We need to talk about safe
injecting sites, says Nick Goldstein
‘In Europe and Australia
consumption rooms are the fruit
of better funding and treatment
philosophy, but in England the
situation is different. This is not to
say things won’t change...’
Consumption rooms in Germany. The centres provide clean
drug paraphernalia as well as advice on how to use safely.
There are also on-site counselling programmes, which aim
to refer users to treatment programmes. They also provide
free condoms and affordable meals and often have
showers and laundry services.
time travelling to use a safe injecting site, and I’m far from alone in this. In fact
while preparing to write this article I asked several current and past IV drug users
what they thought of safe injecting sites. To a man/woman they replied they
were a wonderful idea, but when asked if they’d use them personally they
universally replied ‘NO’.
S
afe injecting sites’ clientele will tend to be chaotic, homeless users with
complex problems, and that’s a small subset of not just drug users, but
also a small subset of IV drug users – a very vulnerable, very visible subset,
yet still a subset. So, the question is, is it acceptable to furnish the signifi -
cant cost of a site that will only be used by a small percentage of drug
users from a budget aimed at a much wider community of drug users?
I must admit that one of my pet peeves is that drug treatment is rarely designed
for the primary purpose of helping drug users. Instead it tends to be designed to
protect wider society from drug users by reducing crime, reducing the spread of
BBVs in society and even by attempting to make drug users more economically
productive. Safe injecting sites fit firmly into this peeve because it’s easy to see the
benefit for local merchants and residents, but it’s a lot harder to discern much of a
benefit to the majority of IV drug users.
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A
t my most cynical I feel there’s something disturbing about an
approach that can easily be seen as saying ‘come in for half an hour,
have a shot so you don’t scare the public and then fuck off back to
your cardboard box’. I’m sorry, but there are far more effective ways
of helping a larger percentage of IV users – like the far more prosaic
re-evaluation and design of housing, welfare, mental health and
drug treatment services in the area for a start.
In October 2018 a safe injecting site shouldn’t be a priority in England. However,
in other parts of the world they’re a viable policy option. In America the opioid
epidemic and open air drug markets (which cause users to congregate in one place)
make safe injecting sites viable. In Europe and Australia they’re the fruit of better
funding and treatment philosophy, but in England the situation is different. This is
not to say things won’t change – it would take a brave person to bet that the
gradual arrival of fentanyl and other research chemical opioids won’t completely
change the equation and push safe injecting sites up the agenda, but in the here
and now we have other more pressing needs.
If, or rather when, the situation in England changes, then safe injecting sites may
well become a viable treatment option, and when that time comes there’s much
that can be done to mitigate the costs involved. We can accept that the sites should
be temporary and serve as an emergency measure while the fundamental issues
underlying their need are fixed. Temporary sites would also do much to allay local
community concerns regarding their impact. A temporary safe injecting site also
opens the door to using pre-fabricated buildings or converted buses, which would
help to reduce the financial cost. So, there are options that can be taken to help
make safe injecting sites viable in the future – IF they become needed.
As it is today, safe injecting sites aren’t an exciting panacea to all drug users’
problems. They are in fact a luxury in an age of austerity and all the virtue signalling
and group-think in the world won’t change that.
Nick Goldstein is a service user
November 2018 | drinkanddrugsnews | 11