Guest blog: Law reform - Drug Consumption Rooms a key weapon in war on drugs?

I submitted an earlier version of this essay at university. In updating the statistics (and generally re-working the proposal), it came as little surprise that the situation facing both users and society continues to deteriorate.

Drug Consumption Rooms (‘DCRs’) are facilities which enable people to use controlled substances (purchased elsewhere) in a hygienic, medically-supervised setting. They are focussed mainly on injecting drug users, and are widespread across Europe, Canada and Australia. DCRs are proven to reduce drug-related deaths and crime (along with the associated public health costs), and to improve long-term drug cessation in comparison to other measures like Opioid-Substitution Therapy. 

I chose this topic after hearing about Neil Woods, an undercover police officer who risked life and limb infiltrating drug gangs until his recent retirement. Neil’s greatest success came with the dismantling of ‘The Burger Bar Boys’, who controlled the drugs trade in much of the West Midlands. Although scores were convicted and imprisoned, this huge operation interrupted Birmingham’s drug supply for just six hours. Months of dangerous work and tens of thousands of pounds achieved almost nothing - logic alone calls for a new approach. 

It is easy to get side-tracked in this area. Many will point to choices, arguing that users have brought the illnesses, crime and death tied to heavy drug use upon themselves. Others will counter with the socio-economic factors which, for many users, re-cast choices as inevitabilities; this in turn leads to debates over the de-criminalisation and legalisation of controlled substances.

I thought it best to step away from this, and instead explore how society is being affected by the drugs crisis, and how the real benefits of DCRs can be secured through legal reform.

The scale of the problem is staggering. Since 2010, drug-related deaths in the UK have increased by almost two-thirds, with all-time records broken in each of the last three years. There are emerging threats within this crisis, such as the contamination of drugs (particularly from Fentanyl) across the country; alongside increases in the availability of heroin, this has had a significant impact on drug-related morbidity.

The blame for this lies firmly with current regulation, policy and practice, which has failed to adapt to the crisis or neuter drug supply. Central to this architecture is the Misuse of Drugs Act 1971 (‘MDA’), which creates offences for possession and supply of controlled substances, and the use of equipment and premises for their consumption. Some inroads have been made into the MDA, including  ‘Needle and Syringe Programmes’ (centres dispensing sterile needles and other drug paraphernalia).

There are substantial issues with each of this and other measures, but analysing them collectively highlights a broader and more difficult problem: incoherence. Government facilitates the injection of drugs without changing user risk behaviour (such as groin injections and needle-sharing) or providing safe places to inject. Both factors have a substantial bearing on the risk of overdose and complications from intravenous drug use, and yet cannot be addressed due to the rigidity of the current regime.

At the policy level, Drug Strategies outline government thinking and aspirations for drug regulation. Incoherence is rife here, too: the latest Strategy from 2017 called for an “effective, universal approach to drug use”, and yet made no moves to implement this, instead reiterating that “local partners” must identify risks and take appropriate action. Although local knowledge is a valuable resource, there is no national framework through which that knowledge can be filtered and used effectively. 

Such incoherence also breeds uncertainty. The failure of the ‘war on drugs’ to combat use and supply in this country (with Class A drug use now at its highest since the early 1990s) for want of resources. Whatever one’s view on the merits of the war on drugs itself, the fragmented approach we have now makes it far more difficult to predict the law’s application with any certainty, and fails to combat the harm to both users and wider society.

It does not have to be this way. DCRs are increasingly appreciated for the effective harm-reduction tools that they are. Even the International Narcotics Control Board, which for years criticised DCRs, commended (in 2019) their effectiveness in France and Germany .

Our government is aware of DCRs but has rejected them for fear of increased crime and strain on police forces, and the condoning of drug use. The evidence rebuts the former; as to the latter, an enlightened new approach which appreciates current realities is needed.

I am thrilled to have been selected as the winner of this competition by the Bar Council's Law Reform Committee, and truly humbled by the generosity of the award. It enables me to replace my ancient laptop, which will make the Bar Course somewhat less stressful, and to keep pursuing a career at the criminal Bar. 

Joseph Lord is the 2021 winner of the Bar Council's Law Reform Essay Competition. He read Law at UCL, graduating with First Class Hons in 2020. He took a year out, which included working for charity Advocate in the Casework Team, and then commenced the Bar Practice Course with the Inns of Court College of Advocacy (ICCA) in September 2021, made possible by a scholarship from the Leonard Sainer Foundation.