Is it time for a drug consumption room in Dundee?

Walk through Dundee city centre and the stark reality of drug addiction is often impossible to ignore.

The brightly coloured shops and cafes stand in sharp contrast to the bleakness that some carry in their eyes.

It is a silent, visible plea that contrasts with the public-facing side of the city.

It’s not unusual to see addicts taking drugs behind gravestones in a corner of the Howff in broad daylight.

Charges linked to drug-related crime persistently litter sheriff court business in the city.

Yet, beyond the public cries for help and visible anti-social behaviour, there lies another world, hidden behind closed doors, where addiction festers in secret, unspoken and unseen.

Here, the struggle is silent, the pain masked, and the truth of the city’s battle with drugs – and alcohol – remains just as vivid, even if it is often hidden in the shadows.

Dundee drug deaths second highest in Scotland

With the release of Scotland’s latest and “hugely concerning” drug death figures last week, Dundee once again finds itself in the throes of a worsening tragedy.

Of the 1,172 cases recorded in Scotland in 2023 –  up 121 from the previous year – Dundee saw 46 drug-related deaths.

That is an increase of eight following hopeful decline the previous year and a staggering 92% rise compared to 2013.

This grim statistic places Dundee second only to Glasgow in terms of the highest drug mortality rate in Scotland over the past five years.

In Fife, the number of drugs deaths in 2023 was at its highest since 2019, with 70 recorded in total.

This was an increase of 14 on the year before.

As the city grapples with the implications of these figures, a controversial question looms larger than ever: Should Dundee have a drug consumption room?

A city on the brink

Dundee’s drug crisis is not new, but the spike in deaths has reignited the debate over how to address the issue effectively.

The city’s rate of drug-related deaths now stands at 31.01 per 100,000 people. That is significantly higher than the national average.

The National Records of Scotland report highlighted that those living in the most deprived areas are 15 times more likely to die from drug misuse than those in more affluent regions.

With opioids like heroin and methadone present in the majority of these deaths, the situation is increasingly dire.

The Scottish Government’s health secretary, Neil Gray, called the rise in deaths “hugely concerning,” emphasising the need for urgent action.

He pointed to the government’s £250 million National Mission on alcohol and drugs as a key initiative to combat the crisis.

Part of that includes the planned opening of a Safer Drug Consumption Facility (SDCF) pilot in Glasgow.

He suggested that Dundee might follow suit, saying, “We have been clear that we want to see more of these facilities operating.”

But is a drug consumption room—where individuals can use drugs under medical supervision—the right solution for Dundee?

The case for a drug consumption room

Advocates argue that a drug consumption room could be a critical tool in reducing harm and saving lives.

Pamela Dudek, the recently appointed independent chairperson of the Dundee Alcohol and Drug Partnership (ADP), expressed cautious support, noting that the ADP remains “alert to all new initiatives to reduce drug harm.”

She indicated that the ADP would carefully consider the outcomes of Glasgow’s pilot programme before deciding on a similar initiative in Dundee.

The ADP’s recent report highlighted several successes in improving access to treatment and support.

It praises frontline staff  for their efforts to reduce harm caused by drug and alcohol use across Dundee communities.

Recent national statistics confirm that the city is in the top three in Scotland for progress to implement Medication Assisted Treatment (MAT) standards to provide care for people affected by drug and alcohol use.

Yet the rising death toll suggests more radical measures might be necessary.

Drug consumption rooms have been ‘globally proven’

Cranstoun, a leading service provider that applied to run a drug consumption facility in Dundee in 2022, remains a vocal proponent of the initiative.

Luke O’Neil, Cranstoun’s interim director of services, told The Courier: “It is inconceivable that we are not trying evidenced measures which reduce suffering, when drug deaths are once again soaring.”

He advocates for a third-sector operated social model. He argues this would be more cost-effective and quicker to implement than a medicalised NHS-run facility.

According to Cranstoun, drug consumption rooms have been globally proven to reduce deaths. They also provide critical support to those at the highest risk.

Mr O’Neil also emphasised the importance of drug-checking services. These could help address the increasingly toxic drug supply, exacerbated by potent synthetic opioids like nitazenes.

Cranstoun’s position is clear: a drug consumption room should be part of a broader suite of harm reduction measures aimed at addressing the crisis head-on.

A community divided over Dundee drug deaths

Michael Marra is the Dundee-based Labour MSP for north east Scotland.

He says the people of the city have a “real empathy” with those individuals and families affected by addiction. Even though he acknowledges drugs cause huge social disorder.

He has warned, however, there is no “silver bullet” to solve what is a complex problem.

Mr Marra supports innovative measures, including drug-checking services. But he insists any new initiative must be backed by robust evidence.

“I want the Glasgow situation to work,” he said, “but if it doesn’t work we shouldn’t do it in Dundee.”

Mr Marra’s stance reflects a broader concern within the community about the potential social impacts of a drug consumption room, including the effect on neighbourhoods where such a facility might be located.

He also pointed to deeper systemic issues. These include what he sees as the slow pace of reform in Dundee’s drug services.

He criticised the lack of leadership and the failure to fully implement the recommendations of the Dundee Drugs Commission. That previously called for a cultural shift in how services are provided.

“We need a whole system change to the way that drug services work in the city,” he insisted.

For him, the focus should be on improving existing services, such as Medication Assisted Treatment (MAT) standards, before exploring new and potentially disruptive approaches.

The Scottish Government’s stance

The Scottish Government, while supportive of the Glasgow pilot, is treading carefully.

Health secretary Neil Gray told The Courier in a statement: “My heartfelt condolences go to all those affected by the loss of a loved one through drugs.

“Through our £250 million National Mission on drugs we are taking a range of actions, including supporting the opening of a Safer Drug Consumption Facility pilot in Glasgow.

“We have been clear that we want to see more of these facilities operating, therefore support partners, including those in Dundee, to explore how additional facilities could be opened as quickly as possible.”

The Home Office is currently considering licence applications for three drug-checking pilots, including one in Dundee.

The Scottish Government says these would enable it to respond faster to emerging drug trends.

That is particularly important given the presence of highly dangerous, super-strong synthetic opioids like nitazenes in an increasingly toxic and unpredictable drug supply.

These increase the risk of overdose, hospitalisation and death, and are being found in a range of substances.