Consumption Rooms: Enabling or Preventing?

Anthony Heron explores some of the detail of the proposed safe consumption rooms in Glasgow, given Scotland’s shocking statistics for drugs-related mortality, its essential that we get these right.

The UK’s first consumption room for illegal drugs was announced in September of this year. With the location being in the east end of Glasgow, a city well known for its drug epidemic. These consumption rooms are intended to be a safe space for users to consume their drugs safely; but is it a good idea?

 Yvonne Barbour Paton is a member of the Harm Reduction Unit at Simon Community. A Glasgow charity set up to help those in need, particularly the homeless and drug addicts. Paton’s brother was a heroin user, and it’s a topic that hit very close to home for her, and she has been an avid supporter of the introduction of consumption rooms among other drug prevention ideas, believing it to be a safer way for users.

Barbour-Paton said: “Why would we not want to keep people safe from harm?”

“We’re always pushing to keep people safe. We give people naloxone, we train them to carry naloxone, to be able to administer naloxone.”

Consumption rooms have been operated elsewhere in Europe as early as 1986, in countries like the Netherlands, Germany, Denmark and France. They have been very successful. Consumption rooms have proven useful in these countries not just as a means to prevent drug deaths, but as a way to gain insight into new trends and patterns appearing with high-risk drug users.

Professor Andrew McCauley is at Glasgow Caledonian University, specialising in injections and harm legislation. Over the years he’s investigated consumption rooms and their effectiveness through various studies. He believes they could be just as effective in Glasgow.

He said: “The evidence base from other countries suggests they will be effective and cost-effective. Effectiveness can be measured in different ways, but they are most effective at reducing public injecting, injecting equipment sharing less drug litter and reducing the burden on the NHS, less ambulance attendance at overdoses.”

They were originally created in these countries as a response to the aids epidemic of the 1980s, which was rapidly becoming a problem for users. Particularly because of the use of shared needles. Their introduction in Glasgow has similar reasoning behind it.

McCauley said: “The decision to open is very specific to Glasgow and the rooms were proposed as a response to an HIV outbreak among people who inject drugs in the city which was associated with public injecting. Glasgow city also has high drug death rates which the facility will impact, but the initial proposal was to address public injecting and HIV risk.”

Even with the procedures in place to avoid these diseases spreading in consumption rooms, it’s still a concern for users. Many of the consumption room facilities have provided provision to users, instructing them on how to safely smoke or inhale these drugs as an alternative. 

This is something Babour-Paton should be taken further in Glasgow’s consumption rooms, rather than providing provision, they should set up a separate room for users to safely smoke their substances.

She said: “There’s always room for improvement. Personally, I’d like to see them get around all the smoking legislation. Coming from a harm reduction view, people want to go in and smoke their heroin that would be safer than injection. Injection leads into masses of other risks: your central nervous system, bloodborne viruses, sexual health, and wound care. People have big wounds from injecting into their groin, into their femoral vein, they can be left with holes.”

One concern amongst drug users according to Barbour-Paton, is the illegality.

“Obviously consumption rooms are legal by themselves, but its’s still illegal to be in possession of drugs. A few people I’ve spoken to have brought up police using the consumption rooms to catch them out. They’ll obviously know someone coming out of there will have been using drugs and can then search them.”

Despite this, a poll from 2021 among Scottish drug users found that 75% were open to using a consumption room, with only 25% of those surveyed saying no.

Comparisons have been drawn between consumption rooms and methadone treatment. 

Although according to both McCauley and Barbour-Paton, it’s a difficult comparison to make.

McCauley said: “Two different interventions, one therapeutic and one not. Therefore, you need to be careful what you are comparing them against. Methadone and other forms of OAT are the most effective way to prevent deaths. But these interventions are all better when used together, there is no magic bullet to solving these issues.”

Barbour-Paton said: “It’s a different thing isn’t it really? This is getting people who wouldn’t even consider getting on any sort of treatment, they’d probably use this facility the most. It’s going to be a good way to discuss treatment options with people who aren’t engaging within services.”

One of the biggest criticisms of these treatment rooms is that they’re potentially prolonging addiction, whereas more funds should be put into treatments that help users fully quit.

McCauley said: “They neither fight addiction or prolong it, they are not treatment services. They provide a low-threshold service to a vulnerable population suffering from extreme health inequalities. There is some evidence to suggest they can be effective at engaging people with treatment, but that is not their primary purpose.”

With the consumption room set to open its doors next summer, it is projected to cost the Scottish government £7m in its first three years. Despite the high amount of funds, it’s believed to be a worthwhile venture financially. 

McCauley said: “The cost effectiveness evidence suggests they will pay for themselves once up and running in terms of the reduced burden and cost on the NHS.”

From the evidence gathered, it looks like the rewards outweighs the risks in regard to consumption rooms. Despite this they’re still a polarising topic among the general public.

With the opening of the first one imminent, it’s only going to become more widely discussed and debated.