magazin-konopi . cz |
‘ We have a good drug policy – pragmatic and evidence-based – so DCRs have become part of the city ’ s strategy .’ |
VIKTOR MRAVČÍK
GERMANY Germany had been a key player in DCR implementation , with a variety of different models .
The Hamburg-based resource centre for women who use drugs , Ragazza e . V ., had been operating a mobile outreach project for street sex workers since 1991 – as many women in the city financed their drug use with sex work – and in 2000 had opened a consumption room . ‘ There was already a lot of experience and good networking among the colleagues – there had been a mobile service for needle exchange , medical care and counselling ,’ explained social worker at the project Marylin Pohler . ‘ But establishing a facility for drug-using women at that time was quite unique , so there
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weren ’ t many references ’.
On the question of how local determinants were incorporated in plans and development , Ragazza was located at the centre of the city ’ s drug scene near the main station , she said . ‘ There was poverty , marginalisation , criminalisation going on , so it was obvious that Ragazza made sense at that place . As it was already a big drug scene the residents were nervous , but we were able to defend the location because the scene isn ’ t very mobile . The women come in , so it makes sense that we ’ re nearby .’
BARCELONA Any discussion of harm reduction in Barcelona , meanwhile , was impossible without talking about homelessness and violence , said Aranda . Catalonia and Barcelona ’ s local administration had also been applying a social determinants of health model , she said , ‘ so it ’ s very easy to add harm reduction into this .’ The DCR catered not just for injection but for inhalation and oral use , she pointed out , and the team was also now implementing an alcohol maintenance programme .
Collaboration with the police had been challenging to begin with , but they now worked very closely together , she said , with meetings every week . ‘ We have very good relations with both the municipal and state police ,’ added Mravčík , although there could sometimes still be issues regarding possession offences . ‘ But we ’ ve prepared very well
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The NHS enhanced drug treatment facility in Glasgow is the UK ’ s first safe drug consumption room and was approved by the Glasgow City Integration Joint Board . The facility will open later this year .
and done our legal analysis , so it ’ s accepted and tolerated – we communicate and cooperate .’ Relationships with police varied widely , said Perez Gayo – from cases like the Netherlands , where the police were one of the main supportive forces , to the opposite – but one model that always worked well was the establishment of local roundtables involving the police , along with standard operating procedures so boundaries were clearly understood . ‘ It means the police provide evidence that there are no problems , and back up the support for the DCR .’
THE CZECH REPUBLIC The Czech Republic ’ s DCR came out of the country ’ s ongoing legislative move away from punitive prohibition , said Mravčík . ‘ As part of this package , we created the concept of consumption rooms and discussed it nationally and interministerially .’ When it came to the local situation in Brno , good governance was important , he stressed . ‘ We have a good drug policy – pragmatic and evidencebased – so DCRs have become part of the city ’ s strategy .’ There was support from the local district where the DCR operated , and a working group that included law enforcement . ‘ We communicated the concept well in advance , so it was done in full cooperation .’ The open drug scene in part of the city centre had ‘ public nuisance and social exclusion ’, he said , ‘ so the district government for this area of the city very much supported our plans ’.
The DCR operated from a second-hand ambulance , and was now working for four hours a day – up from two when it launched last September . ‘ But doubling the operating hours means doubling the budget , so that ’ s challenging ,’ said Mravčík . ‘ We know the coverage and the impact is limited so far , so
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our challenges for the future are how to reduce barriers and increase the confidence of the target groups – especially the Roma community – because the ambulance can look too official .’ There were now plans to open DCRs in drop-centres in other parts of Brno , as well as catering for methamphetamine users alongside opioid users . ‘ We ’ re facing the challenges and trying to ensure the sustainability of the programme – that ’ s the most important thing ,’ he said .
DCR models had to be ‘ flexible , flexible , flexible ’ Aranda reiterated . ‘ All of us have to have the ability to adapt to different forms , different substances , different contexts .’ Ragazza ’ s model had been evolving , with spaces created for smoking , extended opening hours and ‘ re-thinking old rules ’, said Pohler . ‘ We ’ ve created spaces for people to sleep overnight , because poverty and homelessness are a big problem , and we ’ re exploring what new medical treatments we can offer .’ Funding was an ongoing challenge , along with opposition from politicians , media and some local residents , which meant the organisation was also heavily involved in networking and PR work .
Two of the key words when it came to DCRs were humanity and citizenship , Goosdeel concluded . ‘ We still face problems with stigma , as well as this idea that there ’ s one typical drug user . This wasn ’ t true 30 years ago and it ’ s even more wrong today . There are so many different substances and so many different users , and DCRs aren ’ t necessarily the answer for all of them .’
This called for a renewed vision – not just for DCRs , but for harm reduction , he said . ‘ It will never be enough to just talk about needle exchange or substitution treatment . But we don ’ t need to reinvent the wheel – we just need to integrate harm reduction to the new substances and new risk behaviours . That ’ s the way to design the best DCRs – as a response to a specific problem , in a specific location , with clear and achievable objectives .’ DDN
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JUNE 2024 • DRINK AND DRUGS NEWS • 7 |