title: Rationale to evaluate medically supervised safer smoking facilities for non-injection illicit drug users.
abstract: Many cities are experiencing ongoing infectious disease epidemics and substantial community harm as a result of illicit drug use. In an effort to reduce these public order and public health concerns, consideration has been given to the opening in Vancouver of a safer smoking facility (SSF). The present review was conducted to examine if there is a rationale to support the evaluation of a SSF in the Canadian context. Available evidence suggests that conventional drug control strategies are insufficient to address the health and community harms of non-injection drug use, and that the public order benefits of supervised injection facilities may be relevant to SSFs. In addition, there is persuasive evidence to suggest there is potential for blood-borne disease transmission through the sharing of smoking paraphernalia, and the potential for SSFs to address this concern is a pressing public health question. Also relevant to this topic are interventions to prevent transition into injection drug use, and SSFs may also be evaluated as a potential strategy to address this concern.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC.
authors.forename: Courtney L C
authors.initials: CL
authors.lastname: Collins
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
authors.forename: Mark W
authors.initials: MW
authors.lastname: Tyndall
authors.forename: David C
authors.initials: DC
authors.lastname: Marsh
authors.forename: Patricia S
authors.initials: PS
authors.lastname: Kretz
authors.forename: Julio S
authors.initials: JS
authors.lastname: Montaner
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
mesh_terms: D019969:Amphetamine-Related Disorders / Q000150:complications / Q000517:prevention & control; D017848:Blood-Borne Pathogens; D001955:British Columbia; D019970:Cocaine-Related Disorders / Q000150:complications / Q000517:prevention & control; D016578:Crack Cocaine / Q000008:administration & dosage; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006526:Hepatitis C / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D008694:Methamphetamine / Q000008:administration & dosage; D009055:Mouth / Q000473:pathology; D009296:Nasal Cavity / Q000473:pathology; D010865:Pilot Projects; D016730:Program Development; D011633:Public Facilities; D011635:Public Health Administration; D012309:Risk-Taking; D012907:Smoking / Q000009:adverse effects*; D019966:Substance-Related Disorders / Q000150:complications / Q000517:prevention & control*; D014504:Urban Health
chemical_list: D016578:Crack Cocaine; D008694:Methamphetamine