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Feature War on Drugs

Could drug consumption rooms save lives?

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4906 (Published 02 August 2019) Cite this as: BMJ 2019;366:l4906

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  1. Melanie Newman, freelance journalist, London, UK
  1. melanienewman999{at}gmail.com

Despite record deaths, the UK government has rejected calls by Scotland to let people inject drugs such as heroin under medical supervision. But what evidence is there that drug consumption rooms are safer? Melanie Newman investigates

With well over a thousand drug related deaths in Scotland last year, more than double the number in 2008 (fig 1),1 and HIV infection spreading among drug injectors, the Scottish government, charities, and some MPs are calling for the introduction of drug consumption rooms (DCRs). These are safe, sterile places where people with dependency may inject their own drugs under medical supervision. They require at least de facto decriminalisation of drug possession and operate in several countries, such as Portugal, that have reduced drug deaths.

Fig 1

Drug related deaths in Scotland, 1996 to 2018

National Records of Scotland

“DCRs are not a magic wand or a silver bullet, and they will not resolve every issue, but they are humane, productive, and cost effective,” Scottish National Party MP Ronnie Cowan argued in the UK parliament in January 2018.2

Overdose deaths rising

As overdose deaths rise across the world, many jurisdictions are considering similar responses, including at least a dozen US cities.

How many of these proposals will come to fruition is unclear. The UK government has rejected the “harm reduction” approach favoured by proponents of the rooms and reiterated its abstinence focused policy. It says the rooms would be illegal,3 because drug possession is a crime under the Misuse of Drugs Act 1971, and police would have to arrest anyone involved.

A similar argument has been used in the US, where the Department of Justice under President Donald Trump has argued that the facilities would violate federal law.4 The US deputy attorney general Rod Rosenstein has also claimed that the sites would “undermine the deterrent message.”5

Legislators …

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