title: Supervised injection services: what has been demonstrated? A systematic literature review.
abstract: BACKGROUND
  Supervised injection services (SISs) have been developed to promote safer drug injection practices, enhance health-related behaviors among people who inject drugs (PWID), and connect PWID with external health and social services. Nevertheless, SISs have also been accused of fostering drug use and drug trafficking.
  
  
  OBJECTIVE
  To systematically collect and synthesize the currently available evidence regarding SIS-induced benefits and harm.
  
  
  METHODS
  A systematic review was performed via the PubMed, Web of Science, and ScienceDirect databases using the keyword algorithm [("supervised" or "safer") and ("injection" or "injecting" or "shooting" or "consumption") and ("facility" or "facilities" or "room" or "gallery" or "centre" or "site")].
  
  
  RESULTS
  Seventy-five relevant articles were found. All studies converged to find that SISs were efficacious in attracting the most marginalized PWID, promoting safer injection conditions, enhancing access to primary health care, and reducing the overdose frequency. SISs were not found to increase drug injecting, drug trafficking or crime in the surrounding environments. SISs were found to be associated with reduced levels of public drug injections and dropped syringes. Of the articles, 85% originated from Vancouver or Sydney.
  
  
  CONCLUSIONS
  SISs have largely fulfilled their initial objectives without enhancing drug use or drug trafficking. Almost all of the studies found in this review were performed in Canada or Australia, whereas the majority of SISs are located in Europe. The implementation of new SISs in places with high rates of injection drug use and associated harms appears to be supported by evidence.
authors.affiliation: Department of Addiction Medicine, CHRU de Lille, Univ Lille Nord de France, F-59037 Lille, France; University of Lille 2, Faculty of Medicine, F-59045 Lille, France. Electronic address: chloe.potier@yahoo.fr.
authors.forename: Chloé
authors.initials: C
authors.lastname: Potier
authors.affiliation: CHU Nancy, Maison des Addictions, Nancy F-54000, France; CHU Nancy, Centre d'Investigation Clinique CIC-INSERM 9501, Nancy F-54000, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Laprévote
authors.affiliation: Institute of Social and Preventive Medicine, University Hospital Center and University of Lausanne, Chemin de la Corniche 10, 1010 Lausanne, Switzerland.
authors.forename: Françoise
authors.initials: F
authors.lastname: Dubois-Arber
authors.affiliation: Department of Addiction Medicine, CHRU de Lille, Univ Lille Nord de France, F-59037 Lille, France; University of Lille 2, Faculty of Medicine, F-59045 Lille, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Cottencin
authors.affiliation: Department of Addiction Medicine, CHRU de Lille, Univ Lille Nord de France, F-59037 Lille, France; University of Lille 2, Faculty of Medicine, F-59045 Lille, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Rolland
mesh_terms: D001315:Australia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D062787:Drug Overdose / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D005060:Europe / Q000453:epidemiology; D006801:Humans; D007267:Injections; D018671:Needle-Exchange Programs / Q000379:methods* / Q000639:trends; D016320:Substance Abuse Treatment Centers / Q000379:methods* / Q000639:trends; D015819:Substance Abuse, Intravenous / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*
keywords: Drug consumption facility; Drug consumption room; Injection drug user; Safer injection facility; Supervised injecting center; Supervised injection service