Addiction

In late 2020 a converted van appeared in central Glasgow. Inside were clean needles, sterilising equipment, mirrors, sharps bins for the disposal of syringes, and supplies of the overdose reversal drug naloxone. There were also boxes containing protein bars, tea, blankets and a defibrillator, as well as two chairs and tables where injections could be prepared. The van had been converted, and was being driven, by Peter Krykant – a former outreach worker with his own history of homelessness and injecting drug use. Frustrated by the fact that no overdose prevention centre (OPC) had yet opened in the city despite calls from the local NHS, he took the law into his own hands and, after a successful crowdfunding campaign, opened one independently. OPCs are places where people can take illegally purchased drugs in a supervised environment, using clean equipment and with staff able to intervene in the case of an overdose. The first such centre opened in the Swiss capital, Bern, in 1986, and there are now around 200 across the world from Berlin, Paris and Geneva to Sydney, Vancouver and New York. While the centres go under an array of different names including “drug consumption rooms”, “safer consumption sites” and “safe injecting facilities”, the essential concept – providing a safe environment for the use of risky, illegal drugs – remains the same. There have been no recorded overdose deaths at any of these centres since the first opened 36 years ago. No such services exist in the UK, however. As drug-related deaths continue to rise the debate over whether this should change has become increasingly heated – especially in Scotland, where drug mortality rates are the highest in Europe. The largest outbreak of HIV in the UK in over 30 years has been among people who inject drugs in Glasgow, Scotland’s largest city, and is ongoing. Krykant’s unsanctioned Glasgow OPC operated for nine months. It oversaw 894 injection events involving heroin and cocaine and treated nine potentially fatal overdoses. Krykant describes its impact as “overwhelming”. “I saw people move from groin injecting to injecting in less dangerous areas [of the body] due to having a warm and well-lit environment where they could take their time and not feel rushed,” he says. “Myself and the other volunteers who helped run the service witnessed people feeling cared about for the first time. The service turned into a beacon of safety for many. We started supplying basic things like warm clothing, drinks and sanitary products. On one occasion we bought a wheelchair for a person who had lost a leg." The Glasgow police largely tolerated the facility, although on one occasion Krykant was cautioned for refusing to let officers into the van while it was being used. And the media were fascinated: during its brief time of operation, reports about the van appeared in UK and international media including the New York Times. Due to health issues, Krykant reluctantly closed the facility in the summer of 2021. The van was donated to the Transform Drug Policy Foundation and now tours the UK, demonstrating what an OPC would look like in practice. Krykant believes it served a vital purpose in demonstrating that “it could be possible to set up and run OPCs within current frameworks”. He is still hopeful that a formal facility will be commissioned in the near future, but the UK government remains opposed. [See also: Richard Blakeway: “Landlords are too dismissive about damp and mould”] Pat Hudson is an emeritus professor of history at Cardiff University. In 2017 her son Kevin was found dead in a locked toilet in a department store in the Welsh town of Carmarthen. He was 32 and an experienced tree surgeon. Kevin Hudson died of cardiac arrest and brain damage after injecting heroin. He had been battling addiction and was making progress, but died alone after the kind of accidental overdose that kills thousands in the UK every year. His mother said: “If Kevin had had somewhere safe to go in the town to inject, without fear of criminalisation or stigma and with a medically qualified person in attendance, he would certainly not have locked himself in a toilet where no one could reach him.” Pat Hudson, a member of the campaign group Anyone’s Child: Families for Safer Drug Control, is calling for OPCs to be introduced as a way of providing life-saving support. While first and foremost about saving lives, she says this is also about “providing medical and addiction advice for those seeking help”. OPCs have been found to successfully reduce the risk of blood-borne virus transmission, direct clients to treatment services, provide advice on safer consumption, and reduce levels of public injecting and discarded needles. By creating a non-stigmatising environment, they can also attract people who might otherwise not come into contact with support services, or who previously had unhappy experiences in treatment. More than 300,000 people are thought to use opiates or crack cocaine regularly in England, of whom about half are in treatment. But even for those accessing such services, treatment can only help if they are kept safe and alive when they are using. For people such as Kevin Hudson, a lack of safe drug consumption spaces significantly increases the risk of death. In December 2021, in response to record levels of drug-related deaths, the UK government committed £780m to improving treatment services in England and Wales – money that was desperately needed following years of disinvestment. But despite organisations such as the harm reduction charity Cranstoun signalling their intention to open OPCs when conditions allow, there are no plans to pilot such facilities in the UK government’s ten-year drug strategy for England. !function(){"use strict";window.addEventListener("message",(function(e){if(void 0!==e.data["datawrapper-height"]){var t=document.querySelectorAll("iframe");for(var a in e.data["datawrapper-height"])for(var r=0;r

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