Safer drug consumption facilities (SDCFs) are clean, hygienic environments where people can consume drugs, obtained elsewhere, under the supervision of trained health professionals. They offer a compassionate, person-centred service which focuses on reducing the harms associated with injecting drug use and helps people access appropriate services to meet their needs. By doing so, they are able to reach an extremely vulnerable group who often do not engage with our existing services.

These facilities typically consist of a reception area, a drug consumption area with injecting booths and, in some facilities, a drug inhalation room. In addition, they usually provide an area where clients can receive support from relevant services and peer groups, to help improve their health and social circumstances. The exterior of such facilities can look like any other health and social care premises.

Though these services are sometimes described in the media as ‘fix rooms’ or ‘shooting galleries’, we use the term ‘safer drug consumption facilities’ to denote that they are an official service, staffed by health professionals, with close links to other health and social care services.

There are now more than 90 of these facilities worldwide, in Europe, Canada, and Australia.

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Frequently asked questions: Safer drug consumption facilities and heroin-assisted treatment

Kenya is experiencing an HIV epidemic among people who inject drugs, with HIV prevalence recently estimated at 18.3%, and 44% for women.

Methadone, a globally evidenced intervention, is being introduced as part of developing comprehensive HIV prevention and treatment. Methadone acts as a substitute for opiates like heroin (so is called opioid substitution therapy or OST). Methadone works to reduce HIV-related risk from injecting drug use and support engagement in HIV treatment.

There is little experience of methadone in contexts like Kenya. We used modelling and qualitative interviews to assess the potential impact of methadone as a HIV prevention intervention in Kenya. These findings are essential to shape future strategy.

Is the promise of methadone Kenya’s solution to managing HIV and addiction? A mixed-method mathematical modelling and qualitative study

There is a high HIV prevalence among people who inject drugs in Kenya. The sharing of used needles and syringes is a core risk for HIV.

A government-backed needle and syringe programme (NSP) has recently been introduced by community-based organisations. The programme is one of the first in the region and uses a flexible system of delivery, allowing for distribution from community drop-in centres and by outreach workers. Understanding the delivery of NSPs in the Kenyan context is vital.

Exploring the experiences of people who use drugs in engaging with the programme is important for supporting scale up.

Implementing needle and syringe programmes in Kenya: changes, opportunities and challenges in HIV prevention

Kenya is experiencing an HIV epidemic among people who inject drugs, with prevalence recently estimated at 18.3%, and 44% for women. People who inject drugs experience a range of barriers to HIV treatment and care access.

The Kenyan government and civil society partners have sought to develop community oriented HIV care for people who inject drugs to overcome these potential barriers, including through community-based outreach support. We explored people who inject drugs experiences of these services to support their development.

HIV treatment and care for people who inject drugs in Kenya: experiences of community supported clinic-based care

Harm reduction services are being introduced in Kenya to support people who inject drugs. There is a highly concentrated HIV epidemic amongst people who inject drugs in Kenya, with HIV prevalence estimated at 18% (44% for women).

People who smoke or sniff heroin may change their mode of use and transition to injecting in response to a range of factors. The main risks that follow injecting include HIV and hepatitis C transmission from sharing injecting equipment, and overdose. Therefore, if we can prevent or minimise transitions to injecting then we can prevent or reduce the associated harms. Understanding these factors is a priority to support HIV prevention and harm reduction.

A qualitative analysis of transitions to heroin injection in Kenya: implications for HIV prevention and harm reduction

Bolivia’s new General Law on Coca was passed by Congress on February 24th 2017. The law is one of 3 that will replace the longstanding & controversial antidrug law - Law 1008.

Bolivia: General Coca Law

Since the inauguration of President Rodrigo Duterte on June 30, 2016, and his call for a “war on drugs,” Philippine National Police officers and unidentified “vigilantes” have killed over 7,000 people. The anti-drug campaign dubbed “Operation Double Barrel” has targeted suspected drug dealers and users ostensibly for arrest but in practice has been a campaign of extrajudicial execution in impoverished areas of Manila and other urban areas. Duterte’s outspoken endorsement of the campaign implicates him and other senior officials in possible incitement to violence, instigation of murder, and in command responsibility for crimes against humanity.

This report examines 24 incidents, resulting in 32 deaths, involving Philippine National Police personnel between October 2016 and January 2017. Human Rights Watch found that the official police reports of these incidents invariably asserted self-defense to justify police killings, contrary to eyewitness accounts that portray the killings as cold-blooded murders of unarmed drug suspects in custody. To bolster their claims, the police routinely planted guns, spent ammunition, and drug packets next to the victims’ bodies. No one has been meaningfully investigated, let alone prosecuted, for these killings.

“License to Kill”: Philippine police killings in Duterte’s war on drugs

To inform policy makers, researchers, members of NGOs and institutions working in prevention, treatment and social rehabilitation of drug users and everyone interested in the results of the United Nations General Assembly Special Session on drugs (UNGASS), held from 19 to 21, April 2016, in New York (USA)

To present views expressed and which are in discussion about the importance of the UNGASS concerning the assessment of the existing policy on drugs and the strategic direction that governments will decide to follow for their drug policy in the future

To refer to the discussion at the regional conference organized from 1-3 June 2016 in Thessaloniki which focused on exchanging views on the post-UNGASS policy that can be followed in SEE countries.

Drug policy after the UNGASS 2016

The lack of adequate access to opioids in India as analgesics and for agonist therapies, forces millions to live with severe unalleviated pain, or languish with suffering associated with drug dependence. Although India is a major opium exporter, the excessively prohibitive 1985 narcotics law formulated to control harmful use of drugs, impeded the availability and access to opioids for medical and scientific purposes. Amendment of this law in 2014 established a new national regulatory framework for improved access to essential opioid analgesics.

This article reflects on key elements and processes that led to this landmark achievement. Unlike quick timelines associated with effecting policy reforms for law enforcement, realizing the 2014 drug policy change primarily to mitigate human suffering, was a 22-year-long process. The most exacting challenges included recognizing the multilayered complexities of the prior policy framework and understanding their adverse impact on field practices to chart an appropriate and viable path for reform. The evolution of an informal civil society movement involving health care professionals, lawyers, media, policy analysts, government officials, and the public was pivotal in addressing these challenges and garnering momentum for reform.

The success of the effort for improving access to opioid medications was underpinned by a three-pronged strategy:

Persuading the executive arm of the government to take interim enabling measures;

Leveraging judicial intervention through public interest litigation;

Crafting a viable policy document for legislative approval and implementation. We hope our findings are useful for realizing drug policy reforms, given the current transformed global policy mandates emphasizing humanitarian, healthcare, and quality-of-life considerations.

Click here to read the full article (behind paywall)

India: Civil society-driven drug policy reform for health and human welfare

The Foundation Against Illicit Drugs and Child Abuse (FADCA) is pleased to release the report of the Social and Economic Impact of Illicit Drugs in Liberia. The survey was funded by Open Society Foundations for Global Drug Policy through its subsidiary Open Society Initiative for West Africa (OSIWA). The report paints a picture of the trend of the drug problem in Liberia.

The ultimate method for deriving better policies is to understand the nuances of the drug problem, in terms of its social, health, economic and political impact. Such understanding must be based on cogent scientific evidence derived from empirical data. This survey has been embarked to ascertain rising youth debut in drug use; understand the social and economic causes of youth debut and impact of drug in Liberia. To determine the level of health risk based on experiences and feelings of drug users. Findings of the survey will be used as advocacy and strategic information tools for planning future intervention and policy actions. 


Liberia: Social and economic impact of illicit drugs - baseline survey report

Time has come to embrace a different approach and adopt policies that are based on public health, community safety, human rights and development. Only such policies will deliver on the promise to improve people’s lives; only such policies will truly allow Myanmar to reduce the harm caused by problematic drug use, trafficking and production. This policy briefing was drafted by a group of local and international organisations with indepth knowledge and extensive experience of drug-related issues in Myanmar. It is structured around a set of five strategic interventions, each of which comes with concrete recommendations that are adapted to the Myanmar context. It contains reliable, up-to-date information and examples of evidence-based practices from Myanmar and around the world.

We identify the following 5 key strategic interventions.

Increase access to health, harm reduction and voluntary drug treatment for people using drugs

End the criminalisation of drug users and small-scale farmers

Refocus law enforcement efforts on violent organised crime and large-scale drug production and trafficking

Promote development projects in opium growing areas

Include civil society and affected communities in policy reform

Addressing drug problems in Myanmar

Increasing civil society engagement and participation in the policy planning and implementation process underlines the complementary relationship with representative democracy. Civil society organisations (CSOs) bring knowledge and independent expertise to the process of decision making. This has led governments at all levels, from local and regional to national, as well as international institutions, to draw on the relevant experience and competence of NGOs to assist in policy development and implementation. This also applies to the area of drug policy.

Civil society involvement in policy planning and delivery is an obligation in a democratic society. To ensure influence, relevance, added value and practical applicability of civil society involvement in policy planning and delivery – to the benefit of all stakeholders; the civil society actors themselves, the policy makers and society as a whole – it is necessary to define the opportunities, levels and means of participation. This requires taking into account the following aspects:

Determining the specific benefits of CSO participation in the different steps of the policy process should be agreed: agenda setting, drafting, decision, implementation, monitoring, review, reformulation.

Levels of participation: provision of information, consultation, dialogue and partnership between CSOs and public authorities.

Ways to identify the appropriate partners.

Means and tools that enable and support the process of participation.

Publications