Pubdate: Tue, 22 Dec 2020
Source: New York Times (NY)
Copyright: 2020 The New York Times Company
Website: http://www.nytimes.com/
Details: http://www.mapinc.org/media/298
Author: Allison McCann

BATTLING SCOTLAND'S DRUG CRISIS FROM THE BACK OF A VAN

GLASGOW - Every Friday for the past two months, Peter Krykant has
parked his white van on Parnie Street in central Glasgow, around the
corner from a games shop and several art galleries, and waited for
people to come by and inject illegal drugs.

Inside the van are two seats and two tables, each with a stainless
steel tray and hypodermic needles, as well as several biohazard trash
cans. The van is also equipped with naloxone, the medication used to
reverse an opioid overdose, and a defibrillator. (There are Covid-19
safety precautions, too: hand sanitizer and a box of masks.)

Mr. Krykant usually opens the van by 10 a.m., and on this particular
day three people were already waiting to get inside. This was
something of a surprise, since the Scottish police had charged him
with obstruction the week before when he refused to open the vehicle
to officers, knowing several people were inside taking drugs. He
wasn't sure anyone would come back after that scare.

Scotland is in the midst of its worst drug crisis on record, and one
of the worst in the world. The country has tallied five straight years
of record-setting, drug-related deaths and now holds a per capita
death rate three times higher than anywhere else in Europe.

Overdoses are more common in Scotland, by some measures, than even the
United States. In 2018, Scotland had nearly 20 drug-related deaths per
100,000 people, compared with 18 deaths in the United States and
around five in Ireland, Finland and Sweden.

Mr. Krykant is adamant that drug consumption rooms will help slow the
rate of overdose deaths in Scotland by allowing drug users to inject
under supervision and with naloxone on hand.

Mr. Krykant chats easily with several men waiting to be let inside. He
asks them what type of drug they'll be injecting, writes it down and
then opens the sliding back door.

In addition to Mr. Krykant, at least one other trained volunteer is on
duty; they take turns watching for the police and checking on the
people inside.

A 25-year-old man who would give only his first name, Gezzy, for fear
of arrest, said he had injected both heroin and cocaine that day.
Dressed in a navy blue tracksuit with a clean haircut, he talked
candidly about the death of his ex-girlfriend, who suffered an
overdose seven weeks earlier.

"This is what we needed," he said. "There are too many
overdoses."

Mr. Krykant, a former addict himself, said he had "learned very
quickly that harm reduction is the most fundamental thing."

"People don't get any more opportunities after they're dead," he
said.

Drug consumption rooms are facilities that legally allow people to
take illicit drugs under the supervision of trained professionals, in
a sterile environment and with clean equipment. They have been shown
to reduce overdose deaths and blood-borne viruses like H.I.V.,
decrease public injecting and more quickly connect people to treatment
services.

"In all recorded injections that have taken place in these spaces
across the world, there has not been one recorded death," said Andrew
McAuley, a public health professor at Glasgow Caledonian University.

The first legal facility opened in Switzerland in the mid 1980s, and
over the last three decades they have been established across Europe,
Canada and Australia, around 200 in all.

Despite their effectiveness and Scotland's increasingly dire drug
problem, they remain illegal throughout Britain.

The Scottish government has expressed its support, but Westminster has
not budged. "We have no plans to introduce drug consumption rooms, and
anyone running them would be committing a range of offenses," a
spokesperson for the British Home Office said in a statement.

But Mr. Krykant thinks blaming Westminster is an easy
out.

"All we've been hearing is that it's the U.K. government's fault," he
said, adding: "We could have drug consumption rooms in Scotland right
now if there was political will."

With Scotland in control of its own health care and policing - a
system known as devolution - Mr. Krykant and other drug policy
advocates argue that the Lord Advocate, Scotland's chief public
prosecutor, could provide legal cover in the form of a "letter of
comfort" stating that drug consumption rooms could operate without
fear of criminal prosecution. (The Lord Advocate provided similar
guidance this spring for naloxone.)

But he has so far declined to do this, saying the facilities require a
legal solution that addresses civil liability and the full range of
exemptions from criminal law.

To date, the police have not shut down the van, nor have they made any
arrests. In a statement, they seemed to suggest they would leave well
enough alone - for now, at least.

"The establishment of any form of safe consumption location
contravenes the U.K. Misuse of Drugs Act 1971," an assistant chief
constable of Police Scotland, Gary Ritchie, said in a statement. "Any
attempt to circumvent the law, as it stands, by providing an
unregulated and unlicensed facility may expose already vulnerable
people to more risk and harm."

For Mr. Krykant, the goal of the van is to challenge drug policy more
than to curb Scotland's soaring drug deaths.

"We may keep people alive, but this has always been about a push for
an official establishment," he said. "We can't provide a service for
hundreds of people from the back of one transit van."

Mr. Krykant grew up in Falkirk, about 20 miles from Glasgow, and said
he was taking drugs on a daily basis by the time he was 11 years old.
By 17, he was injecting heroin, and a few years later found himself in
Birmingham, England, living on the street and begging for money to
fuel his drug habit.

He was eventually approached by an outreach team in Birmingham and
offered a chance to enter a residential treatment program. "I grabbed
my bag and enough drugs to take on the train and got myself there," he
said.

After that, he moved to Brighton in southern England and completed
another program, and has been clean now for two decades. He returned
to Falkirk in 2013 with his family and started working in drug
recovery services.

But he started to grow disillusioned with the work he was doing. As an
outreach coordinator for a charity, part of his job was testing
homeless people in Glasgow for H.I.V. and hepatitis C.

"We would be walking away from people who tested negative, knowing
that they were going to be back in the alleyway later that day," he
said.

In February, he attended a conference sponsored by the Scottish
government and heard about the promise of drug consumption rooms. He
was intrigued. A few weeks later he traveled to Copenhagen and met
with the people who opened Denmark's first mobile site in 2011. Less
than a year later, the Danish Parliament legalized supervised
injection facilities.

"I took my inspiration from what happened there," he said. "They
quickly got the legal framework and now have the world's largest safe
consumption facility."

He traveled back to Scotland and decided to do the
same.

He invested 500 pounds, or about $650, of his own money and
crowd-funded the remaining ?2,400 to purchase the well-traveled van
and outfit it with the necessary equipment. On Aug. 31 - International
Overdose Awareness Day - he drove it to Parnie Street for the first
time.

"Almost all of the interventions that work to help people were started
through civil disobedience," said Alex Kral, an epidemiologist from
the nonprofit research institute RTI International. "Needle exchange
programs, naloxone programs. Safe consumption sites are no different."

Mr. Kral said the situation in Scotland was "completely parallel" to
the United States. Despite attempts by cities like Seattle and
Philadelphia to establish drug consumption rooms, the country
currently has no legal sites. (One unsanctioned facility has operated
since 2014 in an undisclosed location.)

Mr. Krykant chose the van's parking spot carefully. Within a 30-second
walk is an alleyway where drug users publicly inject. It is filled
with discarded needles, slivers of foil and small spoons.

James Muir, 34, said that when the van was not there he usually
injected in alleys like the one nearby or in parking lots around
Glasgow. He said he had been to the van about three or four times now,
adding, "I think it's really good." I asked if he was worried about
the possibility of the police showing up and arresting him over drug
possession.

"The guy reassured me he locks the van," Mr. Muir said of Mr. Krykant.
"I trust him."