Against political odds: the establishment of a drug consumption room in Belgium.
Drug consumption rooms (DCRs) are an effective harm-reduction intervention that have been implemented in many Western countries for the last three decades. However, in several countries like Belgium, there is no political consensus for the implementation of DCRs because of issues of morality, ideology, public acceptance and negative media reactions.
A 2018 feasibility study on DCRs in the five major cities in Belgium concluded that establishing DCR’s in Belgium is indeed feasible, providing three essential conditions are met: (1) the Belgian drug law has to be changed to provide a sound legal framework, (2) political support from the federal state and federated entities is needed; and (3) sufficient funding has to be provided by the policy makers.
In February of 2018, the research findings were presented at a meeting of the policy makers responsible for Belgian’s drug policy. It became clear then that neither the international scientific evidence on the effectiveness of DCR, nor the legal analysis that a DCR is possible within the UN drug conventions, could convince some of the (national) policy makers that were ideologically opposed to the establishment of a DCR in Belgium. The Minister of Health and the Minister of Justice explicitly stated they were not planning on changing the law.
Yet, at a local level, the city of Liège had been advocating for the establishment of a DCR for many years. The publication of the scientific report was used by Liège authorities to reignite the political debate on DCRs in a context of local elections. At the local level, law enforcement, health, and social welfare stakeholders as well as residents, drug users, and the press were actively informed and prepared to an upcoming DCR implementation. A local consensus was obtained; in particular, a gentleman’s’ agreement was reached with local law enforcement that they would not prosecute drug users nor the DCR (staff). Despite the lack of modification of the federal legal framework, a DCR was opened in the city of Liège in September 2018 with funding from the city. The mayor of Liège was re-elected and three months after its opening, the DCR had reached nearly 75% of its estimated target audience (216 PWUDs) without any major medical or legal incident.
As researchers, we learned that the DCR case illustrates that sound scientific evidence does not automatically imply policy reform (Ritter, Lancaster & Diprose, 2018). Other factors and interests influence policy formation and decision-making, defined by Babor et al. (2010), as the “policy arena”. Scientific evidence is (but) one source in policymaking (WHO, 2018). Still, this is no reason to give up doing research. On the contrary, it is a stimulus to keep on doing research and to actively continue to communicate research results to policy makers. In this respect, inspiration can be found from the WHO 2016 ‘Action plan to strengthen the use of evidence, information and research for policy-making in the WHO European Region’.