Experiences of Drug Consumption Rooms in Europe Cedric Charvet Coordinator DCR   www.deregenboog.org ccharvet@derengboog.org

INTRODUCTION Drug Consumption Room definition DCR in context / Drug policies DCR goals Pros and Cons of DCR From Theory to Practice DCR around the world The Dutch experience DCR standards DCR styles / examples of DCR Set up a DCR DCR approach – a job like no other Conclusion

DEFINITION Drug Consumption Rooms (DCRs) are professionally supervised healthcare facilities where drug users can use drugs in safer and more hygienic conditions.

STREET USE, Switzerland 1986

Drug Consumption Room , Luxemburg 2003

Drug Consumption Rooms in context Drug policies; the 4 pillars: Prevention Repression Therapy Harm Reduction → Drug Consumption Rooms (DCR)

DCR GOALS DCRs aim to establish contact with difficult-to-reach populations of drug users DCRs provide an environment for more hygienic drug use; reduce morbidity and mortality risks associated with drug use DCRs promote drug users’ access to other social, health and drug treatment services.   DCRs also aim to reduce public drug use and public nuisances.

PROS AND CONS PROS decrease in high-risk drug use; decrease in morbidity and mortality among the target population; increase in uptake of health and social care including drug treatment; reduction in public drug use and neighborhood nuisance.   CONS may encourage increased drug use or even initiate new users; make drug use more acceptable and comfortable, delaying initiation to treatment; increase public order problems by attracting drug users and drug dealers from other areas. (Based on the EMCDDA Report/European Monitoring Centre on Drugs and Drug Addiction/www.emcdda.europa.eu)

The Ins and Outs of Harm Reduction

FROM THEORY TO PRACTICE Because DCRs are facilities where drug users can use drugs in safer and more hygienic conditions, let’s talk about it. DRUGS + SAFETY HYGIENE STRESS FREE

DCRs AROUND THE WORLD Existing DCRs = Switzerland , Netherlands, Germany, Spain, Luxemburg, Norway, Australia, Canada Since 1986, more then 90 DCRs have been set up around the world, including 36 European cities Portugal, France, Romania, Finland could be next

AMOC, Amsterdam, the Netherlands, before 2007 THE DUTCH EXPERIENCE AMOC, Amsterdam, the Netherlands, before 2007

AMOC, Amsterdam, the Netherlands, after 2007

DCR STANDARDS Being homeless Being hard drug user for 5 years or more Basic criteria’s to access DCR Being homeless Being hard drug user for 5 years or more Being 18 years of age Understanding and agreeing on the DCR policies Not allowed in the DCR (but very difficult to apply) Stress Inappropriate and/or Dangerous behaviors Illegal activities

DCR STYLE Social DCR Medical DCR Injection Site Smoking Room Mobile DCR Etc. Examples of DCRs

Bern, Switzerland

Vancouver, British Columbia, Canada

Geneva, Switzerland

Sidney, Australia

Luxemburg

Bilbao, Spain

SET UP A DCR KNOW YOUR SCENE LISTEN TO THE NEEDS OF THE CLIENTS GATHER KNOWLEDGE ESTABLISH PARTNERSHIPS

HUMANISTIC APPROACH Allow users space and time to use and think Use without pressure Use without judgment Use without stress (Rat Park) Reward responsible use Allow users to be

CONCLUSION Think globally / Act locally    Keep it simple (hygiene / safety / stress free) Listen to the local drug scene Every material given to users is an act of prevention Every service given by DCR is to implement the quality of life of users and the society as a whole

Thank you for your attention! For further information feel free to contact me: ccharvet@derengboog.org www.deregenboog.org

SOURCES Emcdda , European report on Drug Consumption Rooms, 2004, Dagmar Hedrich. Emcdda, Harm Reduction Monograph, 2010, Chapter 11: Drug consumption facilities in Europe and beyond Dagmar Hedrich, Thomas Kerr and Françoise Dubois-Arber. Indcr, "Setting up a drug consumption room - Legal issues", 2010. Paper F of the Independent Working Group on Drug Consumption Rooms, offers evidence supporting their Report. Forston, R Joseph Rowntree Foundation. Correlation Project, “Drug Consumption Rooms. Evidence and Practice”, 2012. Schatz, E. & Nougier, M. London,International Drug policy Consortium. De Regenboog Groep, DCR, Jubileum 35 years, 2011, Ins and Outs of Harm Reduction Board.