Check your prejudice – Drug rooms are the start of something new

Take a look. The number of drug deaths in Scotland. The widespread use of drugs in prison. The link between drugs and crime. The very visible – particularly if you live in Glasgow – evidence of risky drug use. The fact that we’ve been “cracking down” on drugs for the best part of a century and yet still their use grows. Look at all of this and tell me the current policies are working.

Consumption rooms have the potential to change all of that, or at least some of it. What they’ll do is allow people to take illegal drugs at any point from 9 in the morning until 9 at night, under the supervision of staff. The users will take their own drugs in and inject them in a room designed for the purpose, which is not an easy concept to accept I admit. We’re used to drug use being hidden (or relatively hidden) and shameful (or relatively shameful) so the idea of people going into an organised public place to take drugs takes some getting used to. The plans for the building show a row of booths, clinical and clean and organised like a library or a social security office and you can’t help asking: isn’t this encouraging something bad?

The answer is that we don’t have much choice and that we’re long past the point where discouraging something bad has an effect, if it ever did. For a long time, public policy was – still is, to a large extent – based on the concept of punishment. But as David Strang of Scotland’s Drug Deaths Taskforce has pointed out, it’s hard to punish people out of addiction. In fact, the punishment often makes things worse: prison is very likely to expose you to even more drugs and then tip you back into the situation that got you into prison in the first place.

Some with more right-wing views on crime and justice would suggest the answer is that we haven’t applied the punishment hard enough, but that assumes we have the resources to tackle and reduce illegal drug use – we don’t. It also fails to acknowledge, and it’s really time we did, that lots of people use, and are using, some illegal drugs without it having a profoundly negative effect on their lives. What’s really in it for the rest of us to make them stop? And what makes us think we could? Let’s focus instead on the people who are suffering serious harm.

That, in essence, is what the drug consumption room is all about it. The staff will provide clean equipment, they’ll promote safe injecting techniques and if things go wrong – an overdose for example – they can respond there and then. This means, hopefully, that deaths will be reduced but it may also mean the strain that chaotic drug behaviour has on the wider health services is reduced too. So there’s a positive effect on the person and a positive effect on wider society.

Read more

Mark Smith: It may be time to admit the truth about the A9

Mark Smith: Let’s be honest about Alex Salmond: what made him also destroyed him

The other really critical part of the consumption room is that the staff will be able to encourage and guide people into treatment services, which are central to reducing harm. Everyone I’ve ever spoken to with experience of serious drugs tells me rehab is the key; I remember Darren McGarvey, for example, telling me that rehab was the moment for him that the “window of recovery opened”. Others have told me that rehab, although it doesn’t always work of course, puts you in a controlled, supportive and helpful environment and gives you the best possible chance of recovering.

Sadly, the issue with rehab is that the Scottish Government isn’t spending enough on it; in fact, as they've cut into council budgets, the number of rehab beds has fallen, just as the number of deaths has risen (no coincidence). It is the importance of rehab proved by what happens when it’s shut down. It is the effectiveness of rehab demonstrated by the people who are dying.

I appreciate that there’s still public opinion to overcome here. The new consumption room has been put on a desolate street in a poor part of Glasgow for a specific reason: as soon as something like a drug consumption room, or a homeless hostel or something similar, is proposed, people living nearby object because they assume it spells trouble (and to be fair: sometimes it does). But people also object when they see people doing drugs in the street or find needles lying around and the consumption room has the potential to reduce that.

We also need to take on the issue which the opposition to consumption rooms raises pretty clearly, which is the class bias on drugs. Middle-class people use drugs (not always but often) in a way that shields them from some of the worst effects: they keep a distance from crime and criminals, they don’t have to use the drugs out in the street, and they generally have the resources to protect and help them if things go wrong: money, friends with connections, that sort of thing. We therefore tend to judge middle-class users much less harshly because their use does not “cost” us in the way that more chaotic drug use out on the street does; in other words, drug use linked to poverty.

(Image: Drug rooms represent a major change in policy)

This is something I hear quite often from people when I talk to them about drugs (users as well as people who work in drug services): people who do not use drugs in the nice middle-class way are often subject to prejudice around the services that could and should help them. If you’re a drug addict and you speak in a certain way, or you’ve got a bad attitude, or you’re late for an appointment, you may have your treatment summarily withdrawn in a way that would never happen with a nice middle-class person. There’s basically a higher behavioural threshold required of certain addicts and it’s part of the prejudicial, punitive approach which still predominates in our approach to drugs.

The consumption room is, I hope, a small attempt to change that. Because someone is out on the street, and living a chaotic life and taking drugs should not exclude them from organised, accessible health services that are designed to protect them from harm. We also know from similar services in other parts of the world that consumption rooms can improve the health and recovery of the people who use them, and that’s a good thing isn’t it?

Yes, consumption rooms are controversial and yes, there will be problems with some of the people who use them and sometimes it’ll kick off. But take another look around – at the deaths, the drugs in prison, the failure of public policy – and tell me we don’t need to try something different. So let’s finally do it shall we?