Interview with Damon Barrett on DCRs

DCRs Expert Interview Series; Damon Barrett - Deputy Director
Harm Reduction International



1. What is your opinion on drug consumption rooms?
"DCRs have proven to help people stay healthy, to reduce deaths from overdose, to reduce crime and other positive benefits. They are an essential harm reduction service."

2. Do you think that drug consumption rooms are helpful for drug users? (Please detail…)
"Yes, and I think this is well known now. One need only look at the evidence around the Insite Safe Injection Facility in Vancouver. Of course they must be well run, but, really, DCRs are subject to intense scrutiny and evaluation."

3. Please specify what problems could be solved by drug consumption rooms.
" ‘Solved’ is too strong a word, perhaps. But a lot of harm can be avoided and reduced. DCR’s won’t solve overdose deaths but they will save lives. They will not solve HIV but their will help reduce transmission.
They certainly cannot solve the problems many clients have faced in their lives, but they can show those people that they are valued and respected."

4. In which area of the city do you think should be located such a place?
"This depends on the city and patterns of use within it. If problematic use is located in a particular centre, like the downtown east side of Vancouver, then the DCR should be there. If it is spread out then perhaps more than one DCR is needed, or mobile DCRs may be the better option. Each city or locality needs to look at its own circumstances."

5. What perception would the community have on a drug consumption room in their area of living?
"I can’t answer this. Some will have community support, others may not."

6. Who should support the costs to open a drug consumption room?
"DCRs are in my view an essential health service and healthcare should be free at the point of delivery. I believe DCRs should be funded as part of national health systems, and would be happy to see my own taxes helping to achieve this."

7. From your experience, what were the obstacles in developing such a service.
"Politicians want to look tough on drugs, so zero tolerance approaches dominate. This wins votes, even though it’s harmful overall.
The message sent by DCRs is vitally important. The thing is, most politicians that oppose them, and members of the public, have the message wrong. They think this is about promoting or facilitating drug use. It’s not. Earlier you asked if DCRs are helpful for drug users. One of the most important things is what DCRs say to people who are at risk and experiencing real difficulties. It's that people care about them - not disease prevention or statistical gains - but them. I saw a documentary recently in which a drug user activist from Vancouver (Ann Livingstone) was asked what a safe injection facility would do for drug users in Vancouver. She put it really well (though I am paraphrasing) “It lets them know that people care if they remain alive.”"

Photo source: Plateforme Mondiale SCMR - Global Platform DCR

 

Interview with Marie Nougier on DCRs

DCRs Expert Interview Series; Marie Nougier - Research and Communications Officer
International Drug Policy Consortium

1. What is your opinion on drug consumption rooms?
"Drug consumption rooms are a very efficient harm reduction intervention, and a necessary tool in environments where there are harmful patterns of use (drug injection, open drug scenes, high level of infections of HIV and other blood-borne diseases among people who use drugs, etc.). From a government point of view, they are also a very cost-effective tool since they eventually reduce health and social harms that can be related to drug use. There is no evidence that levels of use or of drug related crime have increased in the areas around drug consumption rooms."

2. Do you think that drug consumption rooms are helpful for drug users? (Please detail…)
"Drug consumption rooms provide a safe and non-judgemental space where people who use drugs can come both to use drugs in a secure environment (both in terms of health, but also in terms of stigma, etc.), but also to socialize with members of the staff and other users. It is a way to reach out to those users who have very harmful patterns of drug use and are marginalized from the rest of society. In such an environment, they can discuss freely about their drug use and any problem they encounter in their lives without fear of being stigmatized or discriminated against. It is also a mechanism for them to access other harm reduction services (such as condoms, clean needles, etc.), as well as treatment for those who would like to treat their drug dependence."

3. Please specify what problems could be solved by drug consumption rooms.
"Many problems can be solved by drug consumption rooms. The first one is an improvement of the health of people who use drugs, for the reasons stated above – access to harm reduction, access to advice on safer use/injection, access to drug dependence treatment, re-socialisation of marginalized people, reduced risks of overdose deaths due to quick interventions by staff from the drug consumption rooms, reduced risks of hep C and HIV infections. The second one is a security one – drug consumption rooms avoid open drug scenes, and therefore harms that could be caused to other people from discarded needles in the street for example. In some locations, drug consumption rooms were also associated with lower levels of drug-related crime."
 
4. In which area of the city do you think should be located such a place?
"It is very important that drug consumption rooms be located where people who use drugs are themselves located, and this will depend a lot from city to city. This is to ensure that people who use drugs have easy access to the room."

5. What perception would the community have on a drug consumption room in their area of living?
"Many communities feel reluctant to have a drug consumption room be established close to their residential areas. The “NIMB” expression (“Not In My Backyard”) reflects this idea very well. However, it is very interesting to see that, in areas where drug consumption rooms were indeed established, communities (and the police!) are very positive about the intervention, and very supportive. In some areas, the local authorities have established a 24h call-in system where people can report any disturbance in the neighbourhood, in order to ensure that the community feels safe and comfortable with the initiative."

6. Who should support the costs to open a drug consumption room?
"Ideally, it should come from national or local government budgets to ensure sustainability. However, in practice, many drug consumption rooms are funded by NGOs and private funds."

7. From your experience, what were the obstacles in developing such a service.
"Many of the obstacles relate to ideological and moral issues, both coming from government officials and from the general public. The initiative should be accompanied by a solid sensitization campaign to ensure that communities are aware of the benefits of the intervention for their neighbourhood. Pilot projects are quite useful in this regard (as long as they are not prolonged as such over and over again…) to show the advantages of such an approach towards drug use."

Photo source: Plateforme Mondiale SCMR - Global Platform DCR

Interview with Peter Sarosi on DCRs

DCRs Expert Interview Series; Peter Sarosi - Drug Policy Program Director

Hungarian Civil Liberties Union

1.What is your opinion on drug consumption rooms?

"It is an innovative method to reduce the harms related to drug use and the drug policies – it provides a controlled environment in which people are able to use their drugs with minimal risks of overdose and infections. It is advisable to open such facilities in cities where there is an open drug scene, where the risk of overdoses and infections is high and where there is a good cooperation between public health services and law enforcement agencies. The decision to open and the implementation should be based on the assessment of needs and environment and should be carefully monitored and evaluated."

2.Do you think that drug consumption rooms are helpful for drug users? (Please detail…)

"Definitely – if they are operated in an appropriate way, they reduce the risk of death and disease, as well as conflicts with people in the neighborhood. The consumption room can be much more – it is connecting vulnerable and marginalized people with the society, it builds communities and can be a bridge to other services."

3.Please specify what problems could be solved by drug consumption rooms.

"Infections, overdose deaths, nuisance caused by open drug use."

4.In which area of the city do you think should be located such a place?

"Where there is an open drug use scene with a significant problem drug user community."

5.What perception would the community have on a drug consumption room in their area of living?

"There is a need to invest in community organizing and peer education to train peer leaders from the user community who can build partnership with the local non-user community. It is critical that the neighbors understand the benefits of the problem. Initial difficulties can be overcome after people see that the program effectively prevents drug related problems in the neighborhood."

6.Who should support the costs to open a drug consumption room?

"The local and national government."

7.From your experience, what were the obstacles in developing such a service.

"Restrictive drug laws, stigma and discrimination, prejudices in the local community, hostile law enforcement attitudes, lack of commitment and knowledge of local service providers."

Photo source: Plateforme Mondiale SCMR - Global Platform DCR

Istoria camerelor de injectare

Consumul de droguri a fost tolerat neoficial în câteva dintre centrele de asistență a persoanelor consumatoare de droguri către sfârșitul anilor `60 și începutul anilor `70. Totuși, primul centru de consum supravegheat și aprobat oficial a fost înființat în Basel, Elveția, în 1986. Asemenea centre au fost introduse în Germania și Olanda în anii `90, iar apoi în Spania și ulterior în Australia și Canada la începutul anilor 2000. Se implementează centre-pilot și în Canada, Australia si Franta. 

 

 Ţări în care au fost dezvoltate astfel de centre (Schatz, Nougier, 2012):

•   Australia

• Canada

• Germania

• Luxemburg

• Olanda

• Norvegia

• Spania

• Elveţia 

• Grecia

Camerele de injectare variază ca mărime, fiecare dintre ele oferind între 4 și 16 locuri destinate clienților, dar în unele cazuri, chiar 30. Centrele mai mari supraveghează între 500–2 000 de consumuri pe săptămână, în timp ce în cele mai mici, numărul poate fi sub 100 de consumuri pe săptămână (Hunt, 2006).
 

Sursa foto: http://www.ottawasun.com/2013/07/10/safe-injection-site-close-to-reality-in-ottawa