Challenges and needs of Cologne's open drug scene: insights from a quantitative study on Neumarkt square

BackgroundIn recent years, a greater impoverishment of drug users and more homeless people can be observed in public spaces in big cities in Germany like Cologne. In addition, there has been an increase in crack cocaine consumption in public spaces and in drug consumption rooms. The largest drug scene in Cologne is to be found on the “Neumarkt”, a centrally located square in the city centre. To date, there is no data that describes the people in the open drug scene on Cologne's Neumarkt in more detail, systematically maps the substances consumed and patterns of use as well as the need for help and the use of the addiction help system by the users. MethodsAs part of a quantitative cross-sectional survey, 119 people from the open drug scene on Cologne's Neumarkt were asked about their socio-demographic data, substances consumed, patterns of use, psychosocial problems and support needs. ResultsThe 24-hour prevalence was 65% for heroin, 56% for alcohol, 33% for benzodiazepines and 21% for crack cocaine. 55% of respondents reported drug overdoses and 32% were homeless. 22% of respondents had no health insurance and therefore had less access to the addiction support system. People who used crack cocaine reported mental health problems and were significantly more likely to be homeless. Crack users usually also used heroin and were significantly less likely to be in opioid substitution treatment than heroin users who did not use crack cocaine. The respondents indicated a clear need for support in the area of housing. In addition, the opening hours of drug consumption rooms should be extended and help should be better coordinated ConclusionsThe data show that people in the open drug scene in Cologne are highly burdened. Crack cocaine is now widespread in Cologne's drug scene and specific help, especially for homeless people, needs to be expanded and better coordinated.