ENGE
‘We know there
are unofficial
consumption
rooms... but
we don’t have
DCRs that can
call themselves
that, or that are
recognised in law.’
MARTIN BLAKEBROUGH
of the West Midlands Police and
Crime Commissioner, explained.
The office had begun by looking at
the scale of the drug problem in
the region, with the cost of heroin
and crack cocaine users calculated
as £1.4bn and the cost of crime
committed by the average heroin or
crack user as £26,000.
A drug policy summit had
involved the public in looking at
a new approach, with the drivers
of reducing harm, reducing crime,
and reducing cost. The eight
recommendations had included
DCRs, and an independent report
– Out of Harm’s Way, written by
Ernie Hendricks in March 2020
– covered evidence from the UK
and across the world. Its two main
recommendations were to develop
a business case through a multiagency
steering group, and to work
with government and the steering
group to support a DCR pilot site in
the West Midlands.
We had to be led by the
evidence, take the public with
us and have an ‘open mature
conversation about drug policy and
its failings,’ she said. It needed to
be done with existing treatment
providers and people with lived
experience, be linked to the
homelessness agenda, and be done
through a partnership approach.
Martin Blakebrough had been
asked to talk about developing a
model for Wales, and as CEO of
Kaleidoscope he had experience
of an early SIF model. In the ’70s
and ’80s Kaleidoscope ran a club
that also had a needle and syringe
exchange in it, with a methadone
dispensing system and doctors and
nurses: ‘In many ways it was a drug
consumption room, but it wasn’t
actually publicised as that.’
Health
authority staff
members work
at SafePoint,
a supervised
injection site in
Surrey, Canada.
Credit: Xinhua/
Alamy
Looking at other places, such
as Cardiff, ‘we know there are
unofficial consumption rooms
there, in hostels,’ he said. ‘So it’s
not quite right to say we don’t have
consumption rooms – but we don’t
have DCRs that can call themselves
that, or that are recognised in law.’
The idea that the facility had
to be an expensive option was
‘ridiculous’, he added. ‘In Wales
we’re saying “it’s just a room”.
The idea that we need to create
ridiculously safe spaces that are
sterile is also difficult – would
you want to be drinking beer
in a sterile environment? We
have to create services that are
hugely attractive to the people
we want to serve. And they need
to be involved in the design and
development of that service.’
Peer mentors were the best
people to advise someone on
how to inject drugs, and the idea
should be around creating a space
for service users to help each
other – ‘and if it’s part of a drug
service or adjacent to it, I don’t
really see the public outcry,’ he said.
‘Let’s make this happen by using
the skills and passion of our drug
using community and champions’,
giving them the money to run the
services, the legal cover, and the
clinical assistance they needed to
run the place safely.
Mat Southwell, technical
consultant specialising in
community mobilisation for people
who use drugs, agreed on the value
of peers’ central role and added
that it was really important to give
drug users choice around a highly
medicalised model or a drop-in
style community centre approach.
‘If you involve people in the design
of a project they’re going to have
more investment,’ he said.
It was important to think about
their inclusion in staffing too, as
part of an ‘empathic committed
service’. Drug user groups had been
‘pivotal’ to delivering NSP around
the country and different parts of
the world and were well placed
to carry on managing many DCR
environments, as they did already.
‘It’s not about saying either
nurses or peer educators, but saying
what’s the combination we can put
together to maximise the impact of
a system,’ he commented.
Summing up the session, Alex
Stevens said it was really important
to build the evidence base, both in
the UK and globally, for whether and
how SIFs work. Three clear stages of
development, piloting and evaluation
could be taken from the Medical
Research Council’s framework and
‘all this needs to be done alongside
service user involvement from the
very early stages’.
We were not starting from
scratch, but had research to build
on, including a ‘logic model’ of how
these services work from Australia
and Canada. A look at costs and
benefits could lead to a template
that people could plug their local
data into.
Joining in the summing up, the
senior police representative Jason
Kew added: ‘This is depoliticising it,
about saving people’s lives, about
keeping people safe – it’s as basic
as that. People talk about going
soft on drugs, but there’s nothing
soft about preventing deaths.
Nothing.’ DDN
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