Since the year 2000, after the reform of the Narcotics Act, not all provinces have adopted corresponding legal regulations and established DCRs. There are now (June 2015) 24 drug consumption rooms operating in 15 cities and six German states (Berlin, Hamburg, Hesse, Lower Saxony, North Rhine-Westphalia and the Saarland). While Hamburg operates (5) five and Frankfurt am Main (4) four drug consumption rooms, many other cities have to manage with fewer facilities. Two consumption rooms are operated in Berlin. All of the other cities such as, Bielefeld, Bochum, Bonn, Cologne, Dortmund, Dusseldorf, Essen, Hannover, Münster, Saarbrücken, Troisdorf and Wuppertal are limited to (1)one drug consumption room each. In addition to that, in Berlin operates a unique mobile safer injection rooms.
The legal opinion of a public prosecutor and director of the Central Office for Combating Drug-related Crime in May 1993 laid down the ground to get the already operating health facilities in Hamburg and Frankfurt legal within existing laws. The analysis formed the basis for the creation of a uniform federal regulation in 2000, amending the national Narcotics Act. Provinces were given the opportunity, through national regulations, to create the legal basis for DCRs. The rooms are anchored in local politics and the conditions of operation are discussed and agreed in regular meetings gathering local working groups composed of local government representatives, law enforcement officers, municipal health and social services and service providers.
All DCRs are integrated in existing harm reduction facilities and aim to support social, mental and health stabilisation, to avoid blood-borne infections and overdose casualties, and to provide timely referrals to other medical and social services. Strong emphasis is given for safe use regulations. At the same time, DCRs aim to reduce public nuisance. People who are under opiate substitution treatment, are excluded from access to DCRs (with the exception of Hamburg).
Available data clearly demonstrates the positive impact of DCRs on overdose cases and drug-related deaths. DCRs have now been used by several million clients to date, and no drug-related deaths have been recorded within the facilities In North Rhine Westphalia, the largest province of Germany, a 2001 – 2009 survey documented 1.2 million consumption processes, with 3,271 drug emergency cases and 710 CPRs. The experiences show that the clients have less abscesses and other drug-related health problems and have adopted safer forms of consumption in comparison to the people who inject drugs who do not use such spaces.
DCR staff is usually composed of doctors, nurses and educators, supported by qualified student assistants and freelancers (training-on-the-job and first-aid training for drug emergency cases).