High willingness to use drug consumption rooms among people who inject drugs in Scotland: findings from a national bio-behavioural survey among people who inject drugs

Kirsten M.A Trayner,Norah E Palmateer,Sharon J Hutchinson,David J Goldberg,Samantha J Shepherd,Rory N Gunson,Emily J Tweed,Saket Priyadarshi,Harry Sumnall,Amanda Atkinson,Andrew Mcauley

doi:10.1016/j.drugpo.2020.102731

Abstract

BackgroundTo address rising drug-related harms (including significant transmission of HIV) among people who inject drugs (PWID) in Glasgow, officials have proposed the introduction of the UK's first drug consumption room (DCR) in Glasgow city centre. Using a nationally representative sample, this study aimed to determine willingness to use a DCR among PWID nationally, in Glasgow city centre (the proposed DCR location), other Scottish city centres (excluding Glasgow) and the rest of Scotland (excluding city centres). MethodsBio-behavioural survey, of 1469 current PWID (injected in last 6 months) across Scotland during 2017-18. Willingness to use DCRs was examined by drug-related risk behaviours and harms overall in Scotland, and then stratified by Glasgow city centre (n = 219), other Scottish city centres (n = 226) and the rest of Scotland (n = 1024). ResultsThe majority of PWID overall in Scotland (75%) were willing to use a DCR; willingness was higher among those recruited in Glasgow city centre (83%) and other Scottish city centres (83%), compared to the rest of Scotland (72%) (p < 0.001). Willingness was greater among PWID who reported (compared to those who did not report) injecting heroin (76%, p = 0.002), cocaine injecting (79%, p = 0.014), homelessness (86%, p < 0.001), public injecting (87%, p < 0.001) and an overdose (80%, p = 0.026). Willingness was found to be associated with a cumulative multiple risk variable: increased from 66% among those with a score of zero to 85% with a score of at least three (p < 0.001). ConclusionsThe vast majority of PWID at greatest risk of drug-related harm in Glasgow and elsewhere in Scotland would be willing to use a DCR, supporting proposals for the introduction of DCRs nationally.

Highlights

There has been an increase in drug-related deaths in recent years, including in Scotland, where figures have reached record levels and are among the highest in Europe (National Records of Scotland, 2019)
There have been recent major outbreaks of infectious disease among people who inject drugs (PWID) in Scotland and the Scottish city of Glasgow; these have included anthrax, the largest outbreak of wound botulism among PWID ever recorded in Europe (Trayner et al, 2018) and the largest outbreak of HIV among PWID observed in the UK for over 30 years, which has resulted in a rapid rise in HIV prevalence from 1% to 11% among PWID in Glasgow city centre (McAuley et al, 2019)
To address the rise in drug-related health burden among PWID in Glasgow, a needs assessment focusing on public drug use was published in 2016, which proposed the establishment of the UK's first drug consumption room (DCR) and co-located heroin assisted treatment (HAT) service located in Glasgow city centre

Summary

Introduction

There has been an increase in drug-related deaths in recent years, including in Scotland, where figures have reached record levels and are among the highest in Europe (National Records of Scotland, 2019). To address rising drug-related harms (including significant transmission of HIV) among people who inject drugs (PWID) in Glasgow, officials have proposed the introduction of the UK's first drug consumption room (DCR) in Glasgow city centre. Willingness to use DCRs was examined by drug-related risk behaviours and harms overall in Scotland, and stratified by Glasgow city centre (n = 219), other Scottish city centres (n = 226) and the rest of Scotland (n = 1024). Results: The majority of PWID overall in Scotland (75%) were willing to use a DCR; willingness was higher among those recruited in Glasgow city centre (83%) and other Scottish city centres (83%), compared to the rest of Scotland (72%) (p < 0.001). Conclusions: The vast majority of PWID at greatest risk of drug-related harm in Glasgow and elsewhere in Scotland would be willing to use a DCR, supporting proposals for the introduction of DCRs nationally

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