Scotland has the highest number of drug related deaths in Europe
Scotland is a beautiful country but it also has a drug crisis as it continues to have the worst drug death rate in the UK and indeed in Europe. In the quarterly report from January to March 2024 by Police Scotland, there were 320 suspected drug deaths during this period which was 8% higher than the previous quarter and 7% higher than the same period for 2023. Glasgow City Council area has reported the highest rate of drug misuse deaths over a 5 year period at 44.4 per 100,000 and therefore it seems appropriate that the first ever safer drug consumption facility, SDCD, should be opened in that area.
Safe drug consumption facility
The pilot unit, called The Thistle, is in Glasgow and it was opened on 13 January 2025. It is the first SDCD unit in Scotland and the UK and will be open from 9am to 9pm, 365 days of the year. The Thistle is staffed by a multi-disciplinary team made up of nurses, harm reduction workers, medical and administration staff. The Thistle is open to everyone and individuals are able to bring their own drug/ drugs that they are using into the facility without any recourse. Within the facility there is a reception and waiting area and private rooms where users can chat to staff and tell them about the drugs that they are about to take. There are 8 separate using booths, some with wheel chair access. There is a post injection recovery area with trained staff and an aftercare lounge area where there are healthcare staff to further engage with. Users can come to the facility as many times a day as their drug addiction would dictate and there will be shower facilities and a clothing bank. It is situated beside a clinic where 23 long term users are currently prescribed pharmaceutical heroin though at The Thistle users will have to bring in their own supply.
This SDCD facility has been in the planning since 2016 following a large HIV outbreak in Glasgow in 2015. Amongst the reasons attributed to the outbreak was people sleeping rough and between 400 and 500 people injecting drugs in public places regularly in the city centre and sharing needles and other drug injecting paraphernalia. Even though there was a needle exchange in Glasgow at the time, it was apparently common for people to be seen picking up a used needle off the streets to inject themselves, despite knowing the risks of infection from openly sharing needles. It is expected that the SDCD will remove the need for people to inject in a public place and remove the obvious danger of used needles left in the street for people and children in general, to get infected from.
Benefits of a safe place to use drugs
One immediate benefit should be the reduction of drug related overdoses leading to death, as users will be in an environment in which, should they start to go into an overdose, there is immediate medical help at hand to stop a death occurring. There is increasing evidence of users dying on their own without the ability to self-administer a dose of Naloxone that is used to reverse an opioid overdose. Drugs are frequently now being cut with Fentanyl, which is a potent synthetic opioid that is approximately 50 times more potent than heroin and over 2 mg of the drug is considered to be a potentially lethal dose. Dealers are also using other cheap manufactured synthetic drugs to contaminate heroin and cocaine, known as Nitazenes, which are also stronger than heroin, and at least as potent and dangerous as fentanyl.
Concerns about a safe using location
However an area of concern with this type of service is that it is not tackling the drug addiction but rather it is enabling it. Already locals are claiming it is going to bring drug dealers into the area who will be hanging around the unit to supply a stream of customers coming to the unit. Others are saying it is there to “encourage people to harm themselves” and of course it may help users to continue using. Many may be trapped in their using, miserable and unhappy, existing not living – and by encouraging use to continue in this way, we are simply preventing people from reaching their ‘rock bottom’ which can be necessary before they start the process of turning their life around.
Addiction rehab treatment is the way forward
Over the next 3 years The Thistle will cost the Scottish Government at least £7 million pounds. It could be seen as an expensive way of tidying up the city centre of heroin users and moving them somewhere else. There is no plan for a care pathway to encourage people to be get funding for residential drug addiction treatment to end their opiate addiction. This should surely be the way forward and not the addiction enabling facility that Glasgow has now put in place. £7 million could provide detox and counselling treatment for around 1000 individuals, giving them the opportunity and means to stop their use all together and to become productive members of society. It is interesting that the UK Government has no intention of opening a similar unit but they too should consider setting aside more available funding to help people end their addiction and not to continue with it.