EU rapport om 74 fixe- og brugerrum

EU’s Overvågningscenter for Narkotika (EMCDDA) udsendte i februar 2004 en rapport om erfaringerne med fixerum.

Nedenfor kan du læse konklusionen.

Du kan finde hele rapporten på dette link:

Fra: “European report on drug consumption rooms” af Dagmar Hedrich. 2004.

Overall conclusions on benefits and risks of consumption rooms

The research evidence on the impact of consumption rooms, although still incomplete, suggests that consumption rooms do achieve some of the specific purposes for which they were set up. They reach a population of long-term problem drug users with various health and social problems. They provide a hygienic environment for drug use and, for regular attenders at least, decrease exposure to risks of infectious diseases. They contribute to a reduction in levels of risk-taking among their clients and increase access for specific ‘hard-to reach’ target populations of drug users to health, welfare and drug treatment services. They provide immediate emergency help in case of overdose, and can make a contribution to the reduction of overdose deaths at community level.

Even among this problematic client group, consumption rooms have facilitated improvements in health, have provided counselling and other therapeutic options and have referred many to medical services and in some cases drug treatment.

As long as there is sufficient capacity and coverage in terms of location and opening hours, as well as consultation with residents and police, consumption rooms can reduce the level of drug use in public places and help to reduce public nuisance.

The expected benefits of consumption rooms are:

  • decreases among the target population in high-risk drug use, morbidity and mortality (in particular supervised drug injecting facilities).
  • increased uptake of health and social care including drug treatment.
  • reductions in public drug use and neighbourhood nuisance.

The evidence suggests that all these benefits can be realised. However, the size of the effect depends on providing adequate capacity, appropriate locations and opening hours, as well as relevant policies regarding access and management of clients. Achieving these benefits also requires that consumption rooms are embedded in a wider network of services and that there is political consensus regarding their role.
Inhalative modes of drug consumption pose a much lower risk of overdose. While Dutch studies have shown that drug consumption facilities that are mainly for non-injectors deliver benefits with regard to reducing nuisance, their impact on morbidity is more difficult to assess.

There is no evidence that consumption rooms encourage increased drug use or initiate new users. There is little evidence that by providing better conditions for drug consumption they perpetuate drug use in clients who would otherwise discontinue consuming drugs such as heroin or cocaine, nor that they undermine treatment goals.
When managed in consultation with local authorities and police, they do not increase public order problems by increasing local drug scenes or attracting drug users and dealers from other areas. If consultation and cooperation between key actors does not take place, then there can be a risk of a ‘pull effect’ and consumption rooms run the risk of being blamed for aggravating local problems of public order including drug dealing.

While the evidence suggests that the benefits of consumption rooms can outweigh the risks, it is important to set this in the wider context of problem drug use and of responses to it, and to be modest in claiming what consumption rooms can or cannot achieve. In particular, it is unrealistic to expect that they can:

  • prevent all public drug use.
  • persuade all clients to reduce risky drug use or enter treatment.
  • in themselves be the major factor in reducing morbidity and mortality.
  • solve wider problems of drug markets and drug dealing.

Three key points must be emphasised. The evidence suggests that consumption rooms only make sense, and can only be effective, if they are:

  • established within the wider framework of a public policy and network of services that aim to reduce individual and social harms arising from problem drug use.
  • based on consensus and active cooperation between key local actors, especially health workers, police, local authorities and local communities.
  • seen for what they are – specific services aiming to reduce problems of health and social harm involving specific high-risk populations of problematic drug users and addressing needs that other responses have failed to meet.

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