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Analysis

Stigma is stopping an evidence based response to drug overdose deaths in the UK

BMJ 2023; 382 doi: https://doi.org/10.1136/bmj-2023-074934 (Published 09 August 2023) Cite this as: BMJ 2023;382:e074934
  1. Andy Guise, senior lecturer in social science and health1 ,
  2. Magdalena Harris, professor of inclusion health sociology2,
  3. Martin McCusker, chair3,
  4. Ryan McNeil, associate professor of medicine4,
  5. Dan Werb, associate professor5 6
  1. 1King’s College London, London, UK
  2. 2London School of Hygiene and Tropical Medicine, London, UK
  3. 3Lambeth Client Council, London, UK
  4. 4University of Yale, New Haven, Connecticut, USA
  5. 5University of Toronto. Toronto, Canada
  6. 6University of California San Diego, San Diego, USA
  1. Correspondence to: A Guise Andrew.guise{at}kcl.ac.uk

Andy Guise and colleagues argue that UK government opposition to drug consumption rooms is underpinned by, and reproduces stigma towards, drug use and people who use drugs

The number of people in the UK dying from drug overdose is rising, with over 4000 deaths in 2021.1 Many countries have introduced drug consumption rooms—also known as supervised injection sites or overdose prevention sites—to help prevent fatal overdoses,2 but the UK government remains opposed. Drug consumption rooms are facilities where people can use drugs under the supervision of staff or trained volunteers who can provide emergency care such as oxygen or the opioid reversal drug naloxone in response to an overdose. They can also facilitate access to other health and social services.3

Although the UK government cites legal and evidential barriers to introducing drug consumption rooms, these difficulties have been overcome elsewhere. This suggests that opposition is underpinned by entrenched and society-wide stigma towards drug use and people who use drugs.1

Evidence supports benefit

Scientific consensus on the efficacy of consumption rooms is growing after 30 years of global experience.34 Consumption rooms have operated in Europe since the 1980s, Australia since the 1990s, Canada since the 2000s, and the US since 2021 (research from unsanctioned sites also supports their efficacy5). Those in Canada are especially well studied, with the opening of one site in Vancouver associated with a 26% net reduction in fatal overdose rates in the vicinity.6 A 2021 systematic review of 22 studies from Australia, Canada, and Europe concluded drug consumption rooms are “associated with reduced overdose morbidity and mortality, increased access to addiction treatment, and minimal change or even reductions in crime and drug use-related public nuisance.”2 Other reviews have shown that consumption rooms are accessible to highly marginalised people, promote safer injecting …

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