[The following are the words of Maria Luísa Salazar, one of the organizers of a safe consumption space in Lisbon, Portugal, as told to Helen Redmond, whose short film depicting the site is above. Initially unsanctioned, the site was recently formalized by local authorities.]
We decided to create this safe space because the Mouraria neighborhood in Lisbon has always been heavily marked by drug use in the streets. At the beginning of 2022, there were changes in the needs of the community of people who use drugs. They were incessantly looking for safe places to use drugs without being exposed to the gaze of neighbors, tourists and the police.
Consumption rooms have been allowed in Portuguese law since 2001, but the first consumption room only started operating in 2019. In Lisbon, there were only two formal consumption spaces and that was clearly insufficient for the needs of the community.
People need a place where there’s no judgment, where they can be accepted, have support and access to safe consumption material in a dignified space.
It has been a long process of constructing a space designed by the community of people who use drugs and by staff.
The GAT team (Grupo de Ativistas em Tratamentos/ Group of Activists in Treatment) decided to use some material, human resources and know-how from previous experiences to informally allow people to use a space to smoke and inject drugs. Taking this decision was a matter of survival because our community is struggling. We already had a previous experience from the mobile DCR (drug consumption room) in Lisbon.
Creating an unsanctioned drug consumption room has been a long process of constructing a space designed by the community of people who use drugs and by staff.
The DCR is led by peer mediators, nurses and harm reduction workers. There are two spaces: the injection area with eight seats; and the smoking area, which is an outdoor space which holds a maximum of 12 people at a time.
In each area there is usually a peer or harm reduction worker supervising the consumption and managing the space. Nurses supervise the injection, and are called in case of emergency or an overdose.
Both consumption areas are very different. The injection space is very intimate and people enjoy the quietness. The smoking area is for socializing and there is a lot of movement.
We’ve tried to create a space that doesn’t feel very medicalized. This is reflected in the leadership of peers and the importance of the participation of people who use drugs, who helped to design the space and service.
Relationships are based on trust, non-judgement and “horizontality” between professionals and members of the community.
When people enter the DCR, they indicate their registration number (if they have one, it’s not obligatory), and indicate which substance they are going to consume. Those who inject drugs are asked a few more questions for safety reasons.
There are more than 1,000 uses per month in the smoking space, and we’ve seen a significant increase in injection of drugs.
People can use the space for 20 to 30 minutes. These rules are a bit flexible according to the service flow.
Heroin and crack cocaine are the most ingested substances and there is a high rate of “speedball” use. There are more than 1,000 uses per month in the smoking space, and we’ve seen a significant increase in injection of drugs to around 350 per month.
Just next door to the DCR there is a drop-in center where there is access to peer counseling, social work services, safe sex and drug consumption material, psychiatry and general medicine consultations.
Considering that harm reduction is underfunded in Portugal, we believe that the formalizing of this drug consumption room is a reflection of the urgent need to provide a safe space to use drugs.