Public injecting and the need for ‘safer environment interventions’ in the reduction of drug‐related harm

摘要: Background One key structural dimension in the distribution of drug-related harm associated with injecting drug use is environment. Epidemiological evidence associates elevated blood-borne viral risk 'public' and 'semipublic' environments. Yet quality on public related variable, lacking many countries such as United Kingdom. Aim This commentary considers micro-injecting environment a critical risk, exploring need for 'safer interventions'. Methods We draw upon published research qualitative case examples. Results note limits epidemiological emphasize ethnographic to determine 'social relations' how users practices interact identify three main forms intervention': purpose-built consumption rooms; interventions within existing spatial relations; programming urban design. While rooms find evidence-based support, they are not panacea. potential embedded social relations. These include low-cost pragmatic enhancing facilities safety at semipublic sites and, primarily, peer-based interventions, including peer-supervised sites. caution against design which can cause displacement socially marginalized populations redistribution harm. Conclusions Public health addictions field have past focused individual behavioural change cost environmental change. wish focus greater attention reducing risks encourage debate interventions' reduction.