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The Case for Overdose Prevention Centres in the UK - An Evidence-based approach

Man holding a copy of Drug Science research

Overdose Prevention Services in the UK 

Drug-related deaths are a public health crisis in the UK, with many deaths linked to injecting drug use. Enhanced harm reduction services – including facilities known as overdose prevention services (OPS), drug consumption rooms, or supervised injecting facilities – have shown to be effective in saving lives and reducing the transmission of infectious diseases.

The UK’s Advisory Council on the Misuse of Drugs has recommended consideration of their use in areas with high concentrations of public and/or unsafe injecting drug use. The Faculty of Public Health, the Royal Society of Public Health, the Royal College of Physicians, the Royal College of GPs and many other bodies and experts in the field also support their use in the UK.

With that said, no officially sanctioned service is currently operating in the UK, although an unsanctioned OPS did run from a converted ambulance in Glasgow in 2020 and 2021. This showed that it was possible to run such a service without it being closed down by the police. Nearly a thousand injection events were recorded. Nine overdose incidents occurred. None resulted in death. The service became a hub for the delivery of care and practical support to a highly marginalised group of people with high levels of complex health and social needs. The service relied entirely on voluntary effort with no official funding and could not be sustained for a longer period.

More and more vulnerable people are needlessly dying in the UK due to the lack of evidence-based harm reduction services. The efficacy of these services has been demonstrated in Europe’s progressively minded countries, Australia, the US and Canada. 

Piloting an Overdose Prevention Service in the UK 

Drug Science believes that access to sterile equipment, overdose prevention and treatment benefits both people who use drugs and the wider community.

More and more vulnerable people are needlessly dying in the UK due to the lack of evidence-based harm reduction services. The efficacy of these services has been demonstrated in Europe’s progressively minded countries, Australia, the US and Canada. With that said, Drug Science deems it important to develop the evidence base for reducing drug-related harms by piloting an OPS in the UK. This collaborative initiative would evaluate whether establishing an OPS in the UK would have the same effect as it has had in other jurisdictions. This pilot would evaluate whether the OPS; proved to be cost effective, reduced crime, improves public health, lessened drug litter, and increased engagement in treatment services.

The Enhanced Harm Reduction Working Group (EHRWG) is a consortium of Drug Science experts, leading academics, researchers, people who use drugs, and policy specialists. The EHRWG has been working with Cranstoun to establish a pilot OPS for evaluation. 

In 2022, Cranstoun and Drug Science have been working together to build a case for the UK government to permit us to operate an OPS in Sandwell – West Midlands.

The need for quantitative and qualitative evidence 

In the two reports below, we report the results of participatory consultation and research with people with lived experience of injecting drug use, and on the quantitative and geographic data which indicates the need and feasibility of an OPS.

Front cover of Reducing Drug-related harms in sandwell

In Part One of this report, we describe the quantitative and geographic indicators. We estimate that there may be over 250 people in Sandwell who are in the population group that is most likely to benefit from an enhanced harm reduction service; people who inject drugs who are homeless or unstable housed.

This report strongly suggests a need for a place where people can inject drugs out of the public gaze, in a hygienic and supervised environment. This would improve the quality of life of all the residents of Sandwell, whether they inject drugs or not. It would reduce the risks of drug-related death and help to meet the complex needs of a group of people who are highly vulnerable to multiple physical and mental health problems. It would also reduce concerns about litter and other problems related to street-based injecting.

We have also identified data that will enable the measurement of the impact of a pilot OPS on the lives of people in Sandwell.

Drug Science research on the case for overdoes prevention centres

In Part Two, we discuss the participatory consultation and research we have carried out with people who use drugs in Sandwell.

We recruited and trained a team of volunteer peer researchers, who named themselves the Sandwell Community Outreach Resources Education, or SCORE, and worked with them to find out about patterns of street-based injecting and related needs in Sandwell.

Qualitative research is essential to understand a specific local context or problem from the perspective of the impacted community.

This environment provided an ethical space within which street-based drug use could be investigated, community mobilisation deployed, and models of enhanced harm reduction discussed.

Piloting a real-world Overdose Prevention Service

Over the past year, Drug Science has evaluated the hypothetical feasibility of setting up a pilot OPS in the UK. This work has demonstrated there is a clear need for the services in areas with high levels of drug-related harm, and cross-agency support for their introduction.

However, the UK Government continues to argue that there is no legal framework to run overdose prevention services in the UK. Although there is no law which specifically bans such services, other offences such as drug possession would be knowingly committed within these sites.

Under the Misuse of Drugs Regulations 2001, some acts that would otherwise be controlled by the Misuse of Drugs Act 1971 are already exempt from criminalisation, in order to enable services that reduce harms.

We call on the UK Government to amend the Misuse of Drugs Regulations 2001 to make it easier to establish pilots of overdose prevention centres. This is an easy step that would not require primary legislation. It would help local agencies to build the evidence base and save lives.

If you support this amendment and would like to see a pilot OPS opened in the UK, please consider signing the form below:

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