Under the law there is no legal impediment for the development of DCRs. At the national level, DCRs are supported by the National Agency of Drugs, the National Agency on AIDS and the corresponding regional and local institutions.
Drug policies in Spain are decentralised and it is therefore the regional and local governments that are responsible for the development of drug services. All DCRs in Spain receive public funds from different public administrations.
DCRs include smoking use and one is a mobile unit. DCRs in Spain commonly belong to the local and regional Health Ministries and agencies, such as Sala Baluard, which belongs to the Public Health Agency of Barcelona. One DCR in Spain – CAS Vall d’Hebrón in Barcelona – belongs to the National Health Service, and is established within a public hospital. The rest of the DCRs, Munduko Medikuak, SAPS, La Mina and Arrels, are not directly related with the public health system but work in collaboration with it.
The first DCR in Spain opened in 2000 in Madrid. Today there are seven of these facilities in four different cities (Madrid, Barcelona, St. Adrià del Besòs, Bilbao and Lleida). For political and financial reasons, the DCR ‘Dave’, located in Madrid and the first DCR which opened in Spain in 2000, closed at the end of 2011.
More safe injection facilities were planned to open in Barcelona within already existing drug treatment centres over the course of 2012 but not all of them were taken into use for political reasons. The latest initiative was taken in 2015 in Reus, Catalonia were terapeutical-room was adapted to provide 1 hour per day a space to drug-users, that use injection, from monday to Friday.
Spanish DCRs have the following common objectives:
- To promote safer use through the provision of more hygienic conditions.
- To supervise and counsel clients before, during and after drug consumption.
- To involve users in social and health programmes.
- To offer social and health care, and to refer clients to appropriate social, healthcare and drug dependence treatment services.
- To research new drug use patterns, emergent problems or needs among drug use.
- To raise the community about the need and benefits of DCRs as a strategy on public health.
- To reduce the drug use in public spaces.
Since these facilities opened in Spain:
- overdose deaths have decreased from 1,833 in 1991 to 773 in 2008
- the number of new HIV infections has also decreased among DCR clients from 19.9% in 2004 to 8.2 in 2008
- users’ awareness of safer injection techniques has improved
- community awareness about DCRs and the public health strategy towards drugs has increased
- littering of injecting paraphernalia in public spaces was reduced.
Facilities have multidisciplinary staff (including at least one nurse) on-hand to supervise and counsel clients during all stages of drug consumption. Staff can also refer clients to social and healthcare services or drug treatment centres. DCRs also enable research into new drug use patterns, and are also a useful tool to identify emergent problems or needs among people who use drugs.