning a total of 1255 articles. After screening, we extracted data from 24 articles. Findings indicate that SCFs were associated with reducing drug use related infection and disease transmission, enhancing access to addiction and other health services, reducing the risk of non-fatal overdoses, and were not associated with a significant increase in drug use, an increased rate of drug-related crime. Both qualitative and quantitative research support SCFs as a cost-effective approach to harm reduction for people who inject drugs with positive community outcomes as well. This review discusses the current state of the evidence and provides recommendations for future research directions.