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  • SisterSpace – Women Only Overdose Prevention Site

  • Location: Vancouver, Canada

    Organization: Atira

    The worlds first and only women-only, community-accessible overdose prevention site.

    About the Wise Practice

    Vancouver was the first city in North America to open a safe-injection site for intravenous drug users. Recognizing that women who use drugs may face barriers in accessing this co-ed space, Atira Women’s Resource Society partnered with local government, health boards and housing associations to open a women-only injection room, SisterSpace. SisterSpace is a culturally safe space where all women are welcome, including sex workers, trans women, genderqueer women, and non-binary people who are femme-identified. The injection room provides access to clean equipment, which reduces the spread of diseases and infections, and is facilitated by staff trained in overdose prevention and peer support workers who have lived experience as former or current drug users. If they choose to, women using the space can access integrated services from Atira’s partner organizations including health education, access to treatment and health care, housing support, legal advocacy and other related services.

    Category

    Health

    Goals

    Goal 1Promote a safe, healthy and secure environment in cities taking into consideration that women and girls and persons in vulnerable situations are often particularly affected (NUA 39).

    Measurement

    SisterSpace was opened in May 2017, and in its first three months of opening produced monthly evaluation reports. These reports provided both quantitative and qualitative measurements to report on impacts. In its first three months, 115 women used substances 1,073 times; women accessed safer injection and smoking supplies 250 times; 5 overdoses were managed; there were zero deaths; more than 620 snacks and drinks were distributed; and 90% of women who used SisterSpace reported feeling safe. In August 2018 a further report was produced which noted that there were more than 16,000 visits to SisterSpace between May 2017 and July 2018, on average 65-75 women use SisterSpace every day, and that since January 2018 18 overdoses were managed, and that no deaths occurred since opening.

    Monitoring

    SisterSpace has produced four publicly available reports which provide quantitative measurements including the number of visits, the number of overdoses prevented, the time visits occurred, and the substances used. These reports also provide qualitative studies including case studies of women who have used SisterSpace’s services. SisterSpace was also the subject of an academic research study that was published in the International Journal of Drug Policy in April 2020. The study drew on ethnographic research including unstructured conversations and semi-structured interviews with 45 users of the space. The study concluded that SisterSpace represented a “potentially life-saving approach to women-centred harm reduction, including overdose.” (Boyd et al, 2020).

    Lessons Learned

    The May 2017 evaluation report, notes that the expertise of the peer support workers had been key to success, and that women were more likely to confide in peer workers. The August 2017 evaluation report recommends the following: explore changing or expanding hours to better meet the needs of women who do sex work; target outreach efforts to women with heightened safety concerns; invest in the skills and well-being of peer support workers; continue to focus on building relationships; continue to operate as an integrated program that provides other services in addition to harm reduction. The study by Boyd et al reported the need to reexamine how structural drivers such as systemic racism, gender inequality, criminalization and transphobia, and the intersection of these drivers, contribute to the overdose crisis and impact women who use drugs. In May 2020, in response to COVID-19, Atira opened SisterSquare, a large outdoor tent for women to access harm reduction and other services.

    Resources and More Information

    1. Website
    2. Reports
    3. Journal article