AMOC, Amsterdam.

Drug Consumption Rooms

This post is also available in: Português (Portuguese (Brazil))

Imagine a health and social care service where people can use substances considered illicit – such as crack and heroin – without being judged or punished. A service where these people are welcomed and receive necessary care, rather than being on the streets, parks and alleys. In the last 20 years such services have been an integral part of the strategies for reducing theharms of drug use in a number of western European countries, North America and Australia. This blog provides a summary about these drug consumption rooms (DCRs) - what they are, their benefits, where they are possible, and what the main existing DCR models are there.


Definition and names
Drug Consumption Rooms are a harm reduction strategy.

"DCRs are facilities where (homeless) people who are dependent on drugs can use their substances in a calmer, safer, hygienic environment, and without judgement or punishment. DCRs aim to reduce the harms to health and society related to drug use"

They offera place where people bring their illicit drugs touse; drugs are not provided.

DCRs can be known by several names, such as:

  • Drug Consumption Rooms ;
  • SupervisedInjectionRooms
  • Supervisedconsumption Rooms
  • Injection rooms


DCRs save lives and promote access to health for people who use drugs. They also bring benefits to society in general as they assist in the prevention of communicable diseases and in reducing crime associated with use in public spaces.

Several studies prove the benefits of drug consumption rooms. In 2018 we reviewed the literature on the benefits of DCRs, specifically for people who use stimulant drugs such as crack. What we found was that the rooms help to:

  • Preven t overdose
  • Prevent communicable diseases
  • Prevent stigma and violence associated with drug use in public spaces
  • Prevent feelings of insecurity associated withuse inpublicspaces
  • Promote access to health and socialservices
  • Promote access to sterile and safer materials for drug use
  • To prevent the loneliness and isolation of people who use drugs

We talked to people who frequent some of the DCRs in the Netherlands and asked if and how these services helped them. The users were extremely positive, and highlighted the aspect of socialization and improvement in their quality of life:

A sala de consumo pra mim é como um café, um lugar para encontrar as pessoas e conversar.
Usuário da sala 1

A maneira principal em que a sala de consumo contribuiu para a minha qualidade de vida é através da alimentação. Há quase sempre alimentos saudáveis e em abundância aqui. […] Socialmente o lugar também é de grande valor. Eles são pessoas de confiança para trocar ideias, mas podem também ser um espelho para mim. Podem verificar minha saúde e dizer-me quando eu não pareço estar muito bem. Nem sempre eu consigo fazer isso sozinho.
Usuário da sala 2

DCRs in the world

The first official DCR appeared in Switzerland in 1986. Since then, these services have multiplied, driven primarily by the HIV/AIDS epidemic in the 1980s-1990s and more recently by the large number of overdoses caused by opiate use in North America.
As much as the number of DRCs has grown, there are still a few – around 120 worldwide. Consumption rooms are still concentrated in the geographic north, in countries such as the USA, Canada, Western Europe countries and Australia. Repressive drug policies and the stigma related to drug use are the main obstacles to further development of these services.


Models of DCRs
There are four main models of DCRs:

  1. Integrated rooms

The integrated rooms have a number of otherassociated services to the space for drug consumption. These services can be:

  • Drop-in centers
  • medical and health care consultations
  • mental health care
  • social care
  • Antagonist Opioid Therapy (such as methadone or buprenorphine for heroin users)
  • income generation activities
  • administrativeand legal support
  • shower and clean clothes
  • food
  • possibility to use a phone or computer (to talk to family, arrange social or legal service issues, look for a job or make a resume, for example)
  • recreationalactivities
  • reference to other services

In addition to these services, users receive materials for safer drug use and information on harm reduction. The video below is an example of these type of DCRs. The first and only room in Latin America at the moment (2020), located in Mexico. The room still faces difficulties to have government support, due to prejudice against drug use. The same type of room exists and has support from government and international institutions in several other countries in Europe and North America.

2. Specialized rooms
These are rooms smaller, anddedicated only to the consumption of substances . In these rooms users can have access toa meal, coffee, tea, sandwiches,syringes, pipes and other materials for safer use,condoms, and general information on how to reduce harm of drug use. The example below is of a room in Germany.

3. Mobile rooms
The mobile rooms work ina. type of van, with space for the use of substances inside the vehicle. Because they are mobile, rooms can adapt tothe scenes of use in terms of routes andtime. Because it is a small space, the mobile rooms generally can assist only two people at the same time. The mobile rooms can count on a spaceto relaxafter use and can offer services such as wound dressings, testing for Hepatites and HIV, materials for safer use, and information on how to reduce harms. This mobile room below is in Canada.

4. Residential rooms
Residential DCRs are spaces created in shelters, hostels or social rental homes where residents can use their licit or illicit drugs. In the Netherlands, for example, they are specific hostels for people who use drugs. In some of these services users may consume substances in their rooms,individually or with a few guests. In others, there is a collective consumption room within the establishment. The creation of these hostels and shelters in the Netherlands has allowed people who have a dependence on a substance, and who cannot stay in abstinence for a long period, to be able to access and stay in the service. Having a place to sleep, in short, is a fundamental right, and essential for an improvement in physical and mental health. The room in the photo below is in the Netherlands.

Styles and rules

DCRs can have several styles, from the most formal to the most informal.

Formal rooms have stricter rules, more hygiene and safety protocols, greater separation between users, and generally include health workers as nurses to supervise drug use. In these rooms, for example, one can have control through cameras and mirrors (as we see in the photo below), metal detectors at the entrance door, and check-ups to check if the user is bringing their own drugs. This photo room is in Canada.

The most informal substance use rooms have fewer rules and protocols and are characterized by a more relaxed and "homely" atmosphere. In general, they do not have sections between users, can contain sofas or paintings, for example, and have a greater focus on socialization among service users. The DCR in the photo is in the Netherlands.

How do DCRs work?

In general, people who use drugs bring their substances and have a set time to make use. This time, around 30 minutes, can be extended if there is no one waiting to use.

Users of the service are usually registered. There may be different admission criteria, for example, age-related, history of substance dependence, or being homeless. Commonly, registration is done on first access, where users also need to sign a contract agreeing to house rules.

The rules vary greatly depending on the model and style of the room and depending on the needs and preferences of service users. A good practice of several DCRs is to define the rules together with users. Fairly common rules are not to be aggressive (verbally or physically), bring your own drugs, do not sell drugs inside the DCR, and respect other users.

With regard to workers, these can be nurses, psychologists, social workers, peers, social educators, and harm reducers in general. The important thing is that workers are welcoming, create a healthy atmosphere, and contribute to improving the quality of life of the service-using population. For this, it is necessary to seek a balance between necessary safety and hygiene conditions (both for users and workers) and the needs and preferences of service users.

Substance use rooms in Brazil

Unfortunately, there are still no DCRs in Brazil. Such rooms, in the various models described here, would be extremely beneficial to welcome people who use drugs and are in a situation of vulnerability. Consumption rooms would allow these people not to have to make use of the street, exposed to police violence, community prejudice, and unhygienic conditions. It would also offer a protected space where access to other health and care services is facilitated. Such services already exist in several other countries, and their effectiveness is proven. It is a matter of political will, and pressure from organized civil society.

Which consumption room would you like to see in your city? Here are a few points to think and discuss:

  • What would be the objectives ofthe service – for what and for whom it would exist?
  • Which model would work better? Integrated, specialized, mobile,residential, or even a new one to be created?
  • And which stile - formal or informal? What kind ofrules would be necessary?

Want to share your ideas? Write it down!

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