Crina Din: Interview with Bernard Bertrand on DCRs 

Published January 14, 2014 - Author: Crina Din

DCRs Expert Interview Series: Bernard Bertrand - Global Platform for Drug Consumption Rooms

What is your opinion on drug consumption rooms?

"I work for the opening of Drug Consumption Rooms since 1998. I am interested in about my professional activity. I was responsible for the organization "AIDES" for the Fight against AIDS (Mulhouse city) a program of Harm Reduction. The city of Mulhouse borders with Germany and Switzerland or structures existed for years. Drug users I accompanied knew their existances and 1/3 were using.

In 2001, I published in an academic paper, a report « Le 'Tourisme d'assistance' des Usagers de drogues. Vers l'ouverture d'une salle d'injection à moindre risque » published in editions L’Harmattan.

The same year, I organized the first National Day on Drug Consumption Rooms with many local and foreign experts.

In 2005, I published a second academic study in partnership with the organization LUDIC (self-supporting drug users in Mulhouse city):  « '…on peut franchir le pas, faire un essai.', Structures d'accueil avec possibilité de consommer à moindre risque des drogues ».

My opinion is built on my field experience and science. The Drug Consumption Rooms are one link in the Harm Reduction which wants no moral or no philosophical or no political but pragmatic, human. Save lives, is not this the most important?"

Do you think that drug consumption rooms are helpful for drug users? (Please detail…)

"Yes. See next question.

The Drug Consumption Rooms help reintegrate drug users in the city.

The Drug Consumption Rooms allow better “management” of consumption and thus a reduction in consumption."

Please specify what problems could be solved by drug consumption rooms.

"1. Reduce health problems arising from drug use:

  • Reduce the number of fatal overdoses
  • Reduce the risks of contamination by hepatitis C, HIV and other blood-borne infections
  • Reduce the development of abscesses, infections and other health problems resulting from drug use when it takes place in a non-hygienic framework (stairwell, building entrance, squats, public toilets, trucks, square ...)

2. Reduce the nuisance associated with drug use in public and semi-public places:

  • Reducing drug use in public and semi-public places
  • Crime Reduction
  • Reducing the number of syringes discarded in the environment

3. Improving access to social, health and therapeutic services to consumers the most marginalized drug:

  • This is to improve access to care, particularly access to alternative treatments and weaning and reach consumers who do not use health and social services and / or therapeutic
  • But also to promote access to testing and blood tests, in the idea that preserved venous system causes the person to be tested more regularly, because less pain

4. Promote education about the risks associated with drug use:

The Drug Consumption Rooms provide education and information on safer practices "in vivo" at the time of consumption. Essential that education is suited to the observation of the practices of people, as opposed to broadcast in the needle exchange programs that can not be precarious situations where users inject their drugs or alternative treatment into account posts eg in hygiene unfit

5. Reduce costs of health services related to drug use:

The introduction of Drug Consumption Rooms offers a cost-effective, which should encourage policymakers to action: In addition to the tragic and costly loss of human lives, some harm may be avoided or mitigated. This would lead to benefits in terms of Health Economics (treatment for chronic diseases, emergency services ...) like the needle exchange programs to reduce the spread of HIV. The costs of implementing repressive laws against crime and drug abuse can also be reduced: these resources could be devoted to the prevention, treatment and care Health

 In which area of the city do you think should be located such a place?

"The Drug Consumption Rooms must be installed in areas frequented by drug users. There is no interest or install it nothing happens! The aim is also to soothe and reduce the problems of a neighborhood. This for all your program Harm reduction."

What perception would the community have on a drug consumption room in their area of living?

"The fears of residents on installing DCR are natural and legitimate: fear of seeing happen all drug users in other areas (“pôt de miel”) fear of crime increase, incitement to drug use; Image give young people ... Today, we have 27 years of experience DCR (the first to open in Bern, Switzerland in 1986).

After some time of operation, opposed to Drug Consumption Rooms residents are seeing the effects in their neighborhood, and often it has been seen that these residents asked the extenstion of hours of Drug Consumption Rooms.

Some misconceptions about Drug Consumption Rooms:

1. The DCR prevent drug user to aim for abstinence

On the contrary! The Drug Consumption Rooms are intended to assist the user in maintaining their health consumption period, while informing the various existing therapeutic programs. A health sharply deteriorated is a handicap, not an advantage, consider stopping consumption.

For example, it was found in Vancouver, a 30% increase in requests for substitution treatment and withdrawal from the opening of the ‘Insite’ Drug Consumption Room.

2. The Drug Consumption Rooms are not effective answer must wean (and punishment) and not encourage

Weaning imposed leads to a vast majority of situations, a relapse that increases the risk of fatal overdose. Most people who lived in addiction need time to develop the basis for a change in their life course. It is unrealistic to expect an abrupt change lifestyle or to make a radical break with their social environment.

3. The Drug Consumption Room give an inconsistent message to youth

It is never inconsistent to offer people ways to better protect their health and protect against injury or damage. Not to be a "non-assistance to people in danger".

4. The Drug Consumption Rooms are legitimizing drug use inconsistent with the prohibition of drugs

The society is faced with the reality of drug use although it is a transgression of the legal standard. Survival and improving the health of "those people" also require a pragmatic and responsible approach.

5. The Drug Consumption Rooms are places where illegal drugs are distributed

No drug is distributed or in the Drug Consumption Rooms or in needle exchange programs. When entering a Drug Consumption Room people who want to use must already be in possession of the product. It should therefore not confuse Drug Consumption Room with the medicalized heroin programs where substitution treatment is prescribed by a medical team.

6. The Drug Consumption Rooms attract "dealers"

No dealer enters the Drug Consumption Rooms under Regulation places (the deal is prohibited within and in the immediate vicinity of the structures). To maintain the social peace of the neighborhood, the Drug Consumption Rooms works in partnership with local stakeholders, including with police.

7. The Drug Consumption Rooms increasing insecurity and sacrifice an entire neighborhood

It has been shown that crime does not increase with the installation of Drug Consumption Rooms. The legitimate concerns expressed by the neighbors are taken into account, including information and mediation meetings. Citizen tool, the Drug Consumption Rooms allow "living together" with accountability of drug (The Drug Consumption Rooms also limit the risk of abandonment of syringes in public spaces).

8. The Drug Consumption Rooms create new consumers among young

People who do not use drugs can not access the Drug Consumption Rooms. In addition, in Europe, the onset of action of Harm Reduction coincides with a progressive decrease in new drug injection. This development is especially important for heroin injectors."

Who should support the costs to open a drug consumption room?

"The Drug Consumption Rooms are part of the device Harm Reduction is a public health policy. I do not quite know how other countries but the state, the local community must contribute to their funding."

From your experience, what were the obstacles in developing such a service.

"The only obstacles are political.

A policy based on the "war on drugs" which we know to fail.

A policy that confuses "fight against trafficking" and "fight against drug users"

A policy based on morality and not on experience, pragmatic and science."

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