Drug Consumption Rooms (DCRs), also known as “Overdose Prevention Centres” and more pejoratively as “shooting galleries” are healthcare facilities, usually run by charities or the state, where healthcare professionals supervise drug users to consume drugs in a safe environment. They provide safe and sterile paraphernalia (the biggest emphasis is placed on needles but smoking and inhalants can be tended to as well). As well as preventing overdoses, DCRs aim to reduce drug use in public and improve public amenity in areas surrounding urban drug markets. For example, in Barcelona, the number of unsafely disposed syringes being collected was at a monthly average of over 13,000 in 2004 which fell to around 3,000 in 2012 (Vecino et al., 2013). They also help addicts connect with addiction treatment and other support. Over half of them are open on a daily basis and are open for an average of eight hours a day.
Internationally, there are two main types of DCR, similar in nature but different in how they coincide with the law. Certain countries have chosen to pass legislation to make DCRs more viable, for instance Ireland passed the Misuse of Drugs (Supervised Injection Facilities) Act in 2017. This law is essentially a permit, enabling the licencing and regulation of DCRs. Ireland’s first facility is expected to launch later this year (2019). The second type of DCR is those that do not work with the explicit consent of the law but have assurance from local police that they will not get involved. Some testing services provided by UK-based “The Loop” arguably fall into this category. The Loop is a non-profit, non-government funded organisation which has offered drug safety testing at festivals, taking people’s recreational drugs and testing them for purity, strength and what’s actually in them. They then give them back to the individual with the information and guidance on how to take them safely. While this is not a government approved service, the Loop have assurance and agreements with local police to not intervene in the drug testing service provision.
Drug use in the UK: Can DCRs reduce harms?
19.8 per cent of young adults (16-24) and 9 per cent of adults (24-59) were reported to have taken an illicit drug in 2017-2018. Over 17,000 people were treated by the NHS for poisoning due to drug misuse, 2,503 resulted in death. The National Treatment Agency (NTA) estimated the cost to the NHS of treating drug misuse at around £500m a year. In Scotland alone, drug-related deaths rose to nearly 30 per cent higher than the previous year, reaching 1,187. This number is more than alcohol related deaths and means Scotland has the highest number of drug-related deaths in Europe per-capita. The UK, as a whole, is in 5th place.
Heroin alone caused 1707 deaths in the UK in 2016, a devastating number. DCRs worldwide have seen a grand total of zero deaths across the whole spectrum of drugs and in the whole of their existence. The evidence strongly suggests that DCRs do save lives. In Vancouver, Canada, in the area where their DCR is located, overdose deaths plummeted from 39% to 9%. Not only do these facilities save lives from overdoses, but they also are effective in preventing potentially fatal diseases, like HIV and Hepatitis. It is predicted that DCRs will mean that Canada would prevent 1191-1517 HIV infections over a 10-year period. DCRs can also help drug users to access primary health care and drug treatment, especially for those who are homeless, more likely to be street-injecting, and harder to reach. DCRs also free up police time and resources by reducing street disorder and drug user encounters with the police.
Home Secretary in June 2019, Sajid Javid, said of DCRs: “I think I would be very hesitant to look at anything that might increase drug usage. Anything I do would be designed to get people completely off drugs, because they are a cancer on our society.” This sums up the UK Government’s hard-line stance on DCRs so far. However the stats and figures show that DCRs can really reduce harm in communities by raising public amenity as well as saving the lives of the most vulnerable. It’s useful to see discussion of DCRs rising in the media and public debate – these effective harm reduction facilities should be reconsidered by Government.
Euan Hunt is on work experience at CDPRG.