Scotland has been making the news for the past year on several headlines. First, as the capital of drug-related deaths in Europe, with 22.4 deaths recorded per 100,000 in 2023. This cost is particularly felt in Glasgow, Scotland’s capital, where there were 33.8 deaths per 100,000 in 2023. However, more recently, the Northern nation made the news again as it finally broke through decades of British drug prohibition. The Thistle, the UK’s first legal safer injection site, opened on 13 January.
I arrived at The Thistle – located just outside of the city centre, where around 500 active drug users are estimated to regularly inject drugs – on a cold Monday afternoon just like any other service user. I walked through the front doors, where I was met by a couple of friendly staff members – from a collection of nurses, and harm reduction and mental health workers. You’re told to wait for a moment before a trained professional can speak to you.
From the chat room
Service Manager Lynn MacDonald and Operations Manager Dan Daly met me in one of the chat rooms to walk me through how the service works. Before using the facilities, service users must have a brief preliminary talk with a staff member who register their name and date of birth on the system, discuss what they plan on using alongside details about The Thistle and its services, and ultimately if there’s anything they can offer to help out. Daly explained to me they have adopted terms like chat rooms, as opposed to interview rooms, to “move away from more clinical terminology.”
The language used across the British medical system – terms like treatment room instead of health room, for example – can be overly medical, which can be a bit of a disincentive, especially in a place to use drugs. This desire to make the site open and welcoming to people is a central tenet of The Thistle’s practice and was embedded in its design and practice.
The site was designed based on input and recommendations by people who currently use or have used drugs. Every step of the design process was shaped by a panel aiming to make The Thistle as inviting as possible.
“It’s really about trying to make people feel welcome when they come in the door. It can be really intimidating walking into a service,” MacDonald explained. “People coming to our service maybe haven’t had a very good service from other organisations in the past. So we want to change that.”
The Thistle opened just over two months ago in mid-January 2025. MacDonald and Daly seemed very pleased with the results so far. “We’re seeing new people most days, and we’re seeing people returning,” Macdonald said proudly. While it’s still too early to see the data on its use, there have already been hundreds of reported visitors, the majority for injecting cocaine.
To the injection space
After the chat room, people are led through to where they can inject drugs; there, they’re given a tray with a sterile needle, a metal plate for heating drugs, and a swab to sterilise their injection spot. As The Thistle still operates as an exception to the UK’s Misuse of Drugs Act, staff cannot legally help people consuming their drugs. However, Macdonald explained, “we can advise, monitor, and provide equipment.”
The consumption space is a small cubicle with a chair, a lighter for heating your drugs, and a waste disposal bin for when you’re finished. The Thistle staff oversee the users; ready to help in case of an overdose. The overdose can be reversed through naloxone, but due to the sophisticated medical facilities at The Thistle, MacDonald explained, oxygen administration is preferred. In the first month, though, The Thistle is yet to face an overdose.
Access to sterile material is another key benefit of The Thistle. In 2015, Glasgow faced an HIV epidemic spurred on by frequent needle sharing between people; the risk of transmission is eliminated at The Thistle.
Users can remain there for as long as they like or move to a recovery area just across the room. The chairs were specially designed for maximum comfort for users with a noticeable slump-encouraged structure. Daly encouraged me to try them, visibly proud of their comfort. He’s not wrong, they’re great.
The legality of The Thistle was a big obstacle to overcome. The Thistle was made possible not due to a radical political push of empathy, rather, it was enabled due to a ruling by the Scottish Lord Advocate Dorothy Bain KC (Scotland’s head of criminal prosecutions), who announced that it would not be in the public’s interest to arrest those using drugs within a safe injection site. While Bain doesn’t have the power to sign off on the facility’s existence, it essentially provided legal protection for The Thistle’s operation, meaning people can possess and use drugs within the site with no fears of criminal repercussions. These protections, however, end right outside The Thistle’s doors, meaning people could be arrested before coming in or on the way out. Thankfully, this hasn’t happened – yet.
And later to the lounge
The lounge is another space at The Thistle. It’s a room next to the injection site which looked like it belongs in university halls. Books and board games line the shelves, and a TV plays quietly in the background. A couple of members of staff chatted to one service user, while someone else made full use of the stocked kitchen, making themselves some tea.
So far, the space has been well received by people, Daly told me; people are happy with the facilities, and to be able to sit in a warm place in these cold winter months, speaking with and forming connections with the staff. The Thistle operates as a one-stop shop for most needs: it offers showers, laundry, and fresh clothes, which, especially in these winter months, can be a game-changer for those struggling to make ends meet.
While The Thistle is strictly a safe injection site, the space works in tandem with partners and other organisations, offering a range of services for their visitors. If, for example, someone comes in and is homeless, they can be put in contact with a housing network to get them a roof over their head. If someone comes to use drugs but is interested in stopping or changing their habits, they can be connected to the opiate substitution service closest to them. There’s even a local dentist who comes in to help out with any issues. The Thistle, then, is another node within the health and social matrix for people using drugs in Glasgow, offering support rather than shunning them away.
The Thistle is a new piece of a global network
Scotland now joins more than 14 countries and 130 individual sites that offer safer drug use spaces for people using drugs worldwide. Those designing the space visited other sites in Athens and Bern for inspiration and protocol construction, hearing from Australian and Canadian harm reduction activists to further understand how to provide a space that is attractive and helpful for those using drugs.
The global success of drug consumption rooms is evident everywhere. Vancouver, for example, saw a decrease in overdose deaths from 253 to 165 per 100,000 in the 500-metre surrounding area of the safe injection site when it opened in 2003. Switzerland, a harm reduction innovator having first opened its safe injection site in 1986, saw a fall from over 3,000 annual HIV cases in 1986 to less than 500 by 2017. Sites in New York found there was no increase in crime in areas surrounding safe injection sites, a common worry and critique of opponents of these spaces. Most importantly, none of these sites have ever had a fatal overdose within them.
The Thistle has appeared despite – rather than supported by – British opposition to drug policy reform, despite recent polling revealing the majority of people support supervised injection facilities. Instead, the local is the site of change. The local activists who know and understand the area, the local community seeking change, and the local users who need the change more than anyone. The Thistle is a celebration of local change, which could spark changes elsewhere.
