Volume 377, Issue 9775, 23–29 April 2011, Pages 1385-1386
Brandon DLMarshallPhDadM-JMilloyMScacEvanWoodPhDabProfJulio SGMontanerMDabThomasKerrPhDab

Methods
We examined population-based overdose mortality rates for the period before (Jan 1, 2001, to Sept 20, 2003) and after (Sept 21, 2003, to Dec 31, 2005) the opening of the Vancouver SIF. The location of death was determined from provincial coroner records. We compared overdose fatality rates within an a priori specified 500 m radius of the SIF and for the rest of the city.

Findings
Of 290 decedents, 229 (79·0%) were male, and the median age at death was 40 years (IQR 32–48 years). A third (89, 30·7%) of deaths occurred in city blocks within 500 m of the SIF. The fatal overdose rate in this area decreased by 35·0% after the opening of the SIF, from 253·8 to 165·1 deaths per 100 000 person-years (p=0·048). By contrast, during the same period, the fatal overdose rate in the rest of the city decreased by only 9·3%, from 7·6 to 6·9 deaths per 100 000 person-years (p=0·490). There was a significant interaction of rate differences across strata (p=0·049).

Interpretation
SIFs should be considered where injection drug use is prevalent, particularly in areas with high densities of overdose.

Funding
Vancouver Coastal Health, Canadian Institutes of Health Research, and the Michael Smith Foundation for Health Research.