Shooting rooms: they refuse to tell you

Who willOn May 18th, 2009, the following associations: Asud, Act Up-Paris, Anitea, Gaïa, Safe, Sos Hepatitis Paris, put in place an injection site at the premises of the Asud association. On the 11th and 12th of June, the Anitea did the same thing, this time at the Villette place, during the celebration of 30 days of Anitea. This time in the presence of Mr. Etienne Apaire, President of MILDT (The Interdepartmental Mission of fight against drugs  and drug addiction) and Ms. Roselyne Bachelot, Minister of Health. From October 13rd to 16th, a new injecting room will be installed at the time of conference THS (Drug-addiction Hepatitises AIDS), in Biarritz. It is surprising that this lobby can squander public money so easily while asking for enormous sacrifices to the French people.



INJECTING ROOMS: Will Mrs. Bachelot Ministre for Health go against the recommendations of the International Body of Control of the Narcotics (INCB) ?
The report 2009 of International Narcotics Control Board - INCB - recommends in its recommendation 32 (page 140) for the governments, of the organizations of the United Nations and other international organizations and regional qualified to close the injection rooms :
Recommendation 32
The Board notes with concern that, in a small number of countries, “drug consumption rooms” and “injecting rooms”, where persons can abuse with impunity drugs acquired on the illicit market, continue to operate.
The Board calls upon Governments to close those facilities and similar outlets and to promote the access of drug abusers to health and social services, including services for the treatment of drug abuse, in conformity with the provisions of the international drug control treaties.



The commission takes note of the efforts made by the German authorities to ensure that the injection rooms are integrated into the general health services for drug addicts, and that they are clean and well maintained. However, according to data collected by the German Government, it seems hardly established that the injection rooms are really encouraging the drug addicts to undergo a treatment and that the very existence of these sites contributes to reducing the number of deaths related to drugs. The commission continues to estimate that since the drugs purchased on the illicit market may be injected inside these injection rooms, they do not comply with the standards required by international treaties related to drug control. 

The commission wishes to remind that the injection rooms (or other similar locations opened in some western countries) may even facilitate drug abuse, are against the regulations of international treaties related to drug control and have an impact on the responsibility of the detention and suppression services. The commission therefore calls on governments to put in place more structures of treatment of drug abuse which comply with the right medical practices and requirements of the  international treaties related to drug control rather than to facilitate and encourage drug abuse and even drug trafficking by  opening injection rooms and other similar places. 

The commission wishes to say once again that the development of such places where the drug addicts can, under the direct or indirect control of authorities, inject drugs obtained by illicit channels is against the provisions of international treaties related to drug control.

The commission remains concerned about the practice not complying with international conventions, which is to put in place injection sites where drugs are subject to non-medical use. Switzerland is a country with a highly developed system of health and social protection and should be able to provide all sorts of means of treatment, rather than develop premises which contribute to prolong and to facilitate the drug abuse in the so-called good conditions of hygiene.



Injecting rooms are contrary with international conventions




Ancien Magistrat
Vice-président de Parents Contre la Drogue / EURAD

Whether in France, Switzerland, or the United States where I currently live, the injection rooms have never solved the problem of drug addiction.


The field work has demonstrated that these injection sites are nothing but the ideal recipe for new disasters in terms of public health. It is the classic illustration of the “false- good idea “: it is a"sexy" idea in terms of public relation; it allows the public authority is give to ease their conscience; finally, it seems to be a "humanitarian" and compassionate solution. However, just pay a little attention to the very basis of this issue, the real and humanitarian consequences of this idea; you’ll realize that this “great “idea is nothing but “snake oil”, a delusion.


If these injection rooms were an effective means of fighting drug addiction, I would fight tooth and nail to support this idea. However my experience as former police officer, magistrate, co-founder of Parent Contre la Drogue, and vice-president of an international organization of fight against drugs has proved the opposite!


These injection rooms for drugs enable the authorities, and more particularly in France to the MILDT, to clear their conscience and hide their failure to create and put in place some real policies regarding prevention and "fresh out of rehab". Once more, the easy solutions overcome the real political fight against drug addiction, which requires courage, effort, energy, courage, and a lot of field work.


I am just asking a question: Just like the heroin injection sites, should we put in place some injection sites…where alcoholics can inject alcohol? What a stupid idea, isn’t it? It is the same for the heroin injection sites: to give somebody the means to take drugs is nothing but help him ruin his health and fall deeper into the hole of drug consumption, everything wrapped up in a fabricated good conscience.


The hell is paved with good intentions! The naivety of MILDT and the slyness of drug lobbies have just added new paving stones on the road which leads to the  physical decline of our compatriots who suffer from drug addiction.


So when will we learn not to repeat the same mistakes again and again? It is time to wake up, to learn some lessons from the experiments conducted in other countries instead of being so self-absorbed. It is time we rolled up our sleeves and create real solutions to answer the true human tragedy of drug addiction.



Swiss Physicians against Drugs

For  the drug addicts there are some rules: it is prohibited to buy and sell drugs inside or outside the injection rooms.


The drugs used inside these injection sites are purchased elsewhere. 

However things are different: outside the injection sites there is always some fifty or even more drug addicts, who not only make conversation, but also buy and sell drugs.


It is a meeting place. The consequence is that there are a lot of dirt and discomfort for the residents. 

The inhabitants of districts goshawks are irritated. They fear for their children, they fear the crime and are irritated because of dirtiness. 

It is terrible for all the people living around these centers. 

Why are the drug addicts going to these injection sites? Because they find other drug addicts there, they can speak of drug trafficking, and they can buy and sell drugs. 

It is a simple drug arena and nothing more. 

These injection sites are no help to anyone.



Jean-Philippe CHENAUX
Center Patronal, Paudex/Lausanne

In 1991, when adopting its “measure set” the Federal Council aims to stabilize the number of addicts to 30 000 by 1993 and subsequently to reduce it by 20% to reach 24 000 by 1996. This objective was never reached. In Switzerland there are currently 40,000 heroine and cocaine addicted persons and 140 000 people who "occasionally" use cocaine (NZZ am Sonntag, 5.10.2003, quoting ISPA and OFSP).


Increasingly large amounts of money have been allocated to institutions with "low threshold" requirements and to "shootoirs", at the expense of therapeutic institutions aimed at abstinence and often active, simultaneously, in the field of prevention. The number of places offered by the latter ones has declined sharply. This movement has amplified once the OFAS started to withdraw its financing of therapies of dependence and their transfer to the cantons. Thus the number of residential institutions decreased form 161 in 1999 to 115 in 2004, with a number of weaning units declining also from 54 to 50 (source: COSTE, 4.6.2004). The result is a serious imbalance of the so called four-pillar policy established in mid-nineties.


With 194 deaths registered in 2003 against 167 in 2002, the number of deaths due to drug use has increased the last year by 16,2%. The number of overdose deaths continues to be higher than it was until mid-eighties, which does not argue in favor of the programs of heroin prescription. The decline in the second half of the 1990s was due, obviously, to the disassembly of open drug scenes. The statistics of the Federal Office of the Police still do not take into account the indirect deaths (deaths due to drug – related infections accidents and suicides). If we do the math we register a much higher drug related death figure: from 750 to 800 deaths in 1996 according to the ISPA, just how much today? With the Swiss Association of former drug addicts (Verein ehemaliger Drogenabhängiger), we require that these deaths are included in the statistics. On the other hand, the number of persons dead in the heroin programs (more than 120 in ten years according to our information) should be indicated separately.

The cases of Aids and HIV infection have been increasing since 2000. While their number was constantly decreasing since 1992, the case of infection (HIV positive tests declared by the laboratories of confirmation) has jumped from 585 in 2000 to 793 in 2002, to further stabilize at the high level of 757 in 2003; injection of drugs as a way of infection represents17,1% of cases  in the last year against 13,7% by 2000 and 12,2% en 2002.

The number of infections by the hepatitis C virus is also on the rise, despite the increasing number of injection sites and other ‘survival assistance’ measures. In 60-80% of cases there appears a chronic disease which often leads (between 3 and 20% of cases) to a fatal liver disease.



Association Jeunesse Sans drogue

Here, everything goes best in the best of worlds. However we must know that in Zurich, some "specialists" of the distribution of heroin now claim already cocaine for cocaine users. This is quite logical, since we still have more cocaine users in Switzerland and that they are at risk of falling into crime and social marginalization; So, let’s give them cocaine funded by the taxpayers … !


The primary purpose fixed at the beginning of these human experiments was the abstinence. This goal has, in reality, been completely abandoned during the last ten years. The rate of persons who leave this program to begin a detoxification program leading (possibly) to abstinence is about 7%. 



Drug Free Australia
Kings Cross injecting room
Only 38% of injections in the injecting room in 2006 were heroin injections. Ice (More powerful than than the Crack, the Ice in the effect of a dynamite for the nervous system) represented 6%, Cocaine: 21%, Prescription Morphine: 31%.

Thus in the injecting room there was one overdose for every 106 heroin injections, while on the street outside there was one overdose for every 3,821 heroin injections. The injecting room consequently had 36 times more overdoses than the rest of Kings Cross. It would have been remarkable if the injecting room had had twice the number of overdoses, horrifying if it had had 3 times the number, but it’s own data shows 36 times the number of overdoses. The high overdose rate was attributed by the MSIC’s own evaluation report to clients taking more risks with higher doses of heroin in the injecting room.  This could suggest that injecting room clients are using medical staff in the room as insurance against the risks of experimenting with higher doses of heroin.
Currently a disturbing 1.6% of Australians have used heroin. However surveys show that 3.6% of NSW respondents say they would use heroin if an injecting room was available to them, most for the first time, potentially doubling the number who would use the drug.

The injecting room saved statistically 0.18 lives in its 18 month evaluation period.

The injecting room did not improve public amenity. The injecting room quite evidently drew drug dealers to its doors. Reductions in the number of public injections and discarded needles in Kings Cross decreased only in line with reduced distributions of needles due to the heroin drought. Recent reports indicate increases in publicly discarded needles.

High Cost for Little Benefit :The injecting room costs $2.5 million a year to operate. That is enough money for the NSW government to fund 109 drug rehabilitation beds.
Injector Safety Not Enhanced.

Heroin addicts inject at least three times a day, or around 1,100 times in a year. If a heroin user wanted to avoid a fatal overdose she would have every injection inside the injecting room. But clients average just 2-3 visits per month, leaving themselves open to a fatal overdose for 34 out of 35 of their heroin injections.

Hep B :  infections - no improvement.

Hep C :
Darlinghurst/Surry Hills - worse by 11% per year despite presence of the injecting room.

Kings cross - no improvement presented by presence of the injecting room.




INSITE (supervised injection rooms) in Vancouver
There is no direct evidence that injection sites reduce the rate of HIV infection. To firmly state that injection sites have a strong impact upon the risk behavior, it should be more evidence with real change in these behaviors, a comparison or a study by a control group.

INSITE saves about a life per year thanks to its intervention in cases of overdose.

The anual fee of INSITE operating is of $ 3 000 000.

There is no direct evidence that injection sites affect the rate of overdose deaths.



Only 10 per cent used the centre more than six times per month. Two thirds used it only once or twice per month after registering as clients. 

The injecting room, an embodiment of several paradoxes :  

One minute the staff are helping clients inject a dose of heroin, and the next they’re making sure clients don’t suffer an adverse reaction to the same dose. 

According to The Alcohol and Drug Addiction Service in the municipality of Oslo the budget for the trial in 2008 is about €1.5 million (opening six hours per day). 

It could also be a paradox that the injecting facility may in fact be contributing to the perpetuation of drug abuse. 

An injecting facility will find it difficult to cope with clients suffering from mental illness and aggressive behaviour. It could therefore be a dilemma that the people most in need of a drug injecting facility may have to be kept out. 

Administering an injection in the neck or groin is more likely to cause physical injury than in the arm. Whether a future injecting facility centre should allow clients to administer injections in the neck or groin is therefore something of a dilemma. 

By running an injecting facility, the authorities may indirectly be seen as condoning drug use. 

And is it wise to spend public resources on an injecting centre, and how far should society go in attending to the various types of assistance needed by drug users? 

One dilemma arising from the injecting room trial is that it could make it easier to maintain the habit, undermining the user’s motivation to quit. 

Harm reduction or prevention? 

Whether society should pursue drug policies aimed at harm reduction or spend resources on preventing young people starting with drugs or helping them quit, is another dilemma. Would the injecting room service attract users who wouldn’t otherwise be injecting heroin? As many have pointed out, it can’t be denied that injecting rooms and other harm reduction measures can be interpreted as a tacit acceptance of drug use by society. Efforts to reduce harm caused by drug use could induce young users at risk of developing a serious habit to feel that society accepted the use of illegal substances. 

How far should society go? 

An injecting room organised along Norwegian lines is an expensive proposition. Is this the right way to spend public money? 

Is this the best way of channelling resources earmarked for this group? How far should society go to provide help that also prolongs substance abuse? Would it not be better to spend resources on measures aimed at getting users to reduce or quit the habit altogether?
The injection room in Oslo opened the 1st of February 2005 and was a trial which was meant to be for three years, but was extended for 2 more years last year, so that the Government should have time to elaborate on a permanent law. The evaluation after two years did not show any reduction in overdose deaths.Last year the city government of Oslo proposed to abolish the injection room because of the costs, but as it is a minority government, the proposal was turned.


The League Against Intoxicants has protested and says that: 

1. Injection rooms can maintain and even strengthen the injection culture. 

2. Neither the Norwegian evaluation nor other research has shown that injection rooms prevent overdose deaths.  

3. A dignified facility for drug users must show the way out of the drug using existence, injection rooms contribute to maintain the patterns of drug use, to maintain the addiction and the street life of drug users. 

4. Injection rooms imply a formal legalisation of the use of narcotic drugs on premises where the police is under obligation not to act. 

5. Trials with injection rooms is a political disclaimer of liability from the fundamental question of legalisation of the use of heroin on premises provided and organised by the authorities. 

6. Injection rooms is not in accordance with the UN conventions to which Norway has signed. In our statement we also pointed to the fact that about one third of all injecting drug users in Oslo have registered  themselves  as injection room users (More than one thousand drug users). That means that they are allowed to have one user dose of heroin with them, if they are on their way to the injection room. Even if they seldom or never use the injection room, is this a good excuse if they should happen to be stopped by the police with one user dose in their pocket.We predict that a still bigger propotion of injecting drug users will register as injection room users as well, and the police's possibility to hinder illegal possesion and use of heroin will be gradually smaller. Heroin in smal doses is de facto legalised in Oslo today, even if it formally is illegal.



Injecting room Vennepark of The Hague

The number visitors of injection room is handled. 

Injection room Vennepark, is located in the middle of a dense residential zone. Since the beginning, there is a strong opposition on behalf of the families with young children. By the force of the law, the room in spite of was very commissioned. Now, the residents shows the city and the institution Parnassia Brijder to handle the figures. They would be quite lower than the official number visitors. The room fills only 65 m2, the remainder is thus empty. That costs 600,000 euros a year. The residents require the closing of injection room to make a better use of it, like a school center post in which 50 or 60 young people without qualification could learn a trade.



You think that they will stop there !


Of course that not, they will also claim heroin distribution, then of cocaine etc.

Until where they will go?

As long as they will not obtain what they want, i.e. "drugs legalization", they will continue.

All this thanks to the money of the taxpayer.




I refuse injecting rooms in France and trivialization of drugs
that wants to impose an associative lobby.   

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Selling drugs is prohibited. Buy drugs is prohibited. Injecting drugs is prohibited. But we will help you do it?
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