Public preferences for safe consumption sites for opioid use: A discrete choice experiment

Background: Safe consumption sites provide people who use drugs with medical supervision and sterile paraphernalia for drug use. Although the presence of sites in neighborhoods can be controversial, few studies have assessed the preferences of individuals for attributes of safe consumption sites. Methods: A discrete choice experiment was conducted to assess public preferences for safe consumption sites. Logit and mixed logit models were used to analyze data. Participants were recruited from Conjointly.com using a sample of the general population in Canada. The sample included adults only, was split approximately evenly by gender, and reflects census data for household income and geographic area. Attributes included: cost of the site to the healthcare system; effectiveness of the site in reducing overdose death; financial compensation to residents if a site opens in their neighborhood; if the site is located in the respondent's neighborhood; and if the site reduces improperly discarded needles. Results: The sample consisted of 203 respondents. Respondents had negative preferences for sites that increased cost to the healthcare system. Conversely, they had positive preferences for sites that would reduce fatal overdoses, that could reduce improperly discarded needles, and sites that provided compensation to those impacted by the establishment of sites. Conclusions: Findings suggest that there exist a set of attributes that influence respondents' preferences for safe consumption sites. By considering these attributes when designing sites and developing messaging for sites, decision-makers may develop sites that are potentially less controversial.