Drug Consumption Rooms (DCRs) are also known as ‘medically supervised injecting centres’, ‘safe injecting facilities’, ‘safe injecting sites’ or 'drug injection rooms', ‘drug consumption rooms’, ‘drug fixing rooms’. Some of these facilities provide places for safe injection only, so it is important to highlight that the majority of DCRs also provide places to smoke or snort drugs. There are even 'smoking only' consumption rooms.
DCR are facilities where illicit drugs can be used under hygienic and safe conditions, professionally supervised by trained staff. The majority of DCRs aim to reduce health problems caused by problematic drug use, improve access to social, therapeutic and health services for people who use drugs (PWUD) and the ‘nuisance’ or public amenity issues associated with drug use in public spaces.
Supervised DCRs have been operating in Europe, Australia and Canada over the last three decades. The first facility was legally established in Bern, Switzerland in 1986. As of July 2015, nearly 100 facilities are operating in Australia, Canada, Denmark, Germany, Luxembourg, the Netherlands, Norway, Spain and Switzerland and they continue to increase in number and geographic spread. After many years on the political agenda, France is paving the way for its first DCR. Other countries such as Portugal, Ireland, the United Kingdom, Belgium and Romania are considering DCRs as a national solution.
The aims of DCRs have multiple levels. Such as, 1) maintaining the survival of the individual and improve their health status, which can be achieved by, 2) providing a protected environment for safer drug use; 3) where one can promote education about the risks of drug use; 4) and improving access to social, health and therapeutic services. This is in addition to 5) reducing public nuisance and 6) reducing costs of health services related to drug use.
Other aims include:
1) Improving health status of the target group
- Reduce number of fatal overdoses (mortality)
- Reduce infectious disease transmission (morbidity)
- Improve risk related behaviours
2) Providing a protected environment for safe drug use
- Conditions for hygienic use by providing sterile paraphernalia
- Conditions for stress-free use by supervision and friendly atmosphere
3) Promote education about risks of drug use
- Specialised staff can provide individual tailored health education and information on 'safer use' before, during or after the time of drug consumption by observing and monitoring using patterns.
4) Improve access to social, health and therapeutic services
- To reach marginalized and vulnerable users
- To be able to improve access to care by referral or uptake with support of specialised staff
5) Reduce public nuisance
- Reduce drug use in public and semi-public places
- Reduce drug related crime
- Reduce the number of syringes discarded in the neighbourhood
- Improve public perception
6) Reduce costs of health service related to drug use
- Less costs for chronic disease treatment by lower infection rates
- Less costs for emergency services
- Less costs for implementing laws criminalizing drug use, even redistribute
Usually DCRs are highly specialized services who are either (1) integrated into an existing health service organisation, (2) specialised and/or stand-alone or (3) mobile.
1) The majority of DCRs are integrated in low-threshold facilities. These facilities offer several survival orientated services among supervised drug consumption, such as: provision of food, clothing and showers, needle exchange, counselling and activity programmes.
2) Specialised and/or stand-alone DCRs offer a narrower range of services directly related to the supervised consumption, like advice on health and safer use, provision of hygienic injection / smoking materials, intervention in case of emergencies and a space where users can be under observation after drug use.
3) Mobile facilities exist in Spain, Germany and Denmark and offer a more flexible deployment of the service – they go where the users are but can usually help a limited amount of people due to limited space of the vehicle.
For a more practical and visual impression of existing DCRs please visit the LOCATION page.
If you are interested in one or more specific topics regarding a DCR, please feel free to contact one of our experts via our CONTACT page.
If you are looking for relevant research papers OR policies and procedures for DCRs please visit our LIBRARY page.