Pubdate: Mon, 06 May 2013
Source: Observer, The (UK)
Copyright: 2013 Guardian News and Media Limited
Author: Daniel Boffey


A groundbreaking 'consumption room' keeps drugs off the streets, with 
staff on hand to help victims. The next may open in Brighton

'We can't change people. People can change themselves, and we can be 
there when they want to' Ivan Christensen, drug worker

Maja Petersen, 38, a prostitute, could not wait a moment longer for 
her fix. She had made her way to Copenhagen's drug consumption room, 
hoping to inject there, away from public view and within sight of its 
nurses. But the room   a place where addicts can use class A drugs 
free of fear of prosecution   doesn't open its doors to the city's 
8,000 addicts until 8.30am.

At 8am last Wednesday, she sat down on the cobbled street outside and 
plunged a syringe into her arm, flushing cocaine into her 
bloodstream. Speaking shortly afterwards, with tears welling in her 
eyes, she estimated that she would inject herself another 20 times 
that day with cocaine, methadone, or a mixture of the two   her usual 
routine. "With cocaine you want more and more and more. If you have 
it, you take it," she said. "I hate life. I don't have a life any 
more. But I have never taken too much. I have never tried to die."

Not wanting to die is the reason why Petersen, like the 1,000 
regulars at what the Danes call the "fixing room", make their way to 
this small health centre in a square that it has made its own, walled 
off from view, in Copenhagen's Vesterbro area   the city's former 
meat-packing district.

Even the most addled addict is unlikely to die here under the watch 
of medics and social workers. It is why, back in Britain, Brighton's 
public health leaders will meet this summer to "give serious 
consideration" to establishing a similar facility in the city, where 
110 people died drug-related deaths between 2009 and 2012.

Copenhagen's drug consumption room is small, but it is the latest 
incarnation of the idea of a safe haven for addicts and those behind 
it have learned lessons from about 90 others around the world. Last 
month's revelation in the Observer that there is a movement 
championing a similar facility on the south coast of England drew 
predictable fire from the rightwing commentariat. If Brighton does go 
ahead, it may wish to learn from Denmark.

In Copenhagen's fixing room, eight people at a time, and another four 
in a van parked up in the courtyard, inject, in the knowledge that 
they are being watched over by nurses and are taking their drugs in a 
clean environment using sterile needles, a dose of saline solution, a 
cotton bud and a pump, all provided by staff.

A large anatomical drawing of a man shows users the location of their 
main veins and arteries, and there is even a machine addicts can use 
that illuminates a healthy vein to spike. The atmosphere is tense; 
drug-takers can be mercurial and outbreaks of violence have been 
known. But, incongruously, it has the atmosphere of a library, as the 
addicts crouch in their booths, complete with small desk lamps, 
offering few words beyond the odd call for hush to those who make a 
noise. Those who inject cocaine   the favoured drug in this area - 
become extremely sensitive to noise while high.

It is not a pleasant place, but it is very popular. There have been 
more than 36,000 injections in the room since it opened in October, 
with the addicts getting through as many as 350 syringes a day. There 
have been an additional 13,000 injections in the van, about 40 a day. 
Most users, about 75%, are male and two thirds are aged 31-50.

Crucially, while nurses in the room have dealt with 36 overdoses in 
the last seven months, not one has been fatal   as is the pattern in 
the other drug-consumption rooms around the world. Dealing in drugs 
is forbidden and the police carefully monitor those hovering outside. 
They will enter the room and its courtyard if necessary, but they 
don't come in for "the sake of it", said Superintendent Henrik Orye.

The lives of addicts are without doubt being saved. All the evidence, 
here and internationally, suggests so. But there is much more to it 
than that, proponents say. When Petersen and the others have finished 
with their needles, they put them in a sharps bin. Up to 10,000 
syringes used to be picked up off the streets of Vesterbro every week 
before the room opened. Everyone in the area appears able to tell a 
tale of a child they know who has been spiked, although none of them 
appears to have been infected. Since the launch of the room, the 
quantity of drug paraphernalia collected from gutters, playgrounds, 
stairwells and doorways in the area has halved.

Vesterbro also appears to be a place where the desperate are 
seemingly becoming a little less desperate. Year on year, burglaries 
in the wider area are down by about 3%, theft from vehicles and 
violence down about 5%, and possession of weapons also down. "From 
the police perspective, I can see the benefits," said Orye. "It feels calmer."

Critics say that such rooms make it easier for drug users to abuse 
themselves and send the wrong message. Only five people using 
Copenhagen's room have been put on treatment since October.

Petersen, like many others using the room or floating around the 
courtyard outside, said that she does not want and would never seek 
treatment. But every day that she comes here to inject she meets 
health professionals, social workers and people offering treatment in 
case she suddenly want to rise from rock bottom, say the room's 
staff. Petersen might change her mind one day, said Nanna Gotfredsen, 
a lawyer who campaigned for the room.

Michael Olsen, a local resident who was a key figure in persuading 
authorities to accept the idea of a consumption room, said that he 
felt moved to champion the cause when he found addicts taking drugs 
in his bins, and women urinating in a phone box because all the 
toilets in the area had been sealed to stop addicts injecting there. 
"There is no country that has solved this problem, so surely, until 
we solve it, we can meet their basic needs   access to food, a 
toilet, medical help and a safe place to take their drugs," he said. 
Ivan Christensen   who runs a nearby hostel for the homeless which, 
in partnership with the Copenhagen town hall, manages the consumption 
room   said that ultimately it is about harm reduction rather than 
treatment. "We don't do this to get people out [of drugs]," he said. 
"We are happy when we do, but at first it is helping people in the 
situation they are in.

"We just intervene when they ask for help because we do not demand 
that they change, or push them to change. The philosophy is that we 
can't change people, people can change themselves and we can be there 
when they want to change."

Frank Nealson, 42, who has been using cocaine and heroin, among other 
drugs, for 27 years, is surprised that anyone could believe 
consumption rooms encourage use. "The reasons I use drugs, and where 
and how I use drugs, are two separate things. This place makes sure I 
don't do it in the street, don't pick up diseases from dirty needles, 
and that is it."

There is a plan to open a second facility, with a smoking room, 
further up the road. It will be called The Cloud. But the local 
authority is struggling to win acceptance from all residents. The 
high school, which is across the road from the current consumption 
room, is worried for its students, said Michael Knudsen, the 
caretaker. "We can't live with it so close."

Martin Petersen, 43, who lives on the road where the second room is 
planned, said that he believed the consumption room had reduced the 
number of addicts he saw injecting on the street by half. Pointing to 
the blood splatter on the archway above the door to his flat, caused 
by an addict injecting in a neck artery, he said: "That used to be normal."

But Petersen said that he was also concerned about the location. "It 
is a good idea, but there is a lot you need to get right." A warning 
for Brighton then. But experience of the Copenhagen room also offers 
a great deal of encouragement. 
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MAP posted-by: Jay Bergstrom