Drug Consumption Rooms (Netherlands)

The problem

In the 1970s and 1980s, small initiatives in support of drug use were established in Europe. Such facilities included the Princehof and HUK in Amsterdam. The main aim of the services was ensuring that there was contact with the drug users and preventing breakdown. They also focused on ensuring that the drug users were stabilized (International Network of Drug Consumption Rooms, 2015). Despite the fact that there were various facilities in Europe, Netherlands lagged behind. However, things changed in the 1990s, when the political momentum influenced the opening of drug consumption rooms. The Netherlands Opium Act (1928, 1976) divides drugs into schedules (Wolf, Inssen & Graaf, 2003). Schedule 1 consists of hard drugs such as heroine, and GHB among others. Schedule II consists of soft drugs such as cannabis products as well as sedatives. The soft drugs have minimal risks. Mainly, the classification of the drugs depends on the risk they have on an individual. In Netherlands, drug use is not viewed as a crime, rather according to the drug policy, it is perceived as a health issue.

People mainly focus on tolerance and supporting the drug user in various ways, for instance, through behavioral interventions and proving treatment (European Harm Reduction Network, 2014). The drug consumption facilities play a huge role in controlling the nuisance brought about by individuals who abuse drugs. They are divided into three groups, specialized, informal as well as the integrated facilities. In the Netherlands, the integrated facilities are common; they are an extension of the existing low-threshold care facilities meant for the homeless individuals (Kappel et al., 2016). They are easy to access and have less disruption from other persons. The specialized rooms are separated from other care facilities. The drug users are offered various services such as psychological counseling, refreshments, doctor’s surgeries and daytime care among others. Informal facilities are located in illegal drug dealing areas. They are mainly managed by individuals who had previous substance abuse issues. Although the use of hard drugs is not allowed, the law enforcement officers allow the operations of the facilities as long as they do not cause annoyance to other individuals.

Target and the implementer

Mainly, the drug consumption facilities target individuals who have a long-term problem with drug use. It targets people who use heroin or cocaine and have experienced problems in different areas of their life (International Network of Drug Consumption Rooms, 2015). Some of the issues include debts, police and court issues, lung problems and HIV infections among other problems. Some individuals visiting the drug consumption rooms have psychiatric issues like depression or anxiety (Kappel et al., 2016). Other have problematic living arrangements, some of the drug users live in the streets.  Other facilities focus on a specific group of individuals like the illegal immigrants or prostitutes.  Different drug consumption rooms can accommodate a diverse number of people (Wolf, Inssen & Graaf, 2003). The number of people depends on the capacity of the rooms, operational hours and the rules of the stay in the consumption rooms. The drug consumption rooms have diverse areas, for example, there is the injecting rooms and the smoking rooms (Steven, 2015). The injecting rooms are more compared to the smoking rooms, and this can be linked to the fact that many drug users in Netherlands smoke rather than injecting drugs.  The drug consumption rooms do not allow the use of alcohol; hence, it is not common to find alcoholics in the facilities.

The implementation of the drug consumption rooms was made possible by the progress of legal guidelines. The College Van Procureur-general enacted the legal guidelines in 1996 (Wolf, Inssen & Graaf, 2003). The guidelines stated that the use of drugs in the drug consumption rooms was allowed provided they were within the framework as stipulated by the mayor, police as well as the public prosecutor. In 2000, the government issued a legal instruction that addicts can use drugs while being supervised by a professional in Drug consumption rooms. The instruction also states that the areas that offer or sell drugs are not allowed so as to prevent a “honeypot effect.”

Goals

The drug consumption rooms have two primary objectives, reducing health issues caused by the use of cocaine and heroin. The other goal is reducing the nuisance that is caused by drug consumption in public areas (Kappel et al., 2016). Many people and the police argue that the facilities are meant to combat public chaos. On the other hand, the facilities’ staffs focus on minimizing the problems caused by drug use (Broe, 2016). The workers seek to offer the drug users space where they can use drugs without being disturbed. Mainly, the drug users are not allowed to use the drugs in public, and they are always chased away by the police and other people. 

Scope

Since the establishment of the drug consumption rooms in Netherlands, the number of facilities has risen. Individuals are required to fulfill certain requirements so as to access the facilities. First, they have an obligation to be registered in the city where the Drug Consumption Room is situated (Kappel et al., 2016). They are also obliged to sign a contract, agreeing that they will follow the house rules. Drug users are also required to carry their drugs while visiting the facilities. However, although there are standard rules implemented by the facilities, some rooms have different rules (Schatz & Nougie, 2012). Some rooms are flexible when it comes to the implementation of the regulation rules. Many rooms have workers that include professionals such as doctors or social workers. Other employees include ex-drug users who volunteer in the facilities. The facilities are in operation for fifteen hours per day (International Network of Drug Consumption Rooms, 2015). Although the rooms are opened for many hours, each person is only allowed to stay for about twenty minutes to two hours per visit. Many Drug Consumption Rooms have different rooms for smokers and individuals who prefer injections. The average number of smokers’ rooms is fifteen and five for the injectors.  The facilities offer different services, some of the rooms provide the clients with practical support, training on how to use the drugs safely and medical counseling (Roberts, Klein & Trace, 2011). Per day the facilities can have twenty-four clients. The number of people visiting the DCRs has minimized due to the decrease in the number of targeted people. The patterns of drug consumption have also evolved thus, leading to the decline of individuals visiting the DCRs. Currently, 90% of persons visiting the facilities are non-injectors. The average age of the drug users visiting the rooms is forty-five years and men make the highest percentage.

Outcomes

Since the inception of the Drug Consumption facilities, various changes have taken place. The changes are mainly positive, for example, the public disturbance linked to drug use has decreased. In this case, few people are selling and using drugs in streets. Additionally, many people have smoking drugs instead of injecting (Havinga, Velden, Gee & Der, 2014). Currently, about 10% of individuals visiting the rooms use injections. Hence, there is a huge decrease of people sharing needles. Nevertheless, the number of smokers has substantially increased.  One of the primary objectives of the establishment of the DRCs was to minimize the health problems caused by the use of drugs (Hunt, 2010). Hence, the decline in the needle sharing reduces the spread of diseases such as HIV and hepatitis C. Research also shows that a high number of people are accepting the DRCs among them, the health care providers, the police as well as residents in the areas where the facilities are located. It is evident that the establishment of the Drug Consumption Rooms has achieved its goals.

It is obvious that DRCs have achieved their objective in Netherlands. The aim of the facilities was to minimize public disturbance caused by the use of drugs and diseases that are mainly linked to drug use. From the study, it is evident that public disturbance has decreased and the rate of HIV and hepatitis C infection has also declined. Hence, the Drug Consumption Rooms can be transferred to another place (Steven, 2015). It could target areas where there is a high rate of public disturbance due to drug abuse. Currently, the drug consumption rooms are allowed in Canada. Research shows that the facilities have been useful in Canada. There has minimal cases of transmission as well as deaths caused by drug overdose. Currently, there are various drug consumption rooms in Toronto (Steven, 2015).. The facilities provide the drug users safe supplies. They offer them needles as well as other injection supplies. Research reveals that a high number of people who inject drugs have hepatitis C. The problem is mainly caused by sharing of needles and other supplies used by the drug users. Although many people are against the Drug Consumption Rooms, the have positive outcomes. One of the consequences is the reduction of needle sharing among the drug users. Another outcome is minimal public disturbance among the drug users.

The drug consumption rooms were meant to minimize the spread of disease and decrease of public disturbance (Roberts, Klein & Trace, 2011). Currently, there is no unintended outcome of the program. However, there has been an increase of smokers and a decline of the injectors. The drug use pattern has changed tremendously since their establishment.  Many people have had positive reviews of the drug consumption facilities.

Overall based on the aim of the drug consumption rooms in Netherlands, it is evident that they have been successful. They have minimized the health problems linked to drug use such as hepatitis C and HIV (Wolf, Inssen & Graaf, 2003). People in the facilities are not allowed to share needles, thus, the reduction of the health problems. It has also helped in controlling the use of drugs among the individuals. Although initially, people did not support the initiative, there have been positive responses from the public. They believe that the rooms have minimized the chaos that is caused by individuals using drugs in public. The police also support the sentiments about the consequences of the facilities. The health workers believe that the program has minimized issues linked to drug use. It is hard to point out the results of the facilities in Toronto as they are still in the inception stage. However, it is expected that they will have the same outcome as other parts of Europe.

References

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