Inside the UK’s first drugs consumption room – and how it can save lives amid soaring drug deaths

Just steps from Glasgow’s Barrowland Ballroom, a UK-first drugs pilot is preparing to open its doors. The safer drugs consumption room, set to welcome people from Monday (13 January), will finally launch after a decade of legal maneuvering and tearing down red tape by the city’s healthcare staff and politicians. 

The room, formally known as the Safer Drugs Consumption Facility or The Thistle, is found on the city’s Hunter Street. It’s part of a harm reduction approach to problem drug use – that means treating it as a public health matter, rather than trying to shame or criminalise people into abstinence. It will allow people who inject illegal drugs like heroin and cocaine to do so with clean equipment, in a protected environment, with nurses on hand if any issues arise. 

Scotland is the drug deaths capital of Europe, with an average 277 deaths per million people linked to drug use in 2023. That compares to Estonia, the second highest, with 95 deaths per million people. The population targeted by the new facility faces high poverty and homelessness levels.

It’s not the only work done in Glasgow to tackle the problem in recent years – naloxone training has been rolled out across the city, for example, with the medication able to quickly reverse an opioid overdose and given out to people in the hope that they’ll use it if they see someone on the street in trouble. In 2020, activist Peter Krykant created a drugs consumption room out of a van in the centre of Glasgow where, like at The Thistle, people could use drugs in a sterile environment.

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But the safer drugs consumption room was proposed off the back of an HIV outbreak in the city, with similar projects running successfully around the world. It was then blocked by the UK government. It was only in 2023 that Scotland’s Lord Advocate released a statement of prosecution policy that made Glasgow’s consumption room possible – making it official that, in essence, police would turn a blind eye to illegal drug possession as long as it was on The Thistle premises. Its opening was delayed further when the building’s water and ventilation was found to be below standard.

But its doors will open for a three-year pilot this month. 

At the Hunter Street building, guests enter into a softly-lit reception, where they have to register – though there’s no requirement to use their real details – and can wait in a seating area, if need be, or deposit substances to be examined as part of a separate drug checking service. Doors off the reception area lead into chat rooms, where they will speak to staff about what drug they’ll be using and how they’ll use it, helping the nursing team to prepare appropriate injecting equipment for them. Here they can also ask to speak to other advisers if they need specific support, which will be arranged by staff while they’re in the injecting area, or using space.

They are named chat rooms, not meeting rooms, after a lived experience team consulted in the development of the facility recommended less clinical labels for what’s on offer. The lived and living experience experts told staff to steer clear of what would often be found in conventional health services – which plenty of drug users have had traumatising experiences of – and helped decide things like the way reception staff will greet people, furniture and colour schemes too (think lots of light wood, greens and turquoise).

Next door is a large room with space for eight people to use drugs at one time. Each booth is brightly lit, fitted with needle deposit boxes and ceiling-high mirrors tilted at an angle to increase privacy. Two booths are wider to allow for wheelchair access. They sit alongside a deliberately wide, open area in case paramedics need to be brought in, with direct access to an ambulance bay outside. Two health rooms – renamed from treatment rooms – with beds and medical supplies sit just off the injecting area. 

Guests then move into the recovery area, where a member of staff will keep watch to ensure no one needs extra healthcare, and where the soft seating is designed to prevent people sliding off if sedated. 

The next door takes them to the lounge, which looks more like a modern student halls communal area than part of a medical facility. With seating areas, shelves lined with books and boardgames, and a kitchen area with tea and coffee available, the hope is that people – many of whom are likely to be living on the streets – will get the chance to relax in a comfortable space and connect with others. Stay safe, the wall above the exit tells them.

The Thistle can connect people with other services, but it’s not designed to change people’s minds or push them into recovery.

“We’re not here to do that,” says service manager Lynn Macdonald. Staff can, instead, teach people techniques to reduce the risks – like using a vein finder tool ahead of injecting – and give them information on the safer injecting sites on their bodies. 

“We’ve had people saying, ‘If I come in to use and I’m on a methadone prescription, will you tell my care manager?’ We don’t know that, we don’t know who your care manager is unless you tell us. It’s about gaining people’s trust.

“Should somebody come in and say, ‘I really want to go on treatment today,’ that’s fine. Let’s get that sorted for you. Somebody says they want rehab, come with us. We will link you in with the appropriate team, and we will start that process for you, and we’ll get wrap-around support for you until you can access that.

“Those options are still there for people, this isn’t an alternative to those other options. It’s an addition. For some people, it’s going to be a pathway.” Residential rehab spots in Scotland are limited and often not available immediately.

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Service users aren’t allowed to smoke drugs at The Thistle, which was set up as an injection-only facility. Nursing staff hold some frustration around this and will still advise people that smoking is generally much safer than injecting. But the facility does have an outdoor smoking area – staff believed that making people walk up the road to have a cigarette would risk pushing them out the door sooner than they might otherwise stick around.

“We will give them foils, we will show them how to use those foils,” says Macdonald. “We will show them how to make a pipe and how to do that safely. We just can’t let them do that here at the moment. We’re constantly asking [for permission to allow the smoking of drugs on site].”

The Lord Advocate’s statement that it is not in the public interest to prosecute anyone for drug possession only covers the Thistle itself – it doesn’t cover the rest of the Hunter Street health and care building, or the car park outside. (Other services, like diamorphine assisted treatment and a Housing First service, continue to operate in adjoining corridors – but people do have to give their real details to access those.)

It’s “always a risk” that people could be intercepted by police en route to the safer drugs consumption room, Macdonald says. “But we’ve got a really good relationship with the police. If this works, as far as they’re concerned, their life is easier. If people are injecting drugs here, they’re not getting calls from people – from businesses and houses saying there’s somebody in my close, there’s somebody at the bottom of my door.”

The facility will be open from 9am until 9pm, 365 days a year. Staff are trained to spot warning signs that someone could have overdosed and act quickly. 

“We do, unfortunately, expect to see medical emergencies,” says Saket Priyardashi, assistant medical director for alcohol and drug recovery services in Glasgow. Staff welfare is a priority, and a psychologist is on site to help.

“There’s also a lot of pressure to try and address the drug-related deaths crisis that’s going on in the city and across Scotland,” Priyardashi adds. “We’re taking a whole range of responses, including this. And I think, for me, it would be harder to justify why we’re not doing this, then justify why we’re doing it.”

Staff have lent on the experience and expertise of other services across the world, Priyardashi says. There are more than 100 of such facilities globally, including in Canada and Australia, which the Glasgow team has worked closely with. “The building design, our protocols, our policies and the staff training are based on what those services have been telling us.” International colleagues also reassured the team about the facility’s name – while certainly not an intentional nod to sharp objects, it did raise some eyebrows among clinicians when first suggested. But others interpreted it as, at most, a bit of warm Glaswegian humour.

As a hard-fought UK first, the safer drugs consumption room still has its critics. “Some people are watching with scepticism, some people are watching because they want to do the same thing we’re doing,” says councillor Allan Casey, the city’s convenor for addiction services. “We have definitely felt a huge amount of pressure to make sure we get it right. Not just for the individuals who will be using it, but we need to demonstrate that it works within the context of the UK.”

The Scottish government is backing the facility with a budget of £2.3m per year. The cost is “far outweighed” by the reduction of costs to other treatment services that would otherwise be necessary for people who will use the safer drugs consumption room, Casey says.

“And for me, saving lives is really invaluable in terms of that. That’s priceless.”

Could safer drugs consumption rooms appear in other cities in the UK?

Eyes are on the service from across the UK. Last month, Blackpool officially overtook Glasgow for the lowest life expectancy for men in the UK, and the city is facing its own drug deaths crisis with 31.4 deaths in 100,000 being linked to drug misuse.

But teams there will have to take the legal battle on afresh if similar services are to be set up. “We would welcome a law change so that we could provide [something similar] in Blackpool,” says Gemma Mukadam, service manager at Horizon. The organisation, funded by Blackpool Council, supports people with drug and alcohol problems, and has pushed for a public health approach to be taken in the area.

Doing so would give people “a safe space to use with safer practices being followed”, Mukadam says. “It would encourage people to use clean equipment, provide some warmth and shelter.”

Crucially, Mukadam adds, it would “demonstrate that they are not being judged”. Setting up a dedicated facility eats away at stigma and makes people more likely to engage with services, she added.

“There’s huge interest across the UK,” Casey says. “We’ve not changed the UK government’s mind on this yet. There still can be a change in legislation that makes opening safer consumption facilities easier. We’ve got a bit of a workaround, but it would actually be much easier to open safer consumption facilities if there was a change in the Misuse of Drugs Act. So I want to work with cities up and down the country, across the UK, to lobby the UK government to make that change.”

But experts in Glasgow, Blackpool and beyond agree that safer drugs consumption facilities aren’t a silver bullet. 

“It’s only one part of a system of care,” Priyardashi says. “Another piece of the jigsaw that’s responding to a very complex problem.

“I used to feel like we needed to justify this. Now, I have a group of people that I know have some of the highest mortality rates of any population in Scotland. They die prematurely. The effect it has on their families, their communities is massive.

“I don’t really see why we should not be spending on reducing the mortality rates of even a small group of people with the level of problems they have. And in fact, if I was the clinical lead for an oncology service or a dialysis service or a neurological unit, I wouldn’t be asked those questions. We’re all saying that the drug deaths crisis is a national shame and something needs to be done about it.”

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