Home > Out of harm’s way. Drug consumption rooms, benefits and challenges.

West Midlands Police and Crime Commissioner. (2020) Out of harm’s way. Drug consumption rooms, benefits and challenges. Birmingham: West Midlands Police and Crime Commissioner.

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This document has been written in response to one of eight recommendations in the West Midlands PCC’s Drugs Policy Report (2018), a report that adopts a new approach that is dictated by evidence and compassion and where the emphasis centres on harm reduction to help to lower crime, save money and support communities. This approach recognises the dangers of a solely recovery and abstinence-based agenda that fails to address the reality that many people who take drugs are not currently ready, or able, to stop because, as is often said in the drug treatment sector, people who are dead cannot recover.

The Evidence DCRs are clinical spaces where people dependent on drugs can take their own illegal drugs, using hygienic equipment, under the supervision of trained staff equipped to treat overdoses. They also provide wider medical support and access to drug treatment and other support services. They are targeted to reach certain groups including homeless people and those not currently engaged in treatment. While there are limitations to the research reviewed in this report, and caution is required when making direct comparisons with other areas, the evidence available indicates the effectiveness of DCRs in achieving their primary health and public order objectives. This is particularly true when they are meshed with other harm reduction, housing and support services.

Perhaps most strikingly, despite many millions of injections in DCRs around the world, operating in different social and healthcare systems over several decades, no one has ever died from a heroin overdose in a DCR. While remaining opposed to DCRs, the UK Home Office has also acknowledged the evidence that they can reduce overdose deaths, improve health outcomes, reduce street injecting and discarded needles without increasing crime and disorder. For example, the most recent research available (June 2019) concluded that overdose deaths would be more than twice as high in British Columbia in Canada (which has a population around double that of the West Midlands) without the scaling up of harm reduction measures including naloxone provision, Opioid Substitution Therapy and Supervised Drug Consumption Rooms.

Developing a network of DCRs alone saved around 230 lives in a twenty-month period in the province. From a policing perspective, the question is whether a custody block or a prison cell is the best place for someone with drug problems or whether such experiences – and a criminal record – present another obstacle on the journey to recovery and increase the likelihood of reoffending. In such circumstances, a DCR, delivering health interventions as part of a system focused on education, prevention and harm reduction, would offer a more holistic and cost-effective solution.

In summary, while recognising the excellent work delivered through existing treatment and support agencies, the findings in this report suggest that, if a DCR pilot was established in the West Midlands, it could add significant value by working in tandem and co-ordinating with existing services to:

• Reduce drug-related deaths locally and at city level if coverage is adequate

• Promote safer injecting practices and reduce risky behaviours including rushed injecting

• Reduce syringe sharing and the risk of blood-borne virus transmissions including HIV and hepatitis C

• Reduce the number of ambulance call outs

• Bring a population with complex needs into contact with detoxification and drug treatment services, potentially reducing drug use in the long term

• Improve access to primary healthcare, housing, welfare and other medical services to reduce adverse life circumstances

• Improve the amenity of city centres by reducing drugrelated litter and street injecting

• Help tackle drug-related criminal activity and antisocial behaviour

• Save the taxpayer money because DCRs are costeffective by preventing more complex health issues and costs associated with responding to crime

• Make a significant contribution to a drug alert framework

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