UK Expected to Approve Its First Supervised Injection Facility, Continuing an International Trend

Oct 31 2016

UK Expected to Approve Its First Supervised Injection Facility, Continuing an International Trend

October 31st, 2016

Glasgow, Scotland is likely to open the UK’s first consumption room for injecting drug users. The project would also provide pharmaceutical-grade heroin for use at the facility (heroin-assisted treatment). The BBC reports that the relevant health board, city council and police department are “expected” to agree to the idea.

Glasgow currently has an estimated 500 street-based injecting drug users and has been experiencing an HIV outbreak. A multi-agency task force has been examining the case for opening the facility to alleviate a range of drug-related harms.

Among the many benefits of such programs, supervised injection facilities reduce overdose or drug-mixing deaths by providing medical supervision (there has been no such recorded death in one of these facilities). They reduce HIV and hepatitis C transmissions by providing clean syringes, and reduce wounds and infections by providing other supplies and guidance.

Heroin-assisted treatment, meanwhile, reduces users’ exposure to risk by ensuring they know exactly what they are putting in their bodies. It also reduces crime because users can obtain drugs without needing money to pay for them. And programs such as these also increase their marginalized participants’ access to beneficial services and human contact.

“These [programs] are in addition to the existing provision,” said David Liddell, director of the Scottish Drugs Forum. “The key point is we have people who are mostly long-term users—people have been using for more than 20 years or more. Abstinence recovery is not on their immediate horizon. The most immediate thing for these individuals is the need to keep them alive so they can recover in the future.”

The UK is set to join 10 other countries, including Australia, Canada, France, Germany, the Netherlands and Switzerland, that have at least one legal drug consumption room. France opened its first, in Paris (pictured above), earlier this month, while the Netherlands already has 31 such facilities, and Germany 24.

Insite in Vancouver has long been the only legal supervised injection facility (SIF) in North America; dozens of studies have demonstrated its benefits to people who use drugs and the wider community. But a number of US cities, including San Francisco, Seattle, New York City and Ithaca, NY have been making various moves towards opening SIFs of their own—and the debates in some of those places have mirrored the one taking place in Scotland.

Professor Neil McKeganey, founder of Glasgow’s Centre of Drug Misuse Research, provided a skeptical voice, telling the BBC that Liddell was “quite wrong” to imply the rooms were not controversial. “For anyone who’s not an advocate of drugs decriminalization, they are controversial and they will be seen as such,” he said. “Some years ago, we surveyed over 1,000 drug addicts in Scotland and we asked them what they wanted to get from treatment. Less than 5 percent said they wanted to help to inject more safely and the overwhelming majority said they wanted help to become drugs-free.”

Yet even if those figures, and the questions that produced them, were beyond dispute, wouldn’t the 5 percent also deserve support on their terms? McKeganey admitted as much: “These facilities have a role to play.”

“We already provide sterile injecting equipment,” said the Scottish Drugs Forum’s Kirsten Horsburgh. “Providing a sterile environment in which people can use drugs is an obvious and necessary next step.”

Dr. Emilia Crighton, vice-chair of the Glasgow City Alcohol and Drug Partnership and the city’s NHS director of public health, agreed. “Nowadays we see that actually that most of Europe is providing addiction services,” she said. “There are safe consumption rooms—Switzerland has a model where there is heroin-assisted treatment and opiates-replacement treatment that satisfies the needs of the population. So we really have to find a solution that brings the solutions elsewhere in the world to Glasgow.”