Drug consumption rooms (DCRs) are professionally supervised healthcare facilities where drug users can use drugs in safer and more hygienic conditions.
Since 1986, more than 90 DCRs have been set up in Switzerland, the Netherlands, Germany, Spain, Luxembourg, Norway, Canada and Australia. Consumption rooms aim to establish contact with difficult-to-reach populations of drug users, provide an environment for more hygienic drug use, reduce morbidity and mortality risks associated with drug use — in particular street-based drug injecting — and promote drug users’ access to other social, health and drug treatment services. They also aim to reduce public drug use and improve public amenity near urban drug markets. At times, their establishment has been controversial due to concerns that they may encourage drug use, delay treatment entry or aggravate problems of local drug markets.
As with evaluations of other public health interventions, research on DCRs faces methodological challenges in taking account of the effects of broader local policy or ecological changes. Despite these limitations, research shows that the facilities reach their target population and provide immediate improvements through better hygiene and safety conditions for injectors. At the same time, the availability of safer injecting facilities does not increase levels of drug use or risky patterns of consumption, nor does it result in higher rates of local drug acquisition crime. There is consistent evidence that DCR use is associated with self-reported reductions in injecting risk behaviour such as syringe sharing, and in public drug use.
Due to a lack of studies, as well as methodological problems such as isolating the effect from other interventions or low coverage of the risk population, evidence regarding DCRs — while encouraging — is insufficient for drawing conclusions with regard to their effectiveness in reducing HIV or hepatitis C virus (HCV) incidence. However, use of the facilities is associated with increased uptake of detoxification and treatment services. While there is suggestive evidence from modelling studies that they may contribute to reducing drug-related deaths at a city level where coverage is adequate, the review-level evidence of this effect is still insufficient.
Taken in sum, the available evidence does not support the main concerns raised about this kind of intervention and points to generally positive impacts in terms of increasing drug users’ access to health and social care, and reducing public drug use and associated nuisance.
For an update of the evidence, please refer to Chapter 11 of the ECMDDA Harm Reduction Monograph ‘Drug Consumption Facilities in Europe and beyond’.