As the heroin crisis continues to escalate in the United States, interest is growing in the experience of North America’s only facility allowed to prescribe diacetylmorphine hydrochloride, the active ingredient in heroin. The facility, located in Vancouver, British Columbia, has been successful in keeping participants out of jail and away from emergency rooms, The New York Times reports.

At the Crosstown Clinic in Vancouver, participants inject the drug under medical supervision as part of a treatment called heroin maintenance.

Red tape and court battles have prevented the opening of other such facilities in Canada, the article notes. Prescription heroin programs are available in Britain, Denmark, Germany, the Netherlands and Switzerland. In all of these nations there have been decreases in drug abuse, crime and disease, according to the newspaper.

Vancouver’s first medically supervised drug injection facility, InSite, opened in 2003, after officials determined that more traditional criminal justice approaches were not stopping widespread illegal drug use and sales. Unlike the Crosstown Clinic, people who come to InSite bring their own drugs. InSite provides clean needles and medical supervision. The clinic serves about 800 people daily.

The proposal to open a supervised drug injection facility in the United States has been met with opposition. Earlier this year, the mayor of Ithaca, New York proposed opening the country’s first supervised injection facility. People addicted to drugs would be able to get clean syringes, while being directed to treatment and recovery programs. The mayor was criticized by some Republican officials, police officers and rehabilitation professionals, who expressed concerns such a program would encourage illicit drug use.

Legal injection facilities have been found to reduce overdoses, but they do not address the criminal behavior linked with heroin addiction. They also do not deal with the problem of heroin laced with the potent opioid fentanyl, which was a cause or contributing factor in 655 deaths in Canada between 2009 and 2014.