Competing interests: Kathryn Dong reports receiving a grant from Alberta Health, for start-up and operating costs of the supervised consumption services at the Royal Alexandra Hospital. This grant was received during the conduct of this study, but none of these funds paid for Dr. Dong’s time to write this article. Dr. Dong also receives a medical leadership salary from Alberta Health Services for her roles as Medical Director, Inner City Health and Wellness Program, during the conduct of the study. Jennifer Brouwer received a salary from Alberta Health Services for her role as Program Manager, Professional Practice Office and Inner City Health and Wellness, during the conduct of the study. Curtis Johnston received a medical leadership salary from Alberta Health Services for his role as Facility Medical Director, Royal Alexandra Hospital, and Associate Zone Medical Director, Edmonton Zone. Elaine Hyshka reports receiving grants from the Canadian Institutes of Health Research, partial salary support paid to her institution from the Royal Alexandra Hospital Foundation, during the conduct of the study; and partial salary support paid to her institution from Alberta Health Services, outside the submitted work Since the writing of this article, Ms. Brouwer has relocated to a different province and Dr. Johnston has moved to a different administrative position. These were their positions at the time of writing.