Drug Consumption Rooms in Hamburg, Germany: Evaluation of the Effects on Harm Reduction and the Reduction of Public Nuisance

Abstract

In order to evaluate the impact of consumption rooms (CRs) on the promotion of health among drug users and the reduction of the public nuisance of drug use, a study examining CRs in three countries was carried out in 2000. The study, supported by the European Commission, examined CRs in Rotterdam (The Netherlands), Innsbruck (Austria), and Hamburg (Germany). This paper evaluates the findings from the study of Hamburg CRs. In order to get evidencebased information on the effects of CRs, 616 drug users in the Hamburg drug scene or in the vicinity of low-threshold institutions were investigated with a standardized questionnaire. Qualitative problem-centered interviews were also carried out with staff members of the CRs, and representatives from the community, including neighborhood residents, business people, police, and politicians. Research findings show that the Hamburg CRs reached the target group of drug users who practice risky behaviors and engage in public drug use. Findings also show that the Hamburg CRs lead to positive changes in healthrelated behavior for drug users. In addition, the findings indicate that the Hamburg CRs played an important role in the reduction of public disturbances in the vicinity of open drug scenes.

Typology of Injection Profiles of Clients of a Supervised Drug Consumption Facility in Geneva, Switzerland

“…In Germany, a survey conducted in 2002 among clients of 18 DCRs in different cities found 80% of clients with more than 1 visit/week [23] ; another study conducted in Hamburg in the DCRs of the city and their immediate surroundings [12] found that one third of the clients were daily users, one third occasional users (one to several visits per week) and one third less than once a week or never. In the Netherlands an average of 6 visits/week was found among pass holders of DCRs in Rotterdam [11] , and in Switzerland, in a survey among the clients of the Biel DCR in 2002, 43% were daily visitors [24] , and in the DCRs of Zurich in 2002, the mean visit frequency was more than 5/week [1] .…”

“…Utilization of DCRs is known to vary according to the characteristics of the services provided: size and location of the premises (especially the proximity of the drug market) [1] , waiting times [12] , opening hours [1] , general accessibility to syringes [25] or the population targeted (e.g. illegal immigrants in specialized structure in the Netherlands) [26] .…”

“…Infrequent visits or not visiting DCRs is mainly related to a preference for injecting in a private place, the fear of being associated with 'junkies', or being seen on the premises, the rules of the premises [20] , and infrequent use [12,15,25,28] .…”

“…Other objectives include increased uptake of health and social care including drug treatment (by education and liaison activities) and reductions in public drug use and neighborhood nuisance [1,6,7] . Several reviews [1,2,4] and specific studies reported some evidence of success with regard to reducing risk behavior [8] and stabilizing/improving health, improved management of overdoses, improvement in liaison with health and social services [9][10][11][12] , and improved public order [5,12] .…”

“…Less is known about the pattern of visiting such DCRs. The available literature suggests that frequentation of DCRs is not homogenous [1,9,12,14] . Yet for the DCRs to be able to fully exert an influence on the health and social integration of drug users, it may be necessary to have frequent contact with them.…”