The serious adverse health consequences associated with illicit drug use inVancouver has brought international attention to the city. It is now widely recognized that innovative and bold strategies are required to confront epidemics of drug overdose, HIV and Hepatitis C infections, and injection-related bacterial infections. The establishment of North America’s first supervised injection facility (SIF) required a major cultural shift in the way drug addiction is viewed. The story behind the SIF in Vancouver is a complex and interconnected series of events brought about by the activities of advocates, peers, community agencies, politicians, journalists, academics and other key players to bring about social change. The aim of this narrative is to highlight the ideas, processes and historical events that contributed to a cultural transformation that was critical to opening the SIF in Vancouver. By doing this, we hope to encourage other communities to take the bold steps necessary to reduce the devastating health and social consequences of injection drug use. (abstract from the article)