Many barriers to health care interventions are principally cultural rather than technical. North America's first and only supervised injection facility, known as Insite, where injection drug users legally inject illicit drugs within a government funded and sanctioned setting, illustrates the cultural roots of health care. Its establishment is a story of intentional cultural change that required the identification of implicit and explicit values about addiction as part of an anthropological action plan. The plan involved changing narratives so that supervised injection could become culturally possible. This essay reviews how an action-based strategy, rooted in practiced anthropology, was deployed to overcome narrative obstacles to create and protect a medically defensible but culturally controversial program located in Vancouver, British Columbia, Canada.

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