October 31, 2016

Full business case to be developed for pilot safer drug consumption facility & heroin assisted treatment in Glasgow

The possibility of a pilot safer drug consumption facility and heroin-assisted treatment within Glasgow city centre moved a step closer today.

Glasgow City Joint Integration Board (IJB) has approved the development of a full business case for the facility which will be considered at the board’s meeting in February. 

The proposed service model of a co-located safer consumption facility and treatment service is based on the review of existing facilities in Europe, Canada and Australia by the Alcohol & Drug Partnership’s short life working group.

Following stakeholder feedback, the working group has concluded that any potential service must offer additional ‘wrap around’ services on the premises such as primary health care, addictions counselling, and housing and welfare advice. 

The group has also advised that any safer injecting facility should also provide the means for the supervised inhalation of drugs to maximise engagement with the target population and increase the potential for harm reduction. As a result, the proposed facility will now be referred to as a safer consumption facility and treatment service. 

Further work will now be undertaken to identify options for the location of the facility. This work will involve consultation with local communities and businesses before a specific location can be identified. 

As part of the full business case now being developed, a detailed costing of the proposed facility will be undertaken. The results of the options appraisal, along with formal economic evaluations, suggest a safer consumption facility and treatment service can be highly cost effective.      

Susanne Millar, chair of the Alcohol & Drug Partnership (ADP), said: “Today’s approval by the Glasgow City IJB enables us to build a robust business case which will support this service. 

“We believe it will improve the health of the target population as well as benefit local communities and businesses that are currently adversely affected by public injecting. 

“People injecting drugs in public spaces are experiencing high levels of harm and are impacting on the wider community. We need to make our communities safer for all people living in, and visiting the city, including those who publicly inject.”

Dr Emilia Crighton, vice chair of the ADP, said: “Today's decision marks real progress towards delivering a service model that meets the needs of this small, but very vulnerable, group. We are now one step closer to catching up with other countries in the way we tackle this problem. 

“This public injecting group has high rates of hospital admissions, incarceration and homelessness. While conventional treatment and services are effective for the majority of people, we believe this facility will make a major impact in reducing health risks and the resulting costs for this group. 

“Our ultimate goal is for drug users to recover from their addiction and remain drug free. 

“However, until someone is ready to seek and receive help to stop using drugs it is important to keep them as safe as possible while do they continue to use drugs.” 

There are approximately 5,500 drug injectors in Glasgow with around 500 very vulnerable people injecting drugs in public places in Glasgow city centre. The majority are individuals experiencing homelessness, mental health issues, recent imprisonment and poverty. 

While this is a very small percentage of the city’s population, it has a huge level of need and consists of a huge cost to the public purse. These individuals are substantially responsible for the majority of discarded needles in public areas such as alleyways, car parks, parks, public toilets, and closes, putting the general public at risk and contributing to other related public order problems. 

In 2015 Glasgow City Council, Police Scotland and Community Safety Glasgow dealt with hundreds of instances of discarded needles and drug misuse in the city centre. 

Last year, the Assertive Outreach Team dealing with homeless injectors distributed almost 13,000 sterile needles. Habitual public injectors’ own health needs include the heightened risk of blood-borne viruses, overdose and drug-related death, and other injecting-related complications such as serious bacterial infections. 

Last year saw an HIV outbreak in the city with 47 new infections compared to the previously consistent annual average of 10. There have also been several other outbreaks of serious infectious diseases such as botulism and anthrax. In addition, the city experiences a high burden of acute drug related deaths with Glasgow city recording 157 in 2015.      

None of these measures on their own will solve the problems associated with public injecting in the city centre. However, they will be part of a wider response to addressing the needs of vulnerable people and supporting their recovery. 

This would involve working with those groups of people for whom our current services, including recovery based services, community addiction teams and homeslessness teams have not been successful to date.   

Medically supervised drug injecting facilities have been running since the mid-1980s with 90 facilities across 61 cities currently running. The majority are in Europe, there is one in Vancouver, one in Sydney and approval has been granted for facilities in Dublin and across France.      

The facilities seek to contribute to a reduction in drug use in public places and the presence of discarded needles and other related public order problems linked with public injecting. 

They are clean, hygienic environments where people can inject drugs under clinical supervision. The facilities provide sterile needles to reduce the risk of infections like HIV, assistance in the event of an overdose and provide linked up health services. 

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) research shows such facilities do not increase drug use, frequency of injecting or higher rates of local drug-related crime.      

Heroin assisted treatment is the next progression for people for whom current treatments have been ineffective, and who continue to use street drugs, with all the risks that entails – injecting-related infections and overdose. 

It uses pharmaceutical grade heroin administered under strict controls. This method of treatment is legal in the UK, having been trialled in London, Darlington and Brighton and is already widely used in Germany, Belgium and Switzerland.

Research trials have shown that it substantially reduces people’s need for street drugs, reduces crime and leads to more engagement with healthcare and addictions services.

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