Public perspectives on supervised consumption sites across Canada: A cross-sectional study

INTRODUCTION: Canada continues to face high rates of drug poisoning, prompting the implementation of harm reduction measures, including supervised consumption sites (SCS). SCS remain politically and socially contested despite evidence supporting their effectiveness. Given recent debates on SCS operations and limited national data on public perceptions of them, this study examined data from a large bilingual pan-Canadian survey to assess attitudes of the general public towards SCS. METHODS: This study utilized data from a national online cross-sectional survey, the Canadian National Questionnaire on Overdose Monitoring (CNQOM). Likert-based questionnaire items evaluated public perceptions of SCS elements. The study examined the general public's perspectives towards SCS client considerations (e.g. safety), community impacts (e.g. discarded needles), and health system impacts (e.g. use of emergency services). CNQOM data was analyzed using the Wilcoxon Signed Rank Test. RESULTS: Between July 2022 and May 2023, out of 2866 valid participants, the general public perceived SCSs to have positive impacts on overdose and infection risk, improved access to healthcare, harm reduction, and social services. Respondents perceived SCS as effective in increasing education and awareness, particularly for people who use substances (PWUS), and viewed these services as appropriate across diverse populations and settings, including rural areas and acute care. Respondents felt SCSs reduced public drug use and discarded needles, but perceptions of broader community effects such as crime, public safety, and property values trended to be more neutral. Similarly, participants viewed SCS as enhancing safety for healthcare providers with neutral effects of healthcare system use and provider burnout. CONCLUSION: Members of the general public generally perceived SCS as beneficial for clients. Furthermore, participants did not identify SCS as having negative impacts on communities or health systems overall. Governments should consider these findings when making decisions about implementing SCS, modifying services, or closing SCS in their jurisdictions. Our findings are informative for harm reduction program planning and policy development at the national and provincial or state levels.