The prospect of implementing a Safer Injection Facility in San Francisco: perspectives of community stakeholders.

BACKGROUND: Government-sanctioned Safer Injection Facilities (SIFs) have been implemented around the world to address public health and public order concerns associated with injection drug use. The goal of this study was to investigate how community stakeholders in San Francisco's Tenderloin district respond to the idea of implementing a SIF.
METHODS: Qualitative in-depth interviews were conducted with 20 purposively sampled stakeholders including representatives from neighbourhood and business associations, politicians, law enforcement, religious leaders, school officials, community activists and service providers. Data were analysed using an inductive approach.
RESULTS: Stakeholders were concerned that implementation of a SIF would further degrade a community struggling with safety and cleanliness and questioned the efficacy of harm reduction strategies to address drug use. Stakeholders were open to dialogue about how a SIF might support neighbourhood goals, stressed the importance of respect and collaboration between stakeholders and those potentially implementing a SIF, and were interested in evidence of the impact SIFs have on communities. Government protection and political leadership would be necessary to implement a SIF.
CONCLUSIONS: Employment of a community collaborative model combined with political leadership could move the policy debate about implementation of a SIF in San Francisco forward.