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Is it time to talk about safe consumption rooms?

Our Research Officer Gareth Lynn Montes discusses public perceptions of drug harm reduction methods in Wales and across the U.K.

Last month, a converted ambulance being used to raise awareness about drug harm reduction interventions visited Llanelli. Barod, in collaboration with Transform Drug Policy Foundation and Anyone’s Child, organised the visit as an opportunity for people to have a look around the van and to discuss how a harm reduction intervention programme operates. 

Peter Krykant set up the service in Glasgow in 2020 without legal sanction as a response to the increasing rates of overdoses and HIV among intravenous drug users. In the 12 months it operated as an overdose prevention service (OPS), the van facilitated over 1,000 injecting episodes, reversed multiple overdoses, and subsequently saved many lives and did not see any deaths. Prior to its stay in Llanelli, the van had been visited Bristol in December 2021. 

What should have been a great opportunity to raise awareness and amplify calls to increase the range of drug harm reduction interventions in Wales, was slightly tainted by popular misconceptions and stigma against drug users. Wales Online ran a live 18 minutes Facebook stream reporting on the van’s visit. Viewers were invited to share their views on these services and how they would feel about one being set up in their community.  

At the time of writing, there have been 598 comments on the video. They offer snippets of some of the misconceptions and ill-informed ideas about drug harm reduction interventions. Some comments labelled it as “disgusting” and criticised it for encouraging drug use by “sending out msg [sic] [that] it's OK to take drugs[.] [C]hildren will see this and think it's OK.” Some complained it was a travesty that tax-payers money was funding such schemes, in spite of the fact that not a single penny of tax-payers money has ever been invested in it. Similarly, some were under the impression that this was an initiative by Carmarthenshire County Council or the NHS. One commenter said “next we'll be offering safe spaces for men to beat their partners! Bloody absurd”, whilst another suggested they, though it is unclear who ‘they’ referred to, should all be sent to the Ukraine.  

Fortunately, a number of commenters saw the benefits of drug harm reduction interventions.  

The negative comments are not unique to this particular Facebook live video, and reflect some of society’s views. In the UK, these sentiments are also held at the very highest level(s) of the political elite. Upon her appointment as UK Home Secretary, Priti Patel said she wanted criminals “to literally feel terror” and wanted a return to a hard line on drugs offences threatening “any form of drug use – you don’t turn a blind eye to it at all.” 

However, despite these beliefs and misconceptions, there is plenty of strong evidence in favour of drug harm reduction interventions. Many of these were highlighted in a previous blog post by Rob Barker, ‘Drug Consumption Rooms: the answer?’, from January 2020. Drug consumption rooms (DCRs) were first introduced in Bern (Switzerland) in 1986 and there were, at the last count in 2018, 117 in 11 countries. Broadly speaking, DCRs provide hygienic and supervised spaces for people to inject or otherwise consume illicit drugs.  

Some DCRs are just a clean, hygienic, and supervised room where people can consume pre-obtained illegal drugs. However, many DCRs operate within an integrated model where among the range of services offered are drug testing, blood borne virus (BBV) testing, diversionary activities, and opportunities to access treatment. For many, visiting a DCR is the first step into engagement with services. Even at its most minimal interaction, DCRs can be a place to distribute condoms, female sanitary products, or bandages and plasters.  

The evidence shows that DCRs prevent drug-related deaths by providing early intervention in potentially fatal overdose incidents, and in their 34-year worldwide history, no-one has ever died from a drug-related overdose in a DCR. In places where DCRs have been introduced, there is a reduction in injections in public places and a reduction of syringes and other drug related litter. Contrary to popular perception, there is nothing to suggest that DCRs act as a magnet for users from outside the local area and there is a reduction in drug dealing in the areas where they operate. The cost-benefit impact of DCRs is apparent, with fewer expensive medical interventions and less drug related criminality and anti-social behaviour in the area.  

If people have chosen to take drugs, they will do so whether they are in a clean hygienic supervised room or in a dangerous dirty alleyway. Surely, the option that poses a reduced risk to the individual and society in general is the preferred location.  

The Welsh Government develops and implements substance misuse policy as part of its health responsibilities, however“misuse of and dealing in drugs or psychoactive substances" is listed as a reserved matter in the Wales Act 2017, which means the Welsh Government cannot legislate in this area.While government ministers in Wales have long supported harm reduction approaches, they are restricted in what they can do by legislation made in Westminster, such as the Misuse of Drugs Act 1971. Unfortunately, successive UK governments have been opposed to implementing, or even piloting, DCRs.    

Back in 2017, the North Wales Police and Crime Commissioner Arfon Jones called for a DCR pilot to be tested in North Wales. As explained at the time, DRCs were not “compatible with current UK legislation relating to the misuse of drugs.” A March 2019 blog post for the Labour Campaign for Drug Policy Reform identified Swansea, where the highest death rate from opioids in England and Wales is recorded, as a perfect place to implement DCRs. 

At the very least, we should encourage and promote events such as the one in Llanelli last week to raise awareness about drug harm reduction interventions and highlight their many benefits. We should also lobby for this evidence-based policy to be implemented leaving behind the opinion-based prejudiced policy which has demonstrably failed so badly for the last few decades. In 2020, in Wales alone, 224 people died from drug consumption related reasons, each one a tragedy. It is time to help save as many lives as possible.  

Sources: 

Anon., “North Wales drug fix room pilot moves forward”, BBC News, 18 September 2017 https://www.bbc.co.uk/news/uk-wales-41267538  

Barod, “Glasgow Overdose Prevention Service to visit Llanelli” (11 February 2022) https://barod.cymru/ops-wales/  

Caitlin Arlow, “Facility designed to allow people to take drugs more safely while supervised is coming to Llanelli!”, Wales Online, 10 March 2022 https://www.walesonline.co.uk/news/wales-news/mobile-centre-designed-allow-people-23349108  

Damien Gayle, “Home secretary Priti Patel criticised over wish for criminals ‘to feel terror’”, The Guardian, 3 August 2019 https://www.theguardian.com/politics/2019/aug/03/priti-patel-home-secretary-wants-criminals-to-literally-feel-terror  

Drug & Alcohol Findings, “Time for safer injecting spaces in Britain?” (27 October 2016) https://findings.org.uk/PHP/dl.php?file=rooms.hot&s=dy&sf=rel  

Jonathan P. Caulkins, Bryce Pardo & Beau Kilmer, “Supervised consumption sites: a nuanced assessment of the causal evidence”, Addiction, Volume114, Issue12 (December 2019), pp. 2,109-2,115  

Joseph Rowntree Foundation, The Report of the Independent Working Group on Drug Consumption Rooms (2006) 

Mattha Busby, “How 'fixing rooms' are saving the lives of drug addicts in Europe” The Guardian, 21 November 2018 https://www.theguardian.com/world/commentisfree/2018/nov/21/fixing-rooms-saving-lives-drug-addicts  

Rob Barker, “Drug Consumption Rooms: the answer?” (24 January 2020) https://www.cymorthcymru.org.uk/en/news-blog/news/drug-consumption-rooms-answer  

Rob Barker, Presentation at Cymorth Cymru’s Homelessness & Health: Beyond Boundaries conference (6 February 2020) https://www.cymorthcymru.org.uk/files/9415/8134/0504/drug_consumption_rooms.pdf  

Rob Barker, “Swansea Pitch Perfect for Drug Consumption Rooms” (8 March 2019) https://www.labourdrugpolicy.com/dblog/dcrs  

Office of National Statistics, Deaths related to drug poisoning in England and Wales Statistical bulletins https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsrelatedtodrugpoisoninginenglandandwales/previousReleases  

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© Cymorth Cymru 2022
Company Registration No: 5093332
Charity No: 1116774