Spotlight on: Drug Consumption Rooms

2022·0.57 MB·English

Spotlight on… Drug consumption rooms | www.emcdda.europa.eu 4/1/22, 12:49 PM
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Spotlight on… Drug
consumption rooms
LAST UPDATED: 24 FEBRUARY 2022
$ Main subject
What are drug consumption
harm reduction (/search-tool_en?
rooms? f%5B0%5D=field_topic%3A1313&f%5B1%5D=type%3Aspotlight)
Spotlights (/search-
& tool_en? Drug consumption rooms, sometimes known as $ Keywords
f[0]=type%3Aspotlighsut)pervised injecting facilities, are fixed or mobile #ResponsesGuide (/search-tool_en?
spaces in which people who inject drugs are f%5B0%5D=field_keywords%3A3311&f%5B1%5D=type%3Aspotlight)
provided with sterile injection equipment and can
drug consumption facility (/search-tool_en?
use illicit drugs under the supervision of trained
f%5B0%5D=field_keywords%3A1271&f%5B1%5D=type%3Aspotlight)
staff. In some countries, consumption rooms also
harm reduction (/search-tool_en?
provide a space and equipment to allow non-
f%5B0%5D=field_keywords%3A1204&f%5B1%5D=type%3Aspotlight)
injecting routes of administration, for example for
health and social responses
crack cocaine smokers. Drug consumption rooms
f%5B0%5D=field_keywords%3A2670&f%5B1%5D=type%3Aspotlight)
exist in several European countries and are usually
located in areas where there is an open drug scene injecting drug use (/search-tool_en?
and injecting in public places is common. Their f%5B0%5D=field_keywords%3A2686&f%5B1%5D=type%3Aspotlight)
primary goal is to reduce morbidity and mortality by
providing a safer environment for drug use and % Target
audience
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Spotlight on… Drug consumption rooms | www.emcdda.europa.eu 4/1/22, 12:49 PM
training clients in safer forms of drug use. Providing general public (/search-tool_en?
a conduit to other care services and reducing public f%5B0%5D=field_target_audience%3A3121&f%5B1%5D=type%3Aspotlight)
nuisance may also be an explicit objective.
policymaker (/search-tool_en?
f%5B0%5D=field_target_audience%3A3124&f%5B1%5D=type%3Aspotlight)
practitioner (/search-tool_en?
What problems do they
f%5B0%5D=field_target_audience%3A3122&f%5B1%5D=type%3Aspotlight)
address?
researcher (/search-tool_en?
f%5B0%5D=field_target_audience%3A3123&f%5B1%5D=type%3Aspotlight)
Drug consumption rooms were originally developed
as a public health response to the rapid spread of
HIV/AIDS among people who inject drugs in the
Related
1980s. Their aims were to reduce the risks of
links:
unhygienic injecting, prevent fatal overdoses and
Health and
the spread of infectious diseases, and link drug
social
users with treatment, health and social services.
responses to
More recently, in some countries, provision has also
drug
been provided for other routes of administration problems: a
such as smoking or inhaling drugs. The European
establishment of drug consumption rooms has guide 2021
sometimes been opposed by local communities
because of fears that they might aggravate open
drug scenes. However, counterarguments have
been made that these facilities may reduce the
harms to communities associated with public drug
injecting.
What services are typically
provided?
A safer environment for drug use.
Provision of sterile injecting equipment.
Intervention in overdoses that occur on-site.
Counselling services.
Primary medical care.
Training for clients in safer forms of drug use,
overdose awareness and the use of naloxone.
Referral of clients to appropriate social,
healthcare and treatment services.
Some drug consumption rooms also promote
engagement in opioid agonist treatment.
Other frequently provided services include tea
and coffee, use of a phone, and the possibility
to take a shower and wash clothes.
Conditions and access
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Spotlight on… Drug consumption rooms | www.emcdda.europa.eu 4/1/22, 12:49 PM
Access to consumption facilities may be restricted
to registered service users, and often certain
conditions have to be met, for example minimum
age and local residency. Typically, drugs used in
these facilities must be obtained prior to entry.
Drug dealing and drug sharing are not allowed
within the facilities (staff may be required to
engage the police if necessary), and staff cannot
assist clients in administering their drugs.
Operational models
Three operational models are typically used in
Europe:
integrated services, operating from separate
areas attached to low-threshold facilities,
where supervision of drug consumption is one
of several services offered;
specialised services, only offering the narrower
range of services directly related to supervised
consumption;
mobile services, providing a geographically
flexible deployment of the service, but typically
catering for a more limited number of clients
than fixed premises.
Drug consumption rooms are usually staffed by
nurses and social workers, but doctors, security
staff and peer workers may also be part of the
team. Other professional groups may also be
represented. Opening hours and the number of
daily visits vary considerably across jurisdictions
and between facilities.
What is known about their
effectiveness?
Most research into the effectiveness of drug
consumption rooms has focused on risk behaviours
associated with injecting. Currently, there is
insufficient evidence to satisfactorily assess the
impact of drug consumption rooms on HCV and HIV
infections and mortality. However, results seem to
suggest that this intervention may have an impact
on reported injecting risk behaviours. It also
remains uncertain whether drug consumption
rooms increase engagement with addiction
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treatment and social services, but there are
indications that they may have a positive impact in
reaching marginalised and vulnerably housed
persons. Current evidence is deemed insufficient,
in part because of the practical and methodological
difficulties of conducting research, especially in
developing randomised controlled trials, in this type
of setting (see Spotlight on… Understanding and
using evidence (/spotlights/understanding-and-
using-evidence)) and also because service delivery
models often differ considerably. However, data
from observational studies and mathematical
modelling does suggest some benefits for certain
services users.
Drug consumption rooms in
Europe
Drug consumption rooms have been operating in
Europe since 1986, when the first one was
established in Bern, Switzerland. Since then,
Norway and an increasing number of EU countries
have opened facilities in one or more of their cities.
Infographic. Location and number of drug
consumption facilities throughout Europe (/media-
library/infographic-location-and-number-drug-
consumption-room-facilities-throughout-
europe_en)
(/media-library/infographic-location-and-number-
drug-consumption-room-facilities-throughout-
europe_en)
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Spotlight on… Drug consumption rooms | www.emcdda.europa.eu 4/1/22, 12:49 PM
Looking to the future
As frontline, low-threshold services, drug
consumption rooms are often among the first to
gain insights into new drug use patterns and, thus,
they have a role to play in the early identification of
new and emerging trends among high-risk
populations using their services.
As rates of injecting in some countries decrease,
consideration has been given to using drug
consumption rooms to reduce harms associated
with other routes of administration (e.g. smoking)
or other substances (e.g. cocaine and
methamphetamine). This implies some changes in
the aims of this response, and research and
evaluation will be necessary to assess the
effectiveness of this approach with non-injecting
populations.
More generally, despite the difficulties of
conducting research in this setting, more studies
are needed to improve the evidence on the extent
to which they reduce individual and community
harms, both for outcomes associated with drug
injecting and those associated with non-injecting
routes of administration.
(/publications/health-and-social-responses-a-european-guide)
Drug consumption facilities hub page (/topics/drug-consumption-
facilities)
Drug consumption rooms: an overview of provision and evidence
(/topics/pods/drug-consumption-rooms), 2018
Opioid-related deaths: health and social responses
(/publications/mini-guides/opioid-related-deaths-health-and-social-
responses), 2021
Drug-related infectious diseases: health and social responses
(/publications/mini-guides/drug-related-infectious-diseases-health-
and-social-responses), 2021
About the EMCDDA Follow us
The European Monitoring Centre for Drugs and Drug
Addiction (EMCDDA) is the reference point on drugs and
drug addiction information in Europe. Inaugurated in
Lisbon in 1995, it is one of the EU’s decentralised
agencies.
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