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

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.