Reasons for (non-)using a drug consumption room: the point of view of drug users.

Background

Switzerland was a pioneer in opening the 1st drug consumption rooms (DCR) more than thirty years ago. Since then, many other countries opened their own in Europe, Australia, and North America in particular. The relevance and benefits of DCR as a central harm reduction measure is not to be proven any more. However, their opening and implementation still raise many challenges. When in 2018 an integrated drug consumption room opened in Lausanne (Canton of Vaud, Switzerland) completing the canton's harm reduction facilities, the success among drug users was not as (important as) expected. What lessons can be learned from this situation and how could it be overcome?

Methods

The evaluation of the three-years pilot project of Lausanne’s DCR involved a wide range of both quantitative and qualitative methods. This presentation is based on interviews conducted for the mid-term (Samitca et al., 2020) and the final report (Samitca et al., 2021) with drug users who may (N=42) or may not (N=20) have used the drug consumption room.

Results

We analysed the reasons given by drug users for attending or not attending the DCR, to understand this resistance. Some of the reasons given for not going to the DCR, as well as the requests for improvement mentioned by consumers following the opening, show that while consuming is important, so are the contexts in which it is consumed. Three factors will be examined in detail: (1) the conviviality of the place of consumption; (2) the serenity of the moment of consumption; and finally (3) the moment of consumption, and their consequences on the management of consumption.

Based on these interviews, we offer a reflection on the discrepancy between the deployment of harm reduction measures that have proven their worth in other contexts and the practices of target groups, which show reluctance and limited adherence. 

Conclusion

Several avenues should be explored, to ensure that the services meet the needs and expectations of drug users. Considering the meaning given to practices and the environments in which they take place is central and thus the importance of working with the target audience. Moreover, opening a DCR by itself isn't enough to imply a modification of drug users’ patterns but should benefit from incentives and support measures. 

Based on these observations’ the city of Lausanne will soon benefit from a second DCR to meet those unmet needs.