title: Ambivalence about supervised injection facilities among community stakeholders.
abstract: BACKGROUND
  Community stakeholders express a range of opinions about supervised injection facilities (SIFs). We sought to identify reasons for ambivalence about SIFs amongst community stakeholders in two Canadian cities.
  
  
  RESULTS
  We used purposive sampling methods to recruit various stakeholder representatives (n = 141) for key informant interviews or focus group discussions. Data were analyzed using a thematic process. We identified seven reasons for ambivalence about SIFs: lack of personal knowledge of evidence about SIFs; concern that SIF goals are too narrow and the need for a comprehensive response to drug use; uncertainty that the community drug problem is large enough to warrant a SIF(s); the need to know more about the "right" places to locate a SIF(s) to avoid damaging communities or businesses; worry that a SIF(s) will renew problems that existed prior to gentrification; concern that resources for drug use prevention and treatment efforts will be diverted to pay for a SIF(s); and concern that SIF implementation must include evaluation, community consultation, and an explicit commitment to discontinue a SIF(s) in the event of adverse outcomes.
  
  
  CONCLUSIONS
  Stakeholders desire evidence about potential SIF impacts relevant to local contexts and that addresses perceived potential harms. Stakeholders would also like to see SIFs situated within a comprehensive response to drug use. Future research should determine the relative importance of these concerns and optimal approaches to address them to help guide decision-making about SIFs.
authors: Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada. carol.strike@utoronto.ca.|Social and Epidemiological Research, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, ON, M5S 2S1, Canada. carol.strike@utoronto.ca.
authors: Carol
authors: C
authors: Strike
authors: Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada. tara.watson@utoronto.ca.
authors: Tara Marie
authors: TM
authors: Watson
authors: Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada. gillian.kolla@utoronto.ca.
authors: Gillian
authors: G
authors: Kolla
authors: Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada. rebecca.penn@mail.utoronto.ca.
authors: Rebecca
authors: R
authors: Penn
authors: Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. ahmed.bayoumi@utoronto.ca.|Department of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada. ahmed.bayoumi@utoronto.ca.|Institute of Health Policy, Management, and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada. ahmed.bayoumi@utoronto.ca.|Division of General Internal Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. ahmed.bayoumi@utoronto.ca.
authors: Ahmed M
authors: AM
authors: Bayoumi
mesh_terms: D001294:Attitude to Health; D002170:Canada; D003153:Community Health Services / Q000706:statistics & numerical data*; D017144:Focus Groups; D040261:Harm Reduction; D006801:Humans; D007407:Interviews as Topic; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data*; D011639:Public Opinion; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D014505:Urban Population