Call to Action: Supervised Injection Facilities

America’s opioid epidemic continues to cause unprecedented overdose deaths and fuel increases in new cases of hepatitis B, C, and HIV. As the nation grapples with how to effectively respond to these epidemics, NASTAD urges policymakers, public health and safety leaders, and impacted communities to embrace a comprehensive approach to end these intersecting epidemics. This approach must include a continuum of services and interventions, based in evidence, that aims to halt the spread of hepatitis B, C, and HIV, support the health of people who use drugs, promote connection to and retention in services, and prevent deaths from overdose. NASTAD and our members are committed to exploring and advocating for innovative and emerging solutions to this complex public health problem and understand that there is no singular solution; rather a multifaceted, dynamic approach is necessary.

As part of this comprehensive approach, NASTAD supports the inclusion of supervised injection facilities for federal, state, and local governments striving to effectively reduce overdose deaths and decrease rates of infectious disease among people who use drugs. These lifesaving harm reduction programs are evidence-based, implemented globally, and play a significant role in reducing overdose death and preventing transmission of hepatitis B, C, and HIV. Supervised injection facilities offer a safe and medically supervised location to consume drugs that were previously obtained.

Supervised injection facilities operate with legal sanction in 11 countries, number over 100 worldwide, and have support from public health and safety leaders. They have been shown to be a cost-effective intervention that lowers emergency room costs associated with overdose and other corollary health issues, and also decrease improperly discarded syringes. Not only do supervised injection facilities prevent overdose among people who inject drugs, but they drastically reduce hepatitis B, C, and HIV risk through education about safe injection practices and link participants to much needed preventive care, testing, treatment, medication-assisted treatment, and behavioral health services. Supervised injection facilities have been endorsed by the American Medical Association, the American Public Health Association, the HIV Medicine Association, and the Infectious Disease Society of America.

NASTAD supports the inclusion of supervised injection facilities in a comprehensive response addressing the intersecting epidemics of hepatitis B, C, HIV, and opioid use. We urge federal, state, and local governments to support efforts to incorporate the implementation of these lifesaving public health and safety initiatives designed to prevent overdose and the transmission of hepatitis B, C, and HIV.

Since its founding in 1992, NASTAD has been committed to supporting the health of people who use drugs through programs intended to reduce transmission of hepatitis and HIV, improve health outcomes, and address the structural and policy barriers that inhibit adequate delivery of services to prevent, care, and treat infectious diseases within this population. We recognize the effectiveness of harm reduction efforts, especially in terms of their proven ability to reduce the transmission and overall negative impact of infectious diseases such as hepatitis and HIV within communities, and embrace these practices with our full support. 

NASTAD and its members are dedicated to working with directly affected communities to identify, support, and implement effective public health interventions to prevent overdose and infectious disease transmission among this population. Expanded federal, state, and local investment in overdose and infectious disease prevention, care, and treatment programs is paramount. NASTAD and its members will continue to advocate for increased and targeted programming and resources to better meet the needs of the communities we serve.

Approved by the NASTAD Board of Directors on January 29, 2018.
Murray C. Penner, Executive Director
Jacquelyn Clymore, North Carolina, Chair 
January 2018

Call to Action: Supervised Injection Facilities