CLAIM:
“I've never seen good research, controlled evidence, of how successful [drug consumption rooms] are." – Dame Carol Black in The Herald, 15 August
DOORSTEP ANSWER:
There is a plethora of international evidence that supervised drug consumption rooms are safer, make it far easier for addicts to get help, and reduce deaths. They are not a “silver bullet” but they are part of the answer.
WHO IS DAME CAROL BLACK?
Professor Carol Black (b. 1939) is a former President of the Royal College of Physicians and latterly was Principal of Newnham College, Cambridge. She has also been a senior advisor to the global business consultancy firm PwC, which specialises in health management and privatisation.
Black was commissioned by former Home Secretary Sajid Javid in February 2019 to conduct an independent review into drug misuse and treatment in England. Though it formed no part of her report, Black told the media she was unconvinced that supervised drug consumption rooms – where addicts can take drugs under medical supervision - are useful.
READ MORE: William Hague calls on UK to follow Portugal's lead and decriminalise drugs
In Scotland, drug-related deaths are at record levels (as they are in England). The SNP government has pledged to spend £250 million in the next five years on tackling drug misuse. As part of this programme, the Scottish Government wants to introduce supervised consumption rooms, but this would require a change in UK legislation. But according to Black: “I've never seen good research, controlled evidence, of how successful [consumption rooms] are”. She went on to say that drug consumption rooms are not a “silver bullet” to reduce Scotland’s chronic drugs deaths problem.
BLACK’S LIMITED APPROACH
Is Black justified in dismissing drug consumption rooms? In the foreword to the first part of her report she says: “I took a market approach because the supply of drugs is driven by profit, and violence is often the result of competition for market share. Only by understanding the market and the drivers behind it can government hope to disrupt it.”
It is also important to note that Black was constrained in her reporting by a directive from the Home Secretary that she could not consider any recommendations that involved changing the current legislation on drugs. According to Black herself: “I am probably going to be limited in what I can say as it would require a change in the law, and I was absolutely not allowed to recommend anything that would need a change in the law”.
EVIDENCE ON DRUG CONSUMPTION ROOMS
What of Black’s contention that she has “never seen good research, controlled evidence, of how successful” consumption rooms are? The main recognised institution conducting research into drug use and cure in Europe is the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), which was established in 1993. The EMCDDA exists to provide the EU and member states with a solid evidence base regarding drugs use (see EMCDDA website).
According to the EMCDDA, supervised drug consumption facilities, where illicit drugs can be used under the supervision of trained staff, have been operating in Europe for the past three decades. They aim to reduce the acute risks of disease transmission through unhygienic injecting, prevent drug-related overdose deaths and – this is crucial - connect high-risk drug users to treatment provision and social services. The latter point is exactly the issue that Black's report is supposed to cover.
The first contemporary supervised drug consumption room was opened in Berne, Switzerland in June 1986. Further facilities have since been established in Germany, Netherlands, Spain, Norway, Luxembourg, Denmark, Greece, France and Ireland. In other words, the use of consumption rooms is widespread in Europe as a contribution to tacking the drugs problem and there is a plethora of data regarding their usefulness.
READ MORE: Safe consumption rooms: Scotland 'committed' to idea despite Westminster opposition
According to the EMCDDA website, the proven effectiveness of drug consumption facilities to reach and stay in contact with highly marginalised target populations has been widely documented by academic studies. Yet in her Herald interview, Black says: “I really wanted to concentrate on what is it that you've got to put together for an addicted person to enable them to move on a journey of recovery”. In which case, the evidence suggests that supervised consumption rooms in Europe are one key to providing this joined-up approach.
EMCDDA also reports that the regular contact between addict and medical and social agencies that result from consumption rooms have resulted in immediate improvements in hygiene and safer use for clients. EMCDDA indicates sound evidence that consumption rooms reduce injecting risk behaviour such as syringe sharing. This reduces the risk of overdose deaths. Finally, EMCDDA finds that use of consumption facilities is associated with increased uptake both of detoxification and drug dependence treatment.
CONCLUSION
Black’s report provides a plethora of statistics to show we need urgent action on drug abuse, as the Scottish Government desires. However, Black's report for the Home Office covers a very narrow agenda of solutions. Her 30 recommendations address closer co-operation of related drug agencies in England, training extra staff at all levels to tackle the problem, and new incentives for English local authorities to engage with the issue. To secure these aims, Black proposes the obligatory increase in public spending – though she provides data to show this cash will be more than recouped if drug addiction is curbed.
READ MORE: Boris Johnson rejects plea to allow drug consumption rooms in Scotland
It is unclear why Black thinks that the parallel introduction of supervised consumption rooms would detract or divert from her proposals. It is possible she is trying to stay within the narrow political agenda of the current, hard-line Home Secretary Priti Patel.
The use of supervised drug consumption rooms has been proven positive everywhere it has been tried. No-one, as far as we know, has ever claimed they are a "silver bullet" to resolve a desperate and complicated problem. But that is no reason to dismiss them entirely, as Black seems to imply.
FACTCHECK RATING: Underwhelming. Black needs to read the scientific evidence.
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