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In many countries, opioid overdoses are a substantial public health issue. Safe consumption sites are facilities where people who use drugs are provided with medical supervision while consuming drugs to reverse overdoses. Though safe consumption sites can reduce drug related adverse events, these facilities are not always welcomed in the communities where they are established. This public opposition can represent a barrier to the development and operation of sites. As a result, this thesis aimed to investigate current knowledge gaps that represent barriers to the establishment of safe consumption sites with respect to public opposition. Specifically, this thesis conducted a discrete choice experiment, described in Chapter 4, to determine the attributes of safe consumption sites that are correlated with public preferences for these facilitates. With respect to findings, the discrete choice experiment identified a set of attributes for safe consumption sites that influence public support for these facilities. Specifically, survey respondents disliked sites that increased cost to the healthcare system. Additionally, survey respondents preferred sites that were better able to reduce fatal overdoses, that could reduce improperly discarded needles, and that were accompanied by policies that provided compensation to individuals living near sites. This thesis also conducted a difference in differences analysis to assess the effectiveness of mobile versus brick & mortar safe consumption sites in preventing drug-related mortality, described in Chapter 5. It has been suggested that mobile sites are more acceptable to the public than brick & mortar facilities. If mobile sites are not less effective than brick & mortar facilities than mobile sites could represent a less controversial approach to safe consumption. The primary analysis of the difference in differences analysis did not find a significant association between drug related mortality and safe consumption site type, sug

Background Safe consumption sites provide people who use drugs with medical supervision and sterile paraphernalia for drug use. Although the presence of sites in neighborhoods can be controversial, few studies have assessed the preferences of individuals for attributes of safe consumption sites. Methods A discrete choice experiment was conducted to assess public preferences for safe consumption sites. Logit and mixed logit models were used to analyze data. Participants were recruited from Conjointly.com using a sample of the general population in Canada. The sample included adults only, was split approximately evenly by gender, and reflects census data for household income and geographic area. Attributes included: cost of the site to the healthcare system; effectiveness of the site in reducing overdose death; financial compensation to residents if a site opens in their neighborhood; if the site is located in the respondent’s neighborhood; and if the site reduces improperly discarded needles. Results The sample consisted of 203 respondents. Respondents had negative preferences for sites that increased cost to the healthcare system. Conversely, they had positive preferences for sites that would reduce fatal overdoses, that could reduce improperly discarded needles, and sites that provided compensation to those impacted by the establishment of sites. Conclusions Findings suggest that there exist a set of attributes that influence respondents’ preferences for safe consumption sites. By considering these attributes when designing sites and developing messaging for sites, decision-makers may develop sites that are potentially less controversial.

Background Safe consumption sites provide people who use drugs with medical supervision and sterile paraphernalia for drug use. Although the presence of sites in neighborhoods can be controversial, few studies have assessed the preferences of individuals for attributes of safe consumption sites. Methods A discrete choice experiment was conducted to assess public preferences for safe consumption sites. Logit and mixed logit models were used to analyze data. Participants were recruited from Conjointly.com using a sample of the general population in Canada. The sample included adults only, was split approximately evenly by gender, and reflects census data for household income and geographic area. Attributes included: cost of the site to the healthcare system; effectiveness of the site in reducing overdose death; financial compensation to residents if a site opens in their neighborhood; if the site is located in the respondent’s neighborhood; and if the site reduces improperly discarded needles. Results The sample consisted of 203 respondents. Respondents had negative preferences for sites that increased cost to the healthcare system. Conversely, they had positive preferences for sites that would reduce fatal overdoses, that could reduce improperly discarded needles, and sites that provided compensation to those impacted by the establishment of sites. Conclusions Findings suggest that there exist a set of attributes that influence respondents’ preferences for safe consumption sites. By considering these attributes when designing sites and developing messaging for sites, decision-makers may develop sites that are potentially less controversial.