After pressure from advocates, Edinburgh city councilors have published a long-awaited report supporting the feasibility of implementing safe consumption sites (SCS). The findings come amid a shifting landscape of harm reduction, as Scotland’s capital adjusts to an increase in cocaine use and the imminent arrival of SCS in Glasgow.
“There is a strong case in principle for safer consumption facilities to be introduced.”
SCS “have the potential to tackle many of the drug-related harms being faced in Edinburgh,” the report states. “Legal challenges remain, but the recent decision regarding the Glasgow facility demonstrates these are not insurmountable. Therefore, there is a strong case in principle for safer consumption facilities to be introduced.”
The report appears to have been published on February 12. It was commissioned by the Edinburgh Alcohol and Drug Partnership in January 2023, and according to advocates local authorities have delayed its publication. It was posted to the Edinburgh city government website with no accompanying announcement.
A report outlining next steps is expected by March 12.
As cocaine use rises across Scotland, harm reduction services still operate from a framework designed for opioids, and as such the report described SCS potentially struggling to accommodate the needs of people using cocaine. Understanding opioid-based patterns of drug use as the default also heightens stigma against stimulant users, with some people who contributed lived experience to the report expressing concern over “uncontrollable” episodes of “aggression and paranoia.”
The report also identified the presence of nitazenes (a class of synthetic opioids) in the United Kingdom’s drug supply as a source of growing concern. The authors underscore that “Edinburgh—alongside the rest of the UK—faces the prospect of increased levels of synthetic opioids in the drug supply chain,” and that nitazenes have been found in samples of drugs sold as oxycodone in the city, tested at WEDINOS. They state that “2023 saw spikes in drug deaths in a number of regions across the UK that were associated with nitazenes and other synthetic opioids. In the context of a significant—and possibly sustained—reduction in the global supply of raw opium, the risk of increased synthetic opioid use is pronounced.”
The report additionally outlines considerations related to legal practices, emphasizing the need for collaboration with police to minimize the threat of prosecution for drug possession.
Scottish SCS could not legally accommodate peer-assisted injection.
SCS operations are not sanctioned by the UK Misuse of Drugs Act (MDA) 1971, which bans possession of controlled substances. However, recently Scotland has seen a move toward de facto authorization that would in theory allow people to access SCS without being criminalized.
“I would be prepared to publish a prosecution policy that it would not be in the public interest to prosecute drug users for simple possession offenses committed within a pilot safer drugs consumption facility,” Lord Advocate Dorothy Bain, Scotland’s top law enforcement officer, stated in September 2023.
The provision of drug “paraphernalia” is permissible under the UK’s Misuse of Drugs Regulation 2001, with exemptions already utilized in existing services. However, unlike some overdose prevention sites in Canada and elsewhere, Scottish SCS could not legally accommodate peer-assisted injection. This would prevent them from serving scores of people who prefer or rely on assistance from peers to inject, or who inject parts of their body besides their arms. As Scotland’s approach to drug use becomes more humane, we can hope it will become more equitable as well.
Photograph of safe consumption site in Canada via State of Massachusetts
Correction, February 16: Due to an editorial miscommunication, the original version of this article contained a section about nitazenes that did not accurately reflect the author’s views. The article has been revised with the author’s agreement, and Filter apologizes for the error.