Types and models of drug consumption rooms

DCRs and their offer may differ significantly depending on the country, land jurisdictions and local environment.

In Europe two operational models are typically used (EMCDDA, 2023):

1. Integrated DCRs, operating within low-threshold (with limited barriers to access) facilities, where the supervision of drug use is just one of several services offered. For example, DCRs operate as a unit within a public healthcare facility (health centre, hospital) or — more commonly — are run by a non-governmental organization).
2. Specialised DCRs, which provide a narrower range of services directly related to supervised consumption.

Integrated DCRs
DCRs are integrated within existing care programs in the city. For example, they may be part of a healthcare facility like a community-based harm reduction center or offered as an additional service at an overnight shelter or other housing facility. The other services provided by the facility might offer:

• Drop-in points (where people can meet their basic needs - shower, eat some food).
• Drug-checking services (allowing individuals to have their substances tested for purity and content, helping to reduce the risks associated with drug use by providing information on the substances they intend to consume).
• Medical care, including wound care and voluntary testing for infections.
• Advice, counselling and referral to treatment for substance use; and, in some cases, access to employment programmes.

Specialised DCRs
DCRs may operate as specialized stand-alone facilities, especially in the areas with greater demand. Although these facilities are physically separate, they remain part of a local network that connects clients to additional health and social services. These facilities typically focus on a narrower range of services directly related to supervised consumption. This includes providing hygienic drug use equipment and materials, offering advice on health and safer drug use, intervening in emergencies, and providing a space where individuals can be observed after consuming drugs.

Mobile services
Stationary services usually face a lot of opposition especially coming from the local residents. They are afraid of the so-called “honeypot effect”, that the injecting room will attract more dealers and users into the area and concentrate them in the neighbourhood immediately surrounding the facility.

Also they need more funding, this is why mobile DCRs are also used. Mobile DCRs are specially equipped vans or buses with one to three injection booths. They are less costly to set up and more flexible, as they can provide services in multiple locations. However, they have limitations, such as accommodating only injection drug use since supervising drug smoking requires a separate compartment with an exhaust system. Weather conditions can also impact their operation. Like fixed-location DCRs, mobile units typically function as part of a broader local network of services, with staff referring and sometimes accompanying clients to other service providers as needed.

You can learn more about mobile DCRs in this video of Drugreporter and Fixpunkt e.V.

Furthermore tent/pop-up – offered as a temporary or semi-permanent DCR space that may be a tent, portable, or other covered space that can be flexible in particular to meet the needs of unhoused people (https://harmreduction.org/issues/supervised-consumption-services/overview-united-states/scs-models/)