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"'It’s just not the same': Exploring PWUD’ Perceptions of and Experiences with Drug Policy and SCS Services Change in a Canadian City "

Article Authors: Carolyn Greene, Katharina Maier, Marta-Marika Urbanik 

Write-up by IRIS team member: Eunsong Park

The initial article presented the experiences of people who use drugs (PWUD) when a safe consumption site (SCS) in a Canadian city underwent closure and changed into a smaller mobile overdose prevention site. SCSs are medically supervised spaces where PWUD can use their pre-obtained drugs. Research has demonstrated that they have positive outcomes for PWUD’ health including reduction of drug overdose deaths and improvement of community safety. Currently, over 150 SCSs are operational in more than 60 cities across 12 countries.   

The SCS in Lethbridge, Canada where the study took place, was established in 2018 and was compelled to close in 2020 due to political opposition. The study conducted 50 semi-structured interviews with PWUD. This study shared the PWUD’ perspectives on their experiences with the SCS and its subsequent closure, leading to the opening of the smaller mobile site. The participants reported that significantly more people utilized the SCS than the mobile site, and they witnessed an increase in drug overdose deaths following the SCS closure.  

The SCS differed from the mobile site in several fundamental ways.  

  1. The SCS provided access to smoking rooms.  

  2. The mobile site was in an area with frequent site of public intimidation and assault. 

  3. The SCS offered various other resources and services, such as social hangout space, health care, social services, and addiction services, beyond providing drug consumption space.  

  4. The SCS was preferred by PWUD over the mobile site despite having a longer waiting time.  

In 2017 the Abell Foundation issued a report emphasizing the need for establishing SCSs in Baltimore and offered recommendations for doing so. The recommendations include the following: 

  1. Providing comprehensive services including housing, legal, and mental health referrals. 

  2. Exploring locations for convenience using existing community-based organizations. 

  3. Considering other drug consumption methods beyond the injection.  

  4. Engaging partners across multiple sectors including business owners and law enforcement.  

  5. Inviting current and former PWUD to participate in planning and implementing the SCSs while adopting a racial justice framework.  

Since 2016, bills aimed at opening SCSs in Maryland have been introduced almost every year but have failed to pass until this year. However, the bill's supporters are optimistic about its chances of success soon, thanks to community education efforts and a more accommodating political environment.  

The Baltimore Harm Reduction Coalition is a leader in advocacy for SCSs, and their BRIDGES Coalition continues to push for their establishment. This includes setting up a mock site at the Charles Theatre in Jan 2023 and launching a “Yes on My Block” campaign, which urges Baltimore City residents to sign a petition in support of SCSs. Valuable insights into the steps necessary to maximize public health outcomes while establishing SCSs in Maryland can be found in both the Canadian study and the Abell Foundations report for Baltimore City. 


Greene, C. M., Maier, K., & Urbanik, M. (2023). “It’s just not the same”: Exploring PWUD’ perceptions of and experiences with drug policy and SCS services change in a Canadian City. International Journal of Drug Policy, 111, 103934. 

Sherman, S. (n.d.) Safe Consumption Spaces: A Strategy for Baltimore City. Abell Foundation. 

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