Future directions and emerging trends
New routes of drug consumption
Across Europe, heroin injection has been in decline for several years. In many countries, it has been increasingly replaced by the use of synthetic opioids or stimulants, which now present significant challenges to public health efforts (EMCDDA,2023). Within this dynamic context, many drug services, including DCRs, have had to adapt their services to the needs of local populations and the marketplace, often this implies addressing a broad range of practices and harms. This has included, in some countries, providing spaces for non-injecting routes of administration, most commonly smoking, and allowing the consumption of a wider range of substances within the facility.
Acknowledging gender
The need to create drug consumption rooms specifically for women is increasingly recognized as essential for addressing the unique challenges faced by female drug users. Women who use drugs often experience higher rates of violence, exploitation, and stigmatization, making them less likely to seek help in mixed-gender environments. Dedicated spaces for women provide a safe and supportive setting where they can access harm reduction services without fear of harassment or judgment. Additionally, these specialized rooms can offer tailored support services, such as counseling for gender-specific issues, reproductive health care, and protection from gender-based violence, ultimately fostering a more inclusive and effective approach to harm reduction.
What should be changed
Country example: Hamburg, Germany
Ragazza is a low-threshold and acceptance-orientated contact point and shelter in Hamburg, Germany. Its services include in-house healthcare and drug use facilities and offers help for women engaging in drug-related sex work.
Aging drug population
As the population of older drug users continues to grow, it becomes increasingly important to address their unique needs and challenges. Many of these individuals face homelessness, which exacerbates their health problems and complicates their access to care. Providing shelters that tolerate drug use is essential to ensure that older drug users have a safe place to stay. These shelters can offer a supportive environment where individuals can access healthcare services, harm reduction programs, and social support, ultimately improving their quality of life and reducing the risks associated with street-level drug use. Taking care of older drug users by providing appropriate housing and support is crucial for their well-being and for the broader community.
Country example: Dutch
An example of such a place is Dutch Woodstock. In 2008, the caregivers at Parnassia noticed that the group of homeless and addicted people aged 45 and older was growing. They kept returning for care, were unable to kick their addiction, and were not capable of living completely independently, but increasingly needed a permanent place of their own. The idea for a housing facility for this group was born, and it was named ‘Woodstock’.