Supervised injection facilities in Canada: past, present, and future.
Supervised injection facilities in Canada: past, present, and future.
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DOI：
10.1186/s12954-017-0154-1
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发表时间：
2017-05-18
影响因子：
4.4
通讯作者：
McNeil R
中科院分区：
文献类型：
--
作者：
Kerr T;Mitra S;Kennedy MC;McNeil R
加拿大长期以来一直在与注射吸毒造成的危害作斗争。为了应对1990年代中期温哥华艾滋病毒感染和吸毒过量的流行，一系列行动者倡导建立监督注射设施，在几个未经批准的注射设施短暂运营并关闭后，加拿大第一个批准的注射设施于2003年开业。然而，尽管大量证据表明，这一SIF在减少与注射毒品使用相关的健康和社会危害方面取得了成功，但需要做出非凡的努力来保护它，还需要当地注射毒品者(PWID)和医疗保健提供者继续积极行动，以促进进一步的创新，解决SIF服务提供方面的差距。自那以来，越来越多的人接受SIF，以及对过量用药的日益担忧，促使在加拿大各地城市建立SIF的努力迅速升级。虽然在这方面已经取得了很大进展，但迫切需要通过修订联邦立法，为小岛屿发展中国家创造一个更有利的环境。还应通过创建适应辅助注射、药物吸入的SIF来鼓励SIF方案的进一步创新。此外，同行运行的、移动的和基于医院的SIF也构成了优化这种形式的减少伤害干预的影响所需的下一步。
Canada has long contended with harms arising from injection drug use. In response to epidemics of HIV infection and overdose in Vancouver in the mid-1990s, a range of actors advocated for the creation of supervised injection facilities (SIFs), and after several unsanctioned SIFs operated briefly and closed, Canada’s first sanctioned SIF opened in 2003. However, while a large body of evidence highlights the successes of this SIF in reducing the health and social harms associated with injection drug use, extraordinary efforts were needed to preserve it, and continued activism by local people who inject drugs (PWID) and healthcare providers was needed to promote further innovation and address gaps in SIF service delivery. A growing acceptance of SIFs and increasing concern about overdose have since prompted a rapid escalation in efforts to establish SIFs in cities across Canada. While much progress has been made in that regard, there is a pressing need to create a more enabling environment for SIFs through amendment of federal legislation. Further innovation in SIF programming should also be encouraged through the creation of SIFs that accommodate assisted injecting, the inhalation of drugs. As well, peer-run, mobile, and hospital-based SIFs also constitute next steps needed to optimize the impact of this form of harm reduction intervention.