Public Knowledge of and Support for Supervised Injection Sites in a Metropolitan Canadian Region

  • Ana Mrazovac
  • John O’Boyle
  • Christopher Watts
  • Tanu Sharma
  • Matteo Ciccarelli
  • Taylor Leshuk
  • Riana Lachhman
  • Stephen Michael
  • Laurie ManwellEmail author
Original Article


To determine the public’s knowledge of and support for supervised injection sites (SIS) in Waterloo Region and to assess the impact of educational pamphlets on attitudes towards harm reduction. Pilot Survey: Participants completed a 5–10-min survey on residence, age, education, and knowledge and opinion of SIS. Experimental Survey: Participants were randomly assigned to a brief educational condition (i) no education, (ii) efficacy of SIS, (iii) efficacy of harm reduction, and (iv) relationship between adverse childhood experiences (ACEs) and substance use, then completed a similar survey. Pilot Survey: Majority (75.4%) of respondents (N = 354) agreed with implementation of SIS and expressed concerns regarding alternative options (intervention, treatment, education), delivery (location, cost, safety), oversight, preventing ACEs, criminality, police involvement, and more global, long-term solutions. Experimental Survey: A majority (82.5%) of respondents (N = 297) agreed with implementation of SIS. One-way ANOVAs showed SIS education increased knowledge of and support for SIS. Multiple regression showed knowledge levels, and general support for SIS, but not location of survey, age, or education, significantly predicted specific support for SIS in Waterloo Region. Thematic analysis highlighted 10 key issues: logistics of SIS regarding its effectiveness and oversight, humanitarian issues concerning personal experience and human rights, additional considerations addressing concerns and misconceptions, and proposing alternatives. Public Health Information: Brief, targeted education (< 5 min) is effective in changing attitudes. Public Policy, Education, and Accountability: Citizens want to be engaged in addressing the opioid crisis through public discourse, planning, and implementing more comprehensive, long-term solutions.


Supervised injection site (SIS) Opioid overdose crisis Public opinion Health services Health policy Human rights 



We wish to thank the following undergraduate student research volunteers for their assistance in data collection and data entry for the project: Chanpreet Grewal, Igor Mitrovic, Verona Vumbaca, Matthew Kotansky, and Seif Adan.


AM, JO, and CW designed, collected, and analysed data for Study 1. LAM designed Study 2. All authors contributed to data collection and/or qualitative analyses for Study 2. LAM conducted quantitative data analyses. LAM wrote the manuscript. LAM supervised the project and is the guarantor. All authors read and approved the final manuscript.

Funding Information

Grants to Laurie A. Manwell (Wilfrid Laurier University Research Awards) and Grant to John O’Boyle (Wilfrid Laurier Faculty of Science Student’s Association (FOSSA) Laboratory Supplies Funding for Student Research (LSFSR) Award).

Compliance with Ethical Standards

Conflict of Interest

All authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Health SciencesWaterlooCanada
  2. 2.Department of BiologyWaterlooCanada
  3. 3.Department of PsychologyWaterlooCanada

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