By Niamh Eastwood
Last week it emerged that Brighton & Hove city council was considering introducing drug consumption rooms (DCRs) in the local area. A DCR is a facility that is set up for people who use drugs problematically and who can consume pre-obtained controlled street drugs in a hygienic environment under the supervision of medically trained staff. More than 90 DCRs have been set up in countries around the world including in Switzerland, Germany, Spain, Norway, the Netherlands, Australia, Denmark, Luxembourg and Canada. The evidence for the effectiveness of such facilities in reducing overdose deaths and improving health outcomes is well established.
On Friday morning in parliament, leader of the Commons and former health secretary Andrew Lansley was asked about the proposals. He responded: "It is important to say that the government will not support any actions that contravene the United Nations drugs conventions or the Misuse of Drugs Act 1971. Permitting premises to be used for consuming or possessing substances controlled under Section 8 of the Act is illegal. As I say, we have not seen detailed proposals. The establishment or operation of drug injection rooms risks encouraging illicit trafficking and carries a significant risk of harm in local communities.
Lansley is simply wrong on every point within that statement. Firstly, the establishment of DCRs does not breach the UK's international obligations under the UN drug conventions. In fact the UN's Office on Drugs and Crime, the body responsible for the international drug conventions, published advice in 2002 which explicitly stating: "It seems clear that in such cases the intention of governments is to provide healthier conditions for intravenous drug abusers, thereby reducing the risk of infection, with grave transmittable diseases and, at least in some cases, reaching out to them with counselling and other therapeutic options. Albeit how insufficient this may look from a demand reduction point of view, it would still fall far from the intent of committing an offence as foreseen in the 1988 convention". So the UN's own legal advice clearly states that DCRs are permissible within the international drug control framework. Andrew Lansley is simply wrong to imply that DCRs are in contravention of our treaty obligations.
This brings us to domestic legislation and whilst it may be difficult to understand complicated international legal arguments there is no excuse for misinterpreting Section 8 of the Misuse of Drugs Act 1971. That section clearly states that where someone permits a premises to be used for a number of prohibited activities they will be guilty of an offence under the 1971 Act. The prohibited activities are:
• production, or attempting to produce, a controlled drugs
• supply, or attempting to supply, a controlled drug
• preparing opium for smoking
• smoking cannabis, cannabis resin or prepared opium
So to be clear, those accessing DCRs bring their own street drugs and the rules of behaviour in the DCRs prohibit drug dealing within the facilities. No one working within the facility supplies any controlled substances and the drug that is primarily consumed by those using the facilities is heroin, not opium or cannabis, so no offence is committed under Section 8 of the MDA 1971. Section 8 simply does not apply to the consumption or possession of all controlled drugs, only to the smoking of cannabis and opium. Wrong again Mr Lansley.
Clearly, those bringing their own controlled drugs onto the premises will be committing the offence of possession but this can be dealt with by setting up agreements with local police not to enforce the law on the grounds that there is a public health argument. This kind of agreement already exists in relation to needle exchanges where service users will be returning used needles which will contain traces of illegal substances. The Crown Prosecution Service has explicit guidance stating that it is not in the public interest to bring such prosecutions on the grounds that the provision of clean needles reduces HIV and Hepatitis C transmission rates. This principle has been in place for decades and could easily be applied to DCRs.
Finally, Mr Lansley notes that DCRs encourage "illicit trafficking and carries a significant risk of harm in the local community". It would be interesting to see where the leader of the Commons obtains his information. The majority of research carried out by academics who have analysed the impact of DCRs has been overwhelmingly positive, both in terms of the impact on the individual accessing these facilities and the wider community. The Joseph Rowntree Foundation (JRF) produced a report in 2006 which looked at the international evidence and concluded that DCRs can prevent overdose drug related deaths; prevent the sharing of needles thus reducing the risk of blood borne virus transmission; improve the general health of people who use drugs; lead to a reduction in injecting in public spaces; and reduce drug related litter including discarded and used syringes. For many accessing DCRs it is often their step towards treatment. Since 2006 there have been further studies on the impact of these facilities including a 2010 report from the European Monitoring Centre on Drugs and Drug Abuse which support the conclusions of the JRF report and also stated that the evidence from DCRs, such as In-Site in Canada, showed that the introduction of the facility did not result in an increase in drug trafficking or in drug related crime.
The debate on drug policy and drug treatment is difficult enough in the UK without politicians espousing information that is incorrect. In a policy area that is clouded in irrational and reactionary positions we continually need to remind parliamentarians and the public about the need for a national policy based on evidence and centred on public health.
Niamh Eastwood is the executive director of Release, the national centre of expertise on drugs and drug laws. Niamh is a non-practising barrister who started at Release in 2002 as a legal advisor, she was then appointed head of legal services in 2007, and deputy director in 2008. She has extensive experience of service delivery, policy strategy, fundraising and operational development.
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