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On the 27th of September, Glasgow’s Integration Joint Board – bringing together officials from NHS Scotland, the publicly funded healthcare system in Scotland, and council officials – have approved the first official drug consumption room in the UK, reports BBC News.
The pilot scheme will be located at a health centre in the east of Glasgow and is funded by the Scottish government as part of a wider strategy to address the country’s drug death crisis. At the facility, people who use drugs will be able to consume their own substances, including heroin and cocaine, under the supervision of health professionals. Due to legal issues concerning the Scottish anti-smoking legislation, and ventilation and filtration-related challenges, the proposal for a room where clients can smoke illegal substances has been removed from the original proposal for now.
Hopes are that the consumption site will be open by the coming summer and run for an initial three years. Plans to open such a project have been on the way in the past years, and the final steps towards their realisation became possible after Lord Advocate Dorothy Bain KC announced earlier in September that it would not be in the public interest for people using a pilot Safer Drug Consumption room to face prosecution for possession within the facility.
Two local organisations from Slovenia, NGO Stigma from Ljubljana (also a C-EHRN focal point), and NGO Šent from Nova Gorica are working towards opening drug consumption rooms in the two cities in the near future. To support the process, during the last week of September (28th-29th), Roberto Perez Gayo and Arianna Rogialli, Policy Officer and Project and Policy Support Officer from Correlation – European Harm Reduction Network (C-EHRN), visited Ljubljana to deliver a training program in collaboration with them. Besides local NGOs, representatives from the Ministry of Health, the Municipality of Nova Gorica, the National Institute of Public Health and the Psychiatric Clinic of Ljubljana have also attended.
C-EHRN in conjunction with the European Network of Drug Consumption Rooms (ENDCR) designed and delivered the training. The content was specifically tailored to align with the local context, drawing from an earlier Assessment of Needs conducted in collaboration with the two host NGOs and the DCR Manual produced by C-EHRN/ENDCR in 2022.
The training in Ljubljana had several important outcomes. Firstly, it equipped participants with practical tools and insights needed for the successful planning, establishment, and operation of DCRs. The event also served as a platform for sharing best practices and service models from different regions, with an aim to enhance the quality of care provided in DCRs.
Notably, the training fostered cooperation among local and national stakeholders, including representatives from diverse sectors like healthcare, government, and NGOs. This collaboration allowed for constructive discussions regarding needs, challenges, and joint strategies—a critical element for the future success of DCR projects.
Additionally, the training offered an introduction to various DCR models and approaches, offering tools and strategies for participants to create their own service models and operational protocols, as well as monitoring, data collection, and evaluation processes.
C-EHRN and ENDCR have made a commitment to providing ongoing support for the DCR initiatives in Slovenia. They plan to follow up with participants through a check-in meeting in the coming months and offer further support materials as required.
In conclusion, the training in Ljubljana marked a step on the long path towards the establishment of Drug Consumption Rooms in Slovenia. It provided participants with valuable tools and knowledge and fostered collaboration among stakeholders.
The Mayor of Amsterdam and Mark Vermeulen, the director of Aidsfonds – Soa Aids Nederland have just shared at the Fast-Track Cities 2023 conference* that Amsterdam had only 9 new HIV acquisitions last year and highlighted the importance of access to PrEP, trans-led services & sex worker community engagement.
In a report of great significance released today, the UN High Commissioner for Human Rights calls for transformative changes toward drug policies that are based on health and human rights, calling for the decriminalization of drug use and recommending governments shift to responsible regulation in order to take control of illegal drug markets.
The report, titled “Human rights challenges in addressing and countering all aspects of the world drug problem”, underlines the harsh consequences of the ‘war on drugs’ and drug policies focused on punitive practices on human rights. The recommendations include the meaningful engagement of civil society organizations, people who use drugs, affected communities, and youth in shaping drug policies, and calls for the inclusion and support of harm reduction services.
In a statement released in response to the report, 133 civil society and community organizations welcomed its recommendations and called on the international community, the Member States, the Human Rights Council, drug control bodies, and UN agencies to act on the UN human rights chief’s call for systemic drug policy reform.
For more information, read IDPC’s thorough coverage here.
The 31st of August marks the International Overdose Awareness Day, a day to amplify the voices fighting to end overdose and to remember those who have passed away due to overdose. In support of initiatives making efforts on this path, we bring some of the latest updates.
Highlights include:
along with some additional resources that came our way in August.
C-EHRN hosts the International Network of Drug Consumption Rooms since 2007. In the past years, it became obvious that more cooperation is needed at the European level to support the development of high-quality DCRs. As an answer to this need, the European Network of Drug Consumption Rooms (ENDCR) began to take shape. At the beginning of 2023, we developed the Terms of Reference for the ENDCR, a network aiming to support capacity-building and advocacy activities and to create a platform for mutual support.
We invite organisations in the WHO Europe Region operating or planning to implement a DCR to apply for membership by reading the Terms of Reference and sending an email to administration@correlation-net.org, indicating their interest in joining the network. Once contacted, we can provide a membership confirmation survey link.
Recent Scottish research offers insights into addressing drug overdoses through effective strategies. Two studies delve into the roles of naloxone distribution and mass media campaigns in preventing overdose-related deaths. Scotland’s “How to Save a Life” (HTSAL) campaign, addressing increasing drug-related deaths, aimed to raise awareness and expand naloxone distribution.
The first study reveals that the campaign significantly boosted community naloxone availability. However, sustainability post-campaign requires consideration. The second study shows the campaign’s success in enhancing public understanding of drug-related deaths and naloxone while highlighting that responses to overdose need comprehensive coverage. Scotland’s proactive HTSAL campaign sets an example for similar regions, highlighting the importance of ongoing investment to sustain overdose prevention efforts beyond campaign periods.
In March 2023, Athens was amongst the 5 cities recognized for public health achievements at the Partnership for Healthy Cities Summit convened in London by Bloomberg Philanthropies, World Health Organization, Vital Strategies, and Mayor Sadiq Khan of London. The recognition was gained for the steps taken to enhance the availability of naloxone within community-based initiatives and among medical practitioners. Additionally, the city has initiated research into the factors leading to mortality among people who inject drugs to gain deeper insights into the effects of the overdose crisis.
Marios Atzemis, Harm Reduction Officer at Positive Voice, C-EHRN’s focal point in Athens, underlined the importance of recognising those who played a crucial role in the progress, including Professors Angelos Hatzakis and Vana Sypsa, the Hellenic Scientific Society for the Study of AIDS, STDs and Emerging Diseases and George Kalamitsis, chair of the Hellenic Liver Patient Association “Prometheus”. He also added: “We are tired of losing friends and peers from deaths that could be prevented and we strongly support the participation of the directly affected communities in the design, implementation and delivery of programs, services and policies that are addressed to them. We also strongly support and encourage the collaboration of all the stakeholders and the key populations in the drug field as it happened to the naloxone case.”
SAVE LIFE is a crucial component of HealthTeam for the Homeless (SundhedsTeam) in Copenhagen, who are also C-EHRN’s focal point. It focuses on outreach health efforts for marginalized people and people who experience homelessness. Since 2010, SAVE LIFE has developed training in lifesaving in combination with the opioid antidote naloxone. Originally in Vesterbro, Copenhagen, the project expanded across rural and urban areas in three phases. Training includes nasal spray naloxone use, overdose recognition, and life-saving assistance. The first cross-municipal project began in 2013, with some municipalities engaged for a decade. Since 2020, SAVE LIFE has coordinated nationwide training in municipalities with a substitution treatment.
Project materials and resources are available on their website, and reports and scientific articles can be accessed here. For inquiries, contact Henrik Thiesen at gg63@kk.dk or alkodoktor@dadlnet.dk.
Access the DCR manual with guidance and resources for the implementation, operation and improvement of drug consumption rooms.
Read Tony Duffin’s inspiring article about the work of OnPoint, Overdose Prevention Centres and what we can learn from the drug treatment approach in NYC.
Date: 12 September
Organised by: Harm Reduction International
Registration here.
A report of the survey will be published on C-EHRN’s website at the end of the year and presented at our partner meeting in December, providing an overview of the current DCR landscape in Europe, including information on locations, functioning, types of services, target groups and consumed substances.
Click here to access the survey.
C-EHRN hosts the International Network of Drug Consumption Rooms since 2007. In the past years, it became obvious that more cooperation is needed at the European level to support the development of high-quality DCRs. As an answer to this need, the European Network of Drug Consumption Rooms (ENDCR) began to take shape.
In 2022, we started to intensify our cooperation with drug consumption rooms in Europe and worked together on a number of activities. C-EHRN prepared ‘Safer Consumption Spaces’, a manual to support organisations with guidance and resources in the implementation, operation and improvement of DCRs. We also organised a technical meeting in cooperation with the EMCDDA in 2022 and 2023, and a session during the ‘Symposium on DCRs’ organised by the Pompidou Group in 2023. At the beginning of 2023, we developed the Terms of Reference for the ENDCR, a network aiming to support capacity-building and advocacy activities and to create a platform for mutual support.
We invite organisations in the WHO Europe Region operating or planning to implement a DCR to apply for membership by reading the Terms of Reference and sending an email to administration@correlation-net.org, indicating their interest in joining the network. Once contacted, we can provide a membership confirmation survey link.
A conversation with Péter Sárosi
In 2021, the Civil Society Forum on Drugs (CSFD) established guiding principles for meaningful civil society involvement in decision-making regarding drug policy. These principles were published in the Quality Standards for Civil Society Involvement in Drug Policy. Currently, four case studies are being conducted in Ireland, Hungary, Greece, and Finland to assess the implementation of these standards.
THE CASE STUDIES
Péter Sárosi, the executive director of the Rights Reporter Foundation and head of the Civil Society Involvement Working Group of CSFD, explained that two focus group discussions are being held in each country, one involving decision-makers and another involving civil society representatives. The Chatham House Rule ensures confidentiality and open discussion, and the conversations address the 9 overarching quality criteria described in the Quality Standards for Civil Society Involvement in Drug Policy and how these are applied in the respective countries and cities. “In June, we went to the first country [Ireland]. In July, we visited Athens. We are now working on the Hungarian one and the Finnish visit will be at the end of August.”
Péter noted active participation in Ireland and Greece, highlighting the importance of such dialogues to build openness and mutual trust between civil society and governments. “This project is really useful for the organizations in those countries because it creates some channels or forums to speak about very sensitive issues for civil society and also for decision-makers. […] It was really interesting to see the different perspectives of the two parties.” He also observed a need for more dialogue on general subjects like what is civil society and its role, as there are many misunderstandings.
Another lesson learnt was that the level of efficiency and quality of the government’s communication with NGOs is not necessarily better in the case of more formal systems. “Sometimes the informal channels can work very well. And sometimes you have formal channels which don’t work very well. […] If you have an official forum to discuss with governments, it doesn’t necessarily mean that it’ll create a good quality involvement of civil society.”
The case studies will offer valuable insights, including positive and negative examples from different mechanisms in the selected countries, with forward-looking examples like the Citizens’ Assembly on Drug Use in Ireland.
Besides some of the progressive examples of Ireland and Finland, where governments are more open to civil society voices, lessons can be learned from Hungary and Greece. In Greece, despite the not-so-developed government system, civil society advocacy had a very positive impact. A drug consumption room and a specific shelter for homeless people who use drugs were created and take-home Naloxone is being provided to prevent drug overdoses. In Hungary, where there is no existing dialogue between the government and civil society, there are still some positive developments at the city level in Budapest, which is an example on how civil society can still use local mechanisms when there are no available national ones.
At the meeting of the Horizontal Working Party on Drugs on the 11th of July, Iga Jeziorska, Correlation’s research officer spoke about the position of people who use drugs in a mental health context on behalf of the Civil Society Forum on Drugs, bringing some recommendations on improving their access to care.
When it comes to access to care, people who experience the co-occurrence of psychiatric disorder and substance use disorder are faced with various barriers on different levels. The prioritisation of specialised, large mental health institutions, the limited amount of alternative, community-based care possibilities and insufficient funding for mental health services are some examples of systemic barriers.
Meanwhile, there is a lack of mental health professionals and the gaps in mental health education result in a lack of comprehensive understanding among practitioners. These are staff-related barriers, which also include the stigma that people who use drugs face when reaching out for care. At the same time, innovations in care services can not keep up with the changing drug markets and drug use patterns.
Besides the above, the low accessibility of the services also challenges access to care. On the one hand, there is a lack of knowledge on available mental health support, while on the other hand the costs and insurance policies, waiting times and necessary documents, and the lack of mental health support in low-threshold services also prevent many when it comes to trying to access care.
To counter these barriers, it is key to ensure the availability of mental health care services for people who use drugs outside the context of drug dependence treatment as well. Community-based service options, such as the integration of mental health care into community-based harm reduction services, would also increase the number of accessible services. Besides, the scaling-up of reintegration services could ensure the continuum of care.
The integration of mental health care and substance use services, and the availability of these at a primary health care level should also be a goal. Training and the establishment of multidisciplinary teams able to address a range of problems could support the promotion of person-centred approaches that can incorporate biological, psychological, and social factors and the complex interactions of these.
Investment in research and innovation in the field is of crucial importance, while continuous monitoring and evaluation of the effectiveness of interventions is also needed. Additionally, awareness-raising campaigns could help reduce stigma and improve health literacy.