The principals behind safe consumption sites lies in the fact that many drug users will continue to use drugs whether they have a safe clean place to use or not. Needle exchange programs offer clean supplies, needles, and medicine for potential infections, but they fail to offer a clean place for people to use thus placing them at risk for fouling their equipment with bacteria. Safe consumption sites offer supervision with persons trained to use Narcan, a clean table, and safe place to use without risk of being interrupted. Currently n the US there are no legalized safe consumption sites and in North America, there is only one site in Canada allowed to supervise the use of drugs.
Why safe consumption sites?
When addicts use alone, they often place their "rigs" and drugs on a dirty surface that has been walked on many times contaminating the clean needles and works offered by the needle exchange. The person often has to use their drugs quickly as the longer they spend preparing their drugs, the greater the risk of being interrupted or arrested becomes. Drug users have prepared their fix in toilets, on the ground, in dirt, and in cramped cars or tents. Also many people may feel ashamed of their use and go lengths to avoid being seen "shooting up" and hide out in dirty places. All of these places place them at great risk of infecting their drug supply or their needles.
With a safe consumption site, the drug user can find a clean table, supply of clean works, and trained staff who know the signs of overdose and how to administer narcan. In the safe consumption site in Canada, onsite, the nurses know the signs of overdose, watch the people to ensure they are not overdosing, and have prevented many overdoses by administering Narcan in a timely manner. They also have a supply of clean works should someone show up without enough supplies. They do manage a large line of persons and have to turn some away due to lack of time and staffing but are able to prevent that many more infections and overdoses.
In some rare sites in Europe, they understand that a great deal of the drug supply is tainted with poison and other chemicals not purported to be the DOC leading to unexpected overdoses and deaths. These sites offer a clean supply of drugs to the user. Although this method may seem very risky or counterintuitive, this does greatly decrease the risk as most of the drugs being sold on the street are less than 50% pure. With medical grade drugs, a person can use without great risk of poisoning or overdose.
In the US
For those in the US, resources are far limited. However, there are some services people can avail themselves of. Should someone not be able to find a trusted friend to use, they can call a hotline that offers over the phone supervision in case they overdose. The person can call the hotline and inform them of their intent to use. They would provide location details and then given a 10 min period to use their DOC. Once the time has elapsed, they are asked to provide feedback. Should the person fail to elicit a response, the operator may call out services to ensure the person has not overdosed. It is unknown how busy the line are and how fast their response time really is but an ounce of prevention goes a long way.