title: Design considerations for supervised consumption facilities (SCFs): preferences for facilities where people can inject and smoke drugs.
abstract: BACKGROUND
  Supervised consumption facilities (SCFs) aim to improve the health and well-being of people who use drugs by offering safer and more hygienic alternatives to the risk environments where people typically use drugs in the community. People who smoke crack cocaine may be willing to use supervised smoking facilities (SSFs), but their facility design preferences and the views of other stakeholders have not been previously investigated in detail.
  
  
  METHODS
  We consulted with people who use drugs and other stakeholders including police, fire and ambulance service personnel, other city employees and city officials, healthcare providers, residents, and business owners (N = 236) in two Canadian cities without SCFs and asked how facilities ought to be designed. All consultations were audio-recorded and transcribed. Thematic analyses were used to describe the knowledge and opinions of stakeholders.
  
  
  RESULTS
  People who use drugs see SSFs as offering public health and safety benefits, while other stakeholders were more sceptical about the need for SSFs. People who use drugs provided insights into how a facility might be designed to accommodate supervised injection and supervised smoking. Their strongest preference would allow both methods of drug use within the same facility with some form of physical separation between the two based on different highs, comfort regarding exposure to different methods of drug administration, and concerns about behaviours often associated with smoking crack cocaine. Other stakeholders raised a number of SSF implementation challenges worthy of consideration.
  
  
  CONCLUSIONS
  Decision-makers in cities considering SCF or SSF implementation should consider the opinions and preferences of potential clients to ensure that facilities will attract, retain, and engage people who use drugs.
authors.affiliation: Centre for Criminology and Sociolegal Studies, University of Toronto, 14 Queen's Park Crescent West, Toronto, Ontario, Canada M5S 3K9.
authors.forename: Tara Marie
authors.initials: TM
authors.lastname: Watson
authors.forename: Carol
authors.initials: C
authors.lastname: Strike
authors.forename: Gillian
authors.initials: G
authors.lastname: Kolla
authors.forename: Rebecca
authors.initials: R
authors.lastname: Penn
authors.forename: Jennifer
authors.initials: J
authors.lastname: Jairam
authors.forename: Shaun
authors.initials: S
authors.lastname: Hopkins
authors.forename: Janine
authors.initials: J
authors.lastname: Luce
authors.forename: Naushaba
authors.initials: N
authors.lastname: Degani
authors.forename: Peggy
authors.initials: P
authors.lastname: Millson
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Bayoumi
mesh_terms: D002170:Canada; D016578:Crack Cocaine / Q000008:administration & dosage*; D055030:Drug Users / Q000523:psychology*; D005160:Facility Design and Construction; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D012646:Self Administration
chemical_list: D016578:Crack Cocaine