The Law (and Politics) of Safe Injection Facilities in the United States

Abstract

Supervised injection facilities (SIFs) have shown promise in reducing harms and social costs associated with injection drug use. Favorable evaluations in other countries have raised the issue of their implementation in the United States. Recognizing that laws shape health interventions targeting drug users, we analyze the legal environment for publicly authorized SIFs in the United States. States and some municipalities have the power to authorize SIFs under state law, but federal authorities could still interfere with these facilities under the Controlled Substances Act. A state- or locally authorized SIF could proceed free of legal uncertainty only if federal authorities explicitly authorized it or were persuaded not to interfere. Given legal uncertainty, and the similar experience of syringe exchange programs, we recommend a process of sustained health research, strategic advocacy, and political deliberation.

Keywords: HIV/AIDS, prevention, harm reduction