Not unlike Dundee and Glasgow, Barcelona once had an “epidemic” of drug-related deaths.

However, the Spanish city has been able to significantly reduce those fatal outcomes – and consumption rooms have been at the very core of that transition. 

The Association of Wellbeing and Development (Asociación bienestar y desarrollo or ABD in Spanish) helped drive the introduction of the first consumption rooms in Barcelona.  

The first of which, CAS Baluard, opened in 2005 and provides safe and clean materials and supervision by a health professional.

Users are also able to check the drug before consumption to ensure it is not contaminated with other substances, alongside rules which ensure a safer experience such as 30-minute wait times between injections. 

The teams of doctors and nurses have successfully prevented fatal outcomes from every single overdose experienced at Cas Baluard over almost two decades. 

Ester Aranda, deputy director of the drugs and health for the organisation said consumption rooms are an essential “part of the health network” needed to support drug users.

She said: “Lethal overdoses are low now and Barcelona previously had an epidemic with deaths related to drug use.

“It is a harm reduction approach but also it is a prevention approach and sometimes the consumption rooms allow us to get to people who are starting to inject and you can try to get them to change their route of administration.

“If you don’t have the service, you only get to people who already have a big problem.” 

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In 2021, Cas Baluard cared for a total of 1362 people and registered 58,793 uses of the safe injection rooms throughout the year.

These facilities can also act as a “step between consumption and the treatment” as the team of nurses, doctors and other professionals offer a wide range of support within Cas Baluard.

And if people stop treatment, they will often return to consumption rooms which can help them return back onto a “long road” to recovery when surrounded by further support.

Crucially it has allowed them to treat what was an epidemic of deaths as a health crisis, while also giving them a better picture of the “reality” of drug use in the city.

Ms Aranda added: “Before the services, nobody knew how many users there were. With harm reduction services you can view the reality.”

It has meant the NGO has been able to track changes in drug use patterns, including supervising a recent rise in methamphetamine use in the city and ensure their programmes are tailored accordingly.  

“You have to adapt and to know really what the health problems are that are associated with these people and with this kind of use to offer good treatment,” Ms Aranda added. “It’s all linked.” 

Other health issues also benefit from the safe consumption rooms, including stabilising an “epidemic of HIV” among drug users.

She added: “If you have psychiatric problems, you have your service. If you need food, you have your services. If you have to work with a doctor, you have your primary health centre.

“If you are a drug user, you have to have your service.”

The key to its success has been incorporating it into the city centre, rather than trying to divert the problem to the outskirts of the city.

“Harm reduction services need to be where there are drug users,” the deputy director said. “I am not going to buy a beer ten kilometres outside the city and move back to a bar. It’s not logical behaviour. “

Alongside operating another consumption room for drug users who smoke substances such as heroin and cocaine, which opened five years after Cas Baluard, ABD emphasises the importance of social inclusion.

This has included work in a community garden where users can feel like they are “doing something, doing something in groups, doing something for the community and doing something with the community.”

The community garden helped “change the community’s view of drug users”, she added.

“I think the biggest barrier for drug users to include drug users in communities is stigma.

“But you need time, you are making a social change. Social change isn’t instant.”