In October 2012, the first stationary, however interim drug consumption room was opened in Denmark close to the Health Room at Halmtorvet in Copenhagen. The Health Room is open on all weekdays from 8.30 a.m. to 11.30 p.m. and is staffed with 6 nurses, 4 educational therapists, a project leader, a group of temps, and a social handyman. The healthcare leader of the Mændenes Hjem is the nursing coordinator and there is also a doctor.
During the first six months of opening, there have been 43,340 drug consumptions in the rooms, distributed on 841 users. Some of the users show up many times a day, whereas others only visit the room once. Around 80% of the users are men, and 20% are women, which equals the distribution among drug abusers in general. Around eve- ry fifth user is of foreign nationality. Users with Danish citizenship come from the mu- nicipalities of the Capital Region of Denmark.
The group of foreigners account for approximately every fifth of all users. Copenhagen Municipality is aware that the drug consumption rooms in themselves attract foreign cit- izens to Vesterbro’s open street scene. However, as long as movement across the boarders is free and there are different social programs in the different countries, it is highly likely that marginalised foreigners will walk the streets of Copenhagen and take advantage of the drug consumption rooms. The homeless unit in Copenhagen Munici- pality has a program that is particularly targeted at the marginalised foreigners, and over time, fruitful collaboration has evolved with the authorities of other countries, where citizens are also receiving help to return.
The drug consumption rooms have also appealed to the female drug users, but it ap- pears as if some of the women prefer to take their drugs in the so-called ”fixelances” where the atmosphere is calmer. ”Fixelances” are rebuilt ambulances with staff, where they can take their drugs in the same way as in the stationary drug consumption rooms.
It is primarily psychostimulants such as cocaine and amphetamine that are used in the drug consumption room. Cocaine and amphetamine thus make up 2/3 of the drugs consumed. Approximately 10% of the drugs used are the combination of hero-
in/cocaine. 10% of the drugs consumed are heroin alone, whereas approximately 6% is methadone.
During the first six months, 32 ODs have been handled, where all the persons survived. Clean syringes are handed out and collected when used. Users of the drug consump- tion rooms are referred to social welfare and health programs as well as to drug abuse treatment.
In August 2013, a drug consumption room called ”Skyen” [the Cloud] opened in Mændenes Hjem in Lille Istedgade. In addition to injecting drugs in ”Skyen”, it is also possible for the user to smoke drugs. The Social Services Committee in Copenhagen Municipality has decided that the interim drug consumption room on Halmtorvet will be open until the turn of the year 2013/2014 in order to service the high number of users with a need for taking their drugs in safe surroundings. Copenhagen Municipality finds it positive that different rooms in different locations provide a variety of options so that everybody – also the women – have access to taking their drugs in safe settings.
Prevention deaths through the use of Naloxone
As described in Chapter 6 of this report, around 80% of all the recorded poisoning deaths in Denmark occur after the intake of opioids (heroin, morphine, methadone, etc). The drug naloxone is an opioid antagonist that counteracts the adverse effects of opioids on the respiratory system.
Countries outside Denmark and Copenhagen Municipality have had good experience with user-administered use of Naloxone for the prevention of poisoning deaths caused by opioids and harmful injury resulting from opioid poisoning. Based on the positive ex- perience from a pilot project in Copenhagen Municipality, a new government financed project has been launched involving other major municipalities in Denmark, where drug abuse in the streets exists.
The purpose of the project is to reduce the number of deaths and other injuries result- ing from overdose in persons with opioid abuse by user-administered naloxone com- bined with training.
The intervention is locally implemented in four municipalities (Copenhagen, Aarhus, Odense, and Glostrup. Persons with a drug abuse problem, their family and relatives, and professionals working with drug abusers are trained in resuscitation and the use of naloxone. Copenhagen Municipality is the coordinating municipality with responsibility for training the other municipalities’ local teachers and for collecting project data. The project terminates with an evaluation in mid-2015.
7.3 Prevention and treatment of drug-related infectious diseases
The most important way to avoid drug-related infectious diseases such as hepatitis B (HBV), C (HCV) and HIV is to reduce the sharing of injection tools. The ways to imple- ment this is to replace intravenous drug use with drugs taken orally, or by smoking and by dispensing clean syringes and needles to the drug abusers.
Furthermore, all current and former drug abusers should be offered testing for HBV, HCV, and HIV when they are in contact with the health care system and offered vac- cination against HBV if they have not been infected. Intravenous drug users, cohabit- ants and family under the age of 18 and persons who have been infected with HBV and HCV are offered free of charge a combination vaccine against both hepatitis A and B to
further reduce the risk of deterioration of the chronic HCV infection. Cohabitants, fami-
ly aged 18 and above and permanent sex partners of persons with HBV are only of- fered a free vaccination against HBV.
All patients who are diagnosed to be infected with HBV or HCV should be instructed thoroughly in how to avoid infecting other people. This information must be given by the physician who gives the diagnosis or treats the patient.