Drug Overdose Prevention Centres Could Prevent Thousands Of Deaths

A major new report led by Queen's University Belfast has highlighted that drug overdose prevention centres (OPCs) could prevent thousands of deaths, reduce the spread of serious disease, improve communities, save taxpayer money and with no increase in drug-related crime.

The report includes research funded by the National Institute for Health and Care Research (NIHR). It was carried out by researchers from Queen's Belfast and the Universities of Oxford, Kent, East Anglia, West London and Bristol in partnership with the charities Release and Drug Science, and is believed to be the largest evidence review of OPCs worldwide. It examined 570 items of peer-reviewed, research evidence and guidance documents from around the world.

OPCs, sometimes also called Drug Consumption Rooms or Safe Consumption Spaces, are places where users can take drugs in a safe, hygienic, and supervised environment. Trained staff can intervene in the case of an overdose and have reportedly saved many thousands of lives in this way. Staff also provide sterile injecting or other equipment which can also be safely disposed of; give advice; and can provide referrals to social care, health care, or addiction treatments.

There are over 200 such services across 17 countries worldwide, including the USA, Canada, France, Germany, Columbia, and Spain – but not the UK or Ireland. Scotland has plans to open its first sanctioned facility in 2024, following an unsanctioned facility in Glasgow in 2020/1 led by Peter Krykant. Lead author on the Queen's University-led report, Dr Gillian Shorter previously conducted an academic review of the Glasgow pilot OPC which concluded it had been a successful, community intervention.

Deaths among drug users from overdose are common and, in the UK, the figures have been soaring, with many commentators terming it a crisis. The latest figures available (2021) show a record number of 4,602 deaths from overdoses and other ‘drug misuse' (3,060 in England and Wales; 1330 in Scotland; 212 in Northern Ireland).

Changes in drug supply in the UK (eg. the emergence of nitazenes and other strong, synthetic opioids) further increase the risk of overdose, and the latest fatality figures are expected to rise again. The figures also show that drug users in the UK are 13 times more likely to die from overdose than their continental-European counterparts.

The new study cites many examples of OPCs around the world where hundreds – in some cases, thousands – of overdoses have reportedly been safely managed by OPC staff, saving many lives. As well as the benefits listed above, the researchers found evidence of further advantages, including preventing the transmission of serious disease such as HIV and hepatitis through the sharing or re-using of drug paraphernalia. Improvements to neighbourhoods were also evidenced, by reducing drug equipment littering the streets.  The clinics were also found to provide valuable data for health services and ultimately, to save taxpayers money by reducing the amount of people needing ambulance callouts, hospital treatment and by the prevention of serious disease. Many OPCs offer referral to drug and other treatment and support services.

The UK government has so far declined to authorise OPCs, despite a groundswell of opposition from leading doctors, public-health experts and social scientists, who argue the benefits far outweigh any negatives, as reported recently in the Lancet Public Health.

Lead author of the study, Dr Gillian Shorter, Reader in Psychology at Queen's University Belfast said: 'There are so many misconceptions about OPCs – how they can help and what the evidence says.

'These are harm-reduction spaces which aim to meet people where they are at, provide health support and basic facilities, and keep people alive. They are places of safety and inclusion, often for those who do not have other places to go. The evidence shows when we create community for people who are often excluded from society, that is when the magic happens, people are empowered to improve their health and wellbeing.

'The evidence shows OPCs don't just improve multiple outcomes for people who use drugs – they reduce drug litter, and lead to less visible drug use on our streets which is good for businesses and communities. Ultimately, they save money through reduced emergency-service use and drug-related deaths.

'We hope our report will improve the public perception of OPCs by demystifying what they do. What our review showed is that OPCs can help save lives in an urgent and growing drug-death crisis in the UK. Alongside other essential public-health strategies such as naloxone availability and real-time drug testing, the adoption of OPCs in areas of need will help reduce the enormous costs facing our communities.'

Welcoming the report, Green Party NI Councillor for Lisnasharragh in Belfast, Brian Smyth said: 'I welcome this report and it is clear that there is a huge amount of evidence that proves not only do Overdose Prevention Facilities save lives, but they also reduce pressure on health resources, emergency call outs etc. The report, published on the 11th January, found that drug overdose prevention centres could prevent thousands of deaths, reduce the spread of serious disease, improve communities, save taxpayer money and with no increase in drug-related crime.

'As Greens we have long advocated the need to have such a facility in the City centre, where there are large numbers of vulnerable people who are injecting substances such as cocanie and heroin. In March last year, Belfast City Council supported a motion brought by our party leader Mal O'Hara and myself for the introduction of an Overdose Prevention facility.

'Current drug policy is failing and we need to stop moralising around drug use. Every drug death in this city is a preventable tragedy.'