Types and models of drug consumption rooms

DCRs and their offer may vary significantly depending on the country, region, and local context.

In Europe two operational models are typically used [^1]:

  1. Integrated DCRs: these operate within low-threshold facilities (generally easily accessible) that offer a range of services beyond supervised drug use.. For example, DCRs may be located within a public healthcare facility (health centre, hospital or - more commonly - run by a non-governmental organisation).
  2. Specialised DCRs: these facilities provide a more focused set of services directly related to supervised consumption.

Integrated DCRs

DCRs are incorporated into the existing care programmes within cities. They may be part of a healthcare facility, such asa community-based harm reduction centre or offered as an additional service at an overnight shelter or other housing facility. Other services provided by the facility might include:

  • Drop-in points (offering basic needs such as showers and meals).
  • 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 specialised stand-alone facilities, especially in the areas with higher demand. Although these facilities are physically separate, they remain part of local networks that provide access to additional health and social services. These facilities typically focus on a limited range of services directly related to supervised drug consumption, providing clean drug use equipment and supplies, offering advice on health and harm reduction associated with using drugs, responding to emergencies, and providing a space for monitoring individuals after drug consumption.

Mobile services

Stationary services often encounter resistance from local residents who express concerns about the so-called “honeypot effect”. They fear that the fixed location for drug injection will attract more dealers and users to the area, concentrating their activity in the immediate vicinity of the facility.

In order to attract more funding, mobile DCRs are also used. These specialised vans or buses feature one to three injection booths. Mobile units offer several advantages: lower setup costs, greater flexibility, and the ability to service multiple locations. However, they have limitations, such as accommodating only injection drug use. Supervising drug smoking requires a separate compartment with an exhaust system. Additionally, weather conditions can affect their operation. Like stationary DCRs, mobile units typically operate as part of a broader network of local services, with staff referring and sometimes accompanying clients to other service providers as needed.

For further information on mobile DCRs, please view this video from Drugreporter and Fixpunkt e.V.

Furthermore, tent/pop-up DCRs offer a temporary or semi-permanent solution. These spaceswhich may be tents, portable structures, or other covered areas, provide flexible options, particularly for unhoused individuals (https://harmreduction.org/issues/supervised-consumption-services/overview-united-states/scs-models/)

To be effective, DCRs should adhere toseveral key principles:

  1. Tailored to local needs: DCRs must be designed to address the specific needs of the local community, taking into account the unique challenges and demographics of the area.
  2. Community engagement: Engaging with the community is essential for garnering support and ensuring the successful operation of DCRs. This includes working with local residents, businesses, and other stakeholders.
  3. Ease of access: DCRs should be easily accessible, located near drug consumption spots, and well-communicated to ensure that those in need can easily find and use the services.
  4. Flexibility and adaptability: DCRs must remain flexible and adaptable to changing circumstances and emerging needs. This allows them to effectively respond to the evolving landscape of drug use and public health.
References:
  1. Correlation – European Harm Reduction Network, & European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). (2023). Drug consumption rooms. Luxembourg: Publications Office of the European Union.
Updated: 2024
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