afe injecting sites, drug consumption rooms, safe injecting facilities, fix
rooms or the rather more grandiose medically supervised injecting
centres are just some of the many labels applied to legally sanctioned
medically supervised drug consumption sites – places where drug users
can inject their drugs safely.
The laudable purpose of these sites is to reduce BBVs and overdose,
while also reducing the nuisance caused by drug users injecting in public. They also
offer users a route into a variety of mainstream services they otherwise might not
have come in contact with.
Sounds super great, right? So, why do I always feel so uneasy when the subject
comes up? I have to say, part of the unease comes from the reaction to anyone
questioning the virtue of safe injecting sites – a reaction which ranges from scorn
to outright hostility. Consequently an orthodoxy is being created around the
subject, and in my experience unquestioned orthodoxies tend to lead to poor policy
– and there’s more than enough of that out there already!
My unease, however, goes beyond a personal dislike of the virtue signalling and
group-think that cloud the issue. There are several concrete reasons for concern
regarding the costs that come with the safe injecting sites – costs that really need
addressing and analysing.
Firstly, there will inevitably be a cost in community relations. Nothing exists in a
vacuum – especially not property prices which, given the amount of stigma around
IV drug use, will inevitably drop at the first mention of a safe injecting site in the
neighbourhood. While it’s tempting to mock this sort of ignorance-based nimbyism,
it would be wiser to realise that anything that further erodes the troubled
relationship between drug users and wider society should be treated carefully.
Then there’s the inevitable political cost. By this I mean that admitting an
area needs a safe injecting site is equivalent to admitting that a laundry list of
policies – including housing, mental health, welfare and addiction polices – have
all failed miserably, and politicians don’t like admitting and taking ownership of
that kind of collection of failures. Persuading them otherwise takes a concerted
effort – effort that could have been used to persuade them to adopt other, less
glamorous, but more productive policies. Far too often substance misuse is an
afterthought for politicians. Can the bandwidth they do devote to the subject be
Then there’s the bottom-line cost. Money is an ugly subject, but sadly it’s always
relevant – especially in an age of austerity and government indifference.
Before we go any further I keep hearing comments like ‘safe injecting sites can
be cheap – you just need a tent and some works’. Guys, that’s not a safe injecting
site. That’s a shooting gallery in a tent! Unfortunately the things that differentiate
between a shooting gallery and a safe injecting site tend to be expensive and range
from the cost of premises to the most important of all – the cost of suitable staff.
Done right, a safe injecting site is not a cheap option.
Importantly, it also needs pointing out that while offering a valuable service to
the drug users who use them, the majority of drug users won’t use a safe
injecting site. Not even a majority of IV drug users will use them – including me. I
won’t use a safe injecting site because I’m fortunate enough to have a home.
Even if I were homeless I wouldn’t travel far, pay for public transport, or spend
10 | drinkanddrugsnews | November 2018