In early October, an injection center opened in one of the most disadvantaged areas of Paris. A six-year experiment in which drug addicts will be able to take drugs under the supervision of medical staff was achieved by the socialist government in spite of local conservatives. In August of this year, the world’s largest center for safe drug use was opened in Copenhagen. A few months earlier, Toronto’s Chief Medical Officer spoke about the need for such centers: “Injection rooms save lives and limit the spread of diseases like HIV and hepatitis, as they exclude unhygienic drug use, such as using the same needles.”
Now there are officially more than a hundred injection rooms in the world: in seven European countries (already counting France), Canada and Australia. Soon such rooms will appear in the United States – the first is going to open in Seattle. Similar ideas were also voiced in Baltimore, New York, Boston and San Francisco.
First Centers
For the first time, a community center where drug use was allowed appeared in the Netherlands in the early 70s. As part of the “Alternative Youth Service”, which was held under the leadership of Rotterdam’s St. Paul’s Church, not only did they give out clean syringes, but also allowed them to be used on the spot. At the center, you could get booklets with basic information about health and drug use, food and clothing. The local administration and the police supported the project, but the center achieved official status only in 1996.
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The first fully legal center was founded exactly ten years earlier, in 1986. At that time, social workers opened a café in Bern, where those who were not allowed into other cafes — that is, drug addicts — were admitted. Visitors were offered simple but hearty food, as well as free condoms and new syringes. As a result, customers felt so comfortable that they began to take drugs right in the café, although this was not provided for by the regulations. After consulting with the local police and authorities, the administration decided to consolidate the practice at the legal level, achieving immunity from the authorities. Officials put forward only one demand: to let only adults with official confirmation of drug addiction in.
How injection rooms are arranged
The target audience of injection centers is the most marginal group of drug users, homeless people with heroin addiction. They are also visited by those who cannot give injections at home, for example, because of family or fear of overdose. The centers are equipped with clean syringes and medicines, medical personnel are on duty in the hall to monitor the condition of drug addicts in case of overdose. Some centers also have crack smoking rooms. In Barcelona and Berlin, there are injection rooms on wheels – they can cover several urban areas at once. In some cases, injection rooms are part of large social care centers, where there are also canteens, showers and laundries.
The standard requirements for visitors are documents proving that they are of legal age and have a drug addiction, as well as that they are sober at the time of arrival at the center. Drug trafficking in the territory is strictly prohibited. Technically, the use of heroin and other drugs in such areas may remain illegal, but in all official centers, the administration agrees with the police that visitors are not accepted on the way to the center or in the building itself – according to this principle, a program for the distribution of clean syringes was popularized in the United States. In fact, we are talking about the legal use of drugs in a particular territory.
Why are they needed?
Many studies confirm the effectiveness of authorized drug use: for example, heroin was injected 355,255 times in Danish centers from 2012 to 2015. In 301 cases, there was an overdose, but this did not lead to a single death – staff equipped with the necessary knowledge and drugs are regularly on duty in the hall. Thus, injection centers fight overdoses with almost 100% efficiency. Some reports claim that they also save budget funds, as ambulances have to be called much less often, and the rate of transmission of diseases in society is noticeably reduced.
Among other advantages: the centers attract and retain high-risk groups – drug addicts with an increased risk of infection or death from overdose, who threaten not only their own, but also public safety. According to a recent survey by the Injection Drug Users Health Alliance, more than half of participants in syringe exchange programs take drugs in parks, stairwells, or just on the street. When injecting a dose in public places, they are not always in a hurry to clean up after themselves, which can later be found by animals, children or other drug addicts.
Thanks to special centers, the level of not only public drug use, but also street crime is decreasing – since the opening of the only center in Sydney, which was organized by a group of Christian volunteers, the police have recorded a sharp decrease in violence and drug-related crimes in particular. It is worth noting the most obvious effects: the fight against HIV, hepatitis C and bacterial diseases – all centers have mandatory access to sterile clean syringes. The heroine of a documentary in support of the opening of injection rooms in New York recalls her visit to one of the local dens: on the table there was a jar of water pink with blood, into which the inhabitants threw already used syringes for public use.
Arguments against
The main argument against injection centers is “Why keep people addicted to deadly drugs when they can simply be cut off from access to heroin by placing them in rehab centers.” In particular, it was used by the Conservative Party of France, which could not prevent the opening of the first injection room. The same sentiment was echoed by their Canadian colleagues, who opposed the introduction of heroin prescriptions for people with opioid addiction: “Our laws assume that we will snatch heroin from the hands of addicts, not give it to them ourselves.”
The position of conservatives is also taken by the UN International Narcotics Control Board, which recently (albeit inconclusively) discussed the lost war on drugs, as well as more humane methods of drug policy that can replace it. In a 2013 report, the organization criticized the governments of the Netherlands and Canada for having “injection rooms,” citing their “inconsistency with international drug control agreements” and citing the example of Portugal, which is the most liberal in terms of drugs, where there are no such centers. Other opponents of injection rooms cite Sweden, which has abandoned left-wing drug policies in favor of “Just Say No,” and claim that no clients of such centers have ever gotten off the opioid.
The UN believes that centers for legal drug use, despite the positive aspects, “raise legal and ethical issues”: illegal drugs bought on the black market are consumed in such establishments, which violates the Convention against Illicit Traffic in Narcotic Drugs of 1988. The agency also recalls that international agreements on drugs provide for their use only for medical and scientific purposes.
What will happen next?
The number of injection rooms is growing: over the past year, they have appeared in Northern Ireland, Toronto and are about to appear in France, Slovenia and the United States. In Spain, Switzerland and Greece, several rooms were closed, but, as a rule, this was due to the lack of critical statistics or the necessary agreements with the authorities. In the context of the general popularization of harm reduction policy (but not in Russia), injection rooms may appear in all EU countries – reports prepared by the European Research Center on Drugs and Drug Addiction assure of the importance of such centers, especially for the prevention of the threat of more potent opioids.
