Seeking refuge from violence in street-based drug scenes: Womenʹs experiences in North Americaʹs first supervised injection facility

Supervised injection facilities are a form of micro-environmental intervention that aim to address various harms associated with injection drug use. Given the numerous threats faced by women who inject drugs and are street-involved, including heightened risks for violence, we sought to elucidate how North Americaʹs first supervised injection facility (SIF) mediates the impact of violence among women during the injection process. Semi-structured qualitative interviews were conducted with 25 women recruited from the Scientific Evaluation of Supervised Injecting (SEOSI) cohort of SIF users in Vancouver, Canada. Audio-recorded interviews elicited womenʹs experiences using the SIF and the related impacts on experiences of violence. Interview data were transcribed verbatim and a thematic analysis was conducted. The perspectives of women participating in this study suggest that the SIF is a unique controlled environment where women who inject drugs are provided refuge from violence and gendered norms that shape drug preparation and consumption practices. Further, by enabling increased control over drugs and the administration of drugs, the SIF promotes enhanced agency at the point of drug consumption. Although this micro-environmental intervention serves to reduce risks common among women who inject drugs, additional interventions that address the structural forces producing and shaping violence and other risks are needed.