The Case for a Fix Room
Plans to establish a safer drug consumption facility in Glasgow have been in the news following reports that the Scottish Government is seeking the devolution of drug laws to enable an exemption which will allow the proposed facility to operate lawfully.
This follows an opinion from the Lord Advocate that an exemption from the Misuse of Drugs Act 1971 is a matter for the UK Government, since the legislation is reserved, and confirmation from the UK Government that they are not minded to grant an exemption.
Before considering the political implications of this it is worth re-capping how – and why – the proposal came about.
Plans to create a safer drug consumption facility flowed from the publication of a report in 2015 from the Glasgow Alcohol and Drugs Partnership called “Taking Away the Chaos” which examined the health needs of people who inject drugs in the city centre.
The report was prompted by concerns about serious outbreaks of infectious diseases such as anthrax, botulism and most recently HIV among city centre drug injectors and a high burden of drug-related deaths. In addition, residents and businesses in the areas where drug injecting takes place have long raised concerns about discarded needles and other problems.
The report found that the population who inject drugs in the city centre – around 400 to 500 individuals, most of them known to the police and Social Work – face multiple barriers to improving their health and accessing existing services, the biggest being the severity of their addiction and the precariousness of their lives.
These are people who live extremely chaotic lives and who have multiple and complex health needs. They are highly likely to experience homelessness, to have been in prison, to be chronically poor. Most of them are men aged between 30 to 50, who have been injecting drugs for a long time and – despite engagements with health services – have not been able to stop. They are often very damaged and extremely vulnerable individuals.
The report recommended piloting a safe drug consumption facility in order to meet the particular needs of this population and the proposal has been taken forward by Glasgow’s Health & Social Care Partnership, whose Integration Joint Board approved the development of a full business case with the support of partners including the police. Preparatory work has been ongoing but the establishment of the facility remains subject to obtaining the exemption necessary to allow it to operate lawfully.
In the meantime Glasgow continues to experience a high rate of new HIV infections and drug-related deaths – around 20 per cent of all drug related deaths occur in the city. The situation has been worsened by the very poor decision of Network Rail to close down the needle exchange located in the late-opening Boots Chemist in Central station, meaning there are fewer clean needles in circulation, increasing the danger of HIV infections.
So the need for a safer drug consumption facility is stronger than ever. But the way forward is far from clear.
Up to now the case for piloting this approach in Glasgow has been, quite properly, made by health and social work professionals whose expertise has driven forward the development of the proposal.
However, with the involvement of the Scottish Government – and their request for the devolution of drug laws to allow the facility to operate – the issue is likely to become more political.
There is, in Scotland, a growing consensus on treating drug use as a public health rather than a criminal justice issue, with implications for our general approach to drug laws. I welcome this. However a general debate shouldn’t overshadow the very specific need for a safer drug consumption facility to meet the health needs of a particular population in Glasgow. Even those who wish drug laws to remain as they are should consider the Glasgow proposal with an open mind, as a specific measure which is necessary to respond to a public health emergency.
There is also, inevitably, a constitutional aspect to the Scottish Government requesting further devolution of powers from the UK Parliament.
I very much welcome the support of the Scottish Government and the measured tone taken by ministers. There is a risk, however, that this issue becomes part of a highly polarised debate. In other words, that it becomes a political football. I would wish to avoid this. When debates become polarised, positions become entrenched and I still have hopes that the UK Government may come to change their minds about this proposal.
There are good reasons for them to do so. Glasgow is far from the only city in the UK to experience this problem and there is a high level of interest from other UK authorities in what Glasgow is proposing. There is also no shortage of academics eager to monitor and evaluate the outcomes.
From a UK Government perspective, therefore, I think it makes sense to co-operate with the Scottish Government by devolving the relevant powers and enabling this proposal to go ahead. Glasgow, with the support of the Scottish Government, will take the risk in piloting this approach and the rest of the UK can benefit from the learning before considering whether it is an option that authorities wish to pursue elsewhere.
It is important, then, that we approach the next stages of this discussion in a measured and constructive way and don’t allow this to become a partisan political battle. Let’s remember what’s at stake – the lives of some of the most vulnerable people in our country.