‘Missing piece of the jigsaw’: Glasgow hopes safe injection site will curb overdose deaths
Glasgow became the first city in the United Kingdom to open a facility where people can openly use illegal drugs earlier this month, in Scotland’s latest effort to cast off its title as Europe’s drug death capital.
Other European cities have been experimenting with so-called drug consumption rooms for decades, but they’ve picked up steam in recent years as policymakers adopt a harm reduction approach to drug abuse despite ongoing controversy over the best way to tackle addiction.
Glasgow’s new safe injection site has been years in the making, after an HIV outbreak galvanised the public amid reports that an estimated 400 to 500 people were regularly injecting drugs in the city centre, with discarded needles and other paraphernalia often left in the street.
Along with Dundee, Glasgow is the epicentre of Scotland’s drug crisis.
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The country saw 833 suspected drug deaths in the first nine months of 2024, compared with 900 in the same period a year earlier.
But the planned drug consumption room was embroiled in years of legal and political debate before the city council approved it in 2023, with the goal of reducing the spread of infectious diseases and the number of drug overdoses.
At the new facility, known as the Thistle, people can bring in drugs like heroin and cocaine and use them in a quiet space with healthcare personnel nearby in case of an emergency.
They can also get treatment for wounds caused by drug use, testing for bloodborne viruses, and receive other medical care, as well as housing support and even access to laundry machines.
The Scottish government will allocate £2.3 million (€2.8 million) annually for the three-year pilot project, which had 131 visits in its first week in January.
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“It's been the biggest missing piece of the jigsaw, because the folk who are going to be using the safe injecting facility are those folk who are hardest to reach,” Allan Casey, a Glasgow city council member who backed the plan, told Euronews Health.
“If we can get them through this kind of low-threshold facility, I think it's a gateway into other forms of treatment, if indeed that's what they want”.
The Thistle is one of more than 100 – and counting – safe injection sites that have opened across Europe since the 1980s.
They’ve been gaining traction in recent years, with Ireland and Brussels opening their first centres last year.
“It’s not yet entirely mainstream,” Alexis Goosdeel, executive director of the European Union Drugs Agency (EUDA), told Euronews Health.
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“But there is a growing number of countries that are deciding to open drug consumption rooms”.
Critics of drug consumption rooms say they enable drug abuse and divert resources from prevention and recovery. But supporters say they curb overdose deaths, help connect people to treatment, and reduce the number of dirty needles left on the streets.
Drug consumption room impacts
Injection sites across Europe see an average of 81 people per day, but some have reported as many as 700 daily visits.
In cities where they have been launched, research indicates drug-related hospitalisations and high-risk self-injecting practices have fallen, while drug treatment uptake is higher and violent crime has not increased near the consumption rooms.
After a facility opened in Vancouver, Canada, for example, fatal overdoses fell by 35 per cent in the 500 surrounding metres.
That’s the outcome Casey is hoping for in Glasgow, where they will be tracking whether the site impacts the number of fatal overdoses, emergency room visits, discarded needles and other drug-related litter, and crime reports.
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He also wants to open additional drug consumption rooms in other parts of Glasgow and said he’s been in talks with advocates in other UK cities who want to open their own sites.
Harm reduction versus recovery
Even if Casey and other advocates clear the UK’s legal hurdles to open more sites, there’s no guarantee that the public – or the broader addiction and recovery community – will be on board.
For example, Annemarie Ward, who leads the charity Faces & Voices of Recovery UK, would rather the government prioritise addiction prevention and recovery programmes, such as school- and community-based education, early intervention for people showing signs of addiction, detox programmes, peer support, and a “substantial investment” in inpatient rehabilitation services.
“The disproportionate focus on harm reduction, which is important for managing immediate risks, has created a massive gap in recovery-oriented services,” Ward told Euronews Health, adding that harm reduction efforts “fail to address the root causes of addiction”.
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The Scottish government aims to have 650 beds available in rehab facilities by 2026, which would be a 50 per cent increase from 2021.
But given the scope of Scotland’s drug problem – and the ongoing nature of addiction recovery – that isn’t anywhere near enough, Ward said.
“We are effectively condemning people to a life of dependency, unable to escape the cycle, because there’s simply not enough support available,” she said.
‘Not a silver bullet’
Marie Jauffret-Roustide, a sociologist and research fellow at the French National Institute of Health & Medical Research (Inserm), has evaluated drug consumption rooms in Paris and Strasbourg.
She told Euronews Health that in order for the public to accept having an injection site nearby, it should be in an area where there is already an open drug scene.
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People who inject drugs on the street will not travel far out of their way to go to a safe consumption room, she said.
“Some neighbours think that when the drug consumption room opens, people who inject drugs will disappear, but … they will be in the area still,” she said.
Most of the visitors to the sites she evaluated were older men, and many were homeless.
“We need to find a way to improve the lives of people who attend the drug consumption room, to make sure that people will not be too vocal, for example, or have violent episodes” nearby.
Jauffret-Roustide and other advocates say drug consumption rooms are not a silver bullet solution to the drug crisis and say they should be paired with broader efforts to support people with addiction, such as housing and mental health programmes.
The programmes should also be tailored to the “local diagnosis,” Goosdeel said, for example by setting up the facility to cater to the drugs of choice in a particular area.
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Meanwhile, Ward said Scotland needs a “holistic, balanced approach, one that invests not just in keeping people alive but in helping them rebuild their lives”.
Elsewhere in Europe, some cities have closed their drug consumption rooms after launching other programmes to tackle addiction.
In the Netherlands, for example, a housing initiative reduced the need for a public injecting site, and in Switzerland and Spain, visitors to the rooms dwindled as heroin use fell, according to an EUDA report.
Back in Glasgow, Casey said the Thistle’s leadership will meet regularly with local residents to ensure the injection site doesn’t negatively affect the surrounding area – and that people who come to the rooms get the right support when they leave.
“This is the start of the journey,” Casey said.
