Drug Consumption Rooms in Europe. Operational characteristics, capacities, services and its associated factors.

Background: Drug consumption rooms (DCRs) are increasingly being implemented in Europe as a public health measure to reduce the harms associated with substance use. While a growing literature supports their effectiveness and impact, there is a lack of updated knowledge on the models of care they implement, and their operational characteristics and capacities. Additionally, there is limited information on factors that may support or hinder DCR implementation and sustainability, including their capacity to adapt to changes in population and other contextual factors. This knowledge gap requires a comprehensive examination of these critical aspects to inform evidence-based decision-making and programme implementation and to further enhance their role in public health efforts.

Methods: To provide an overview of the range, scope and structure of services provided by DCRs in Europe, we assessed their settings, operational characteristics, capacities, services and general client characteristics, as well as emerging and future implementation developments. Using an exhaustive sampling method, a comprehensive online survey was distributed to managers of the 102 DCRs that were operating in Europe as of August 2023. A descriptive cross-country analysis of the main DCR characteristics and associated factors with enhanced provision of care was conducted.

Results: Thirty-one valid responses were retrieved from DCRs in all European countries where they were established at the time of the survey (Spain, Portugal, Netherlands, Germany, Luxembourg, Switzerland, Iceland, France, Greece, Belgium and Noway). Internationally, the operational capacities of DCRs varied regarding the model of operation, services provided, staffing frameworks and setting, but their users all shared common features of vulnerability and marginalisation. A supportive local legal geography, cross-sectoral logistic coordination, harm reduction policing practices, involvement of affected communities, the existence of robust monitoring and evaluation strategies and other broader economic and social characteristics were identified as factors associated with an enhanced provision of care.

Conclusions: The study identifies and assesses operational characteristics and factors that support DCRs planning and operations and are critical to their implementation success in Europe and achieving their social and public health goals. Results are of particular relevance to DCR planners, managers and researchers to help resolve implementation concerns and improve their capacity, effectiveness and impact, particularly when establishing a DCR for the first time or in regions with high drug-related fatalities or limited resources.