What is a drug consumption room anyway?

Drug consumption rooms (DCRs) allow people to use drugs under the supervision of trained staff. They have been shown to reduce deaths and injuries due to drug overdose, reduce ambulance callouts, increase referrals to health and social services including detoxification and drug treatment, reduce the spread of HIV and hepatitis C and reduce public injecting and the number of discarded used needles.

DCRs significantly benefit their communities. They are uniquely effective at attracting isolated people who have almost no contact with any health or social service. An inhalation room is the part of the DCR that allows people to inhale drugs such as ice, crack or heroin. Inhalation of drugs is starting to replace injecting in many parts of the world.

Wouldn’t a DCR send a message that drug use is OK?

Although some critics say DCRs send the wrong message, there is no evidence that they send a message that drug use is safe and acceptable. If anything, they suggest that drug use is so dangerous that it should happen only at the special centres where highly trained health workers can save the life of a person using drugs and provide pathways to treatment.

It sounds like an expensive project. Isn’t it a waste of money?

Seven cost-benefit analyses of DCRs have found the benefits outweighed the costs. It costs about $100,000 to keep an adult in jail for a year and more than twice that for a juvenile. So keeping people out of jail can save a lot of money. DCRs can help by providing an on-ramp to treatment. A conservative country such as Germany has half the incarceration rate of Australia but has nearly 30 DCRs, most with inhalation rooms.

I understand why drug treatment is important but this seems like you’ve given up

DCRs help people to improve their lives. In many countries, people using a DCR can have a shower, shampoo their hair and wash and dry their clothes, buy some cheap and nutritious food, talk to a counsellor, see a healthcare worker, see a doctor and get supervised training for a job. A very important part of the work of a DCR is to engage with people using drugs and build their trust. When people using the centre trust the staff, they are more likely to accept a referral for treatment. Hence the prime reason behind scaling up inhalation rooms around Australia is so we can improve passage into treatment for those who are dependent on drugs such as ice.

Surely the police won’t like this idea?

The Kings Cross police were and still are very strong advocates for the Kings Cross medically supervised injecting centre. In many European cities such as Berlin and Frankfurt, the police and the DCRs have worked very closely for years. In some European cities the police have been very important in getting authorities to approve a DCR. The police in Bern, Switzerland, persuaded the relevant authorities to accept an inhalation room in their DCR after an approach from health workers had been declined.

Don’t we already have a DCR in Kings Cross? Why do we need any more?

The medically supervised injecting centre, Australia’s only DCR, was opened in Kings Cross in 2001. It has been evaluated many times and each evaluation is very positive and has found no serious negative aspects.

Although the notion of the Kings Cross DCR has changed community attitudes to drug dependency around Australia, it cannot single-handedly help people who use drugs in other parts of Sydney, let alone in other states or territories. Some European cities have four DCRs. Australia has one for 24 million people living in a country of 7.5 million square kilometres.

The Kings Cross centre does a great job helping people who inject drugs (including the 8% who inject ice). But inhalation of ice is increasing in Australia. We should adapt to this. Drug inhalation began rising in Europe decades ago. Many European DCRs can now accommodate people who inhale drugs.

Doesn’t this send the wrong message to people who are dependent on ice?

Those who use DCRs around the world are often very impoverished, lacking the resources for food and clothing or to pay for a roof over their head. Many have severe physical or mental health problems and are estranged from their family and friends. If anything, DCRs tell young people that drug dependency is a tragic circumstance to find yourself in. It is hardly an advertisement to start taking drugs such as ice.

Surely the community would get more benefit by being tough on drugs and having more police crackdowns?

For more than half a century we have tried being tough on drugs. We had lots of drug crackdowns. But the results have been so woeful that police commissioners started telling the community that we cannot arrest our way out of our drug problems. At great expense we have filled our jails, which may have helped to produce better-trained criminals. It’s sometimes easier to get drugs in jail than outside. Expanding treatment is a much more effective investment and can reduce the extent of drug use in our community.

Are inhalation rooms dangerous places for staff?

European DCRs are very committed to protecting their staff from any occupational health and safety concerns of an inhalation room. The facility is a sealed-off room (at negative pressure) with a powerful industrial exhaust system that filters the air before it is released outside. DCR staff are trained to deal with difficult situations (including violence) just like treatment centres where people are often affected by substances such as ice. DCRs are designed to make their communities safer. They also reduce the burden on police and hospital emergency departments.

Isn’t there a relatively small number of DCRs around the world?

Over the past 30 years, the number of DCRs around the world has steadily increased and has now nearly reached 100. Authorities in some countries have announced they will soon open a DCR. About 15 are expected in the next couple of years. As inhaling ice has increased in Australia, as more DCRs open around our nation, we should design them to accommodate people who inhale as well as those who inject drugs. This is important for a number of reasons. First, we can help get them into treatment faster. Second, by reducing injecting, Australia could further reduce HIV and hepatitis C infections. Third, we owe it to communities who have had a tough time from big drug markets in their midst.