A systematic review of stakeholder perceptions of supervised injection facilities

•This review aggregated, appraised, and synthesized research on perceptions of SIFs.•Perceived benefits included safety, education, and a reduction in public drug use.•Concerns included existing rules and regulations, and the location of SIFs.•Suggestions centered around the location of SIFs and changes to existing rules.•Understanding stakeholder perceptions is critical for future implementation of SIFs. Supervised injection facilities (SIFs) have been developed to address the public health burden associated with substance use. While these facilities have been associated with a number of positive outcomes, stakeholder opinion (the opinions of those potentially affected by these facilities) is likely to influence their future development. This systematic review aims to answer the question, “how do stakeholders perceive SIFs?” Articles were located through nine academic databases, by searching for grey literature, by contacting health departments in countries where SIFs have been implemented, by searching articles that cited included articles, and by searching the reference lists of included articles. Two reviewers screened all articles. Data was double-extracted and quality appraised. All extracted perceptions were analyzed by two coders. Forty-seven articles were synthesized. Key themes included (1) benefits of SIFs, such as the increased safety of people who use drugs (PWUD) and the education that was provided at these facilities; (2) concerns regarding SIFs, such as the location of these facilities and existing rules and regulations; and (3) suggestions for SIFs, such as changing restrictions and regulations. Perceptions often fluctuated between stakeholders with first-hand experience of SIFs (e.g. staff and PWUD) and stakeholders not involved in the operation of SIFs (e.g. the general public). The findings of this review illustrate how perceptions vary and align across different types of SIFs. Going forward, it will be important to draw on these insights to facilitate a more informed discussion on the implementation and continuation of these facilities.