This week Norwegian parliamentarians voted in favour of making a trial scheme of drug-injection facilities permanent. I find it deeply troubling that I could easily have published an article I wrote about the matter in 2005 without any alternations - save perhaps a new intro and omitting a line or two.
As a testament to how little has changed over the years, I will publish it here. Of course, in the scheme of things, three-four years is nothing, especially not compared to the heroin trials the Norwegian government has recently been considering – more than a decade after they were introduced on the continent.
In fact, the last time I talked to contacts working with drug treatment in the UK (2007), they said the debate had all moved on from heroin to subutex in drug replacement treatment, but what do I know... I’ve covered drugs policy on and off since 1995, and wrote my MA project on heroin prescriptions (2001), but this feeling that the story keeps repeating itself is part of why I couldn’t bear to report on it day to day. Not that there ever was a career to be made in being a drugs reporter, as Phillip Knightley pointed out when I spoke to him for my thesis, but, oh well, here’s that 2005 story:
The UN's narcotics control board scolds Norway for setting up a trial drug-injection facility in the country's capital, Oslo, claiming it will boost the use of illicit drugs.
In its annual report for 2005, The International Narcotics Control Board (INCB), the quasi-judicial control organ monitoring the implementation of the United Nations drug control conventions, reiterates is position that drug injection rooms "violate the provisions of the international drug control treaties" and urges the Norwegian Government "to take immediate and necessary action to ensure full compliance" with these.
So far, Norway has chosen to ignore the INCB, and in that decision the country joins ranks with Canada, Portugal, Spain, Holland, Germany and Switzerland. The three latter countries have run drug injection centres as part of larger policy schemes, aimed at reducing harm to society and individuals, since the late eighties.
In 1995 I attended a conference where the then head of the Drugs Authority in Frankfurt, Germany, Werner Schneider, described the city's drug scene before it adopted harm reduction measures such as injection rooms thus: "The misery was beyond words. In Tanuslage [the city's needle park] people literally died before our eyes and infections spread like fire in dry grass. In 1985 more than 60 per cent of the drug addicts that died in Frankfurt had HIV."
"In 1986 – 87 a very tiny methadone project was started in Frankfurt in response to the explosion of HIV and Aids. Frankfurt is a city of commuters. One million people work here every day, but only 650,000 live here. A lot of commuters would go to prostitutes before they went home, thereby introducing HIV into their families. The methadone project was started to protect normal family life, " said Jürgen Weimer, who was in charge of the low threshold services with the Frankfurt Drugs Authority, when I visited in 2001.
The 'success' of the drug injection rooms that have popped up all over Europe during the last few decades, lies in the fact that they've managed to bring down the number of HIV infections and reduce the number of deaths from overdoses. The 'victory' of these facilities is that they help keep the addicts alive and relatively healthy.
Only in 2002 Oslo was described as the drug deaths capital of Europe, after the Council of Europe's Pompidou centre found that the country topped the continent's statistics of number of drug deaths relative to population. Despite some reduction from the 'record' year 2001, a strong injection culture, prevalence of dangerous drugs cocktails, mixing heroin with rohypnol and amphetamine, and relative affordability of heroin has kept the number of drug overdoses and infections relative to population in Oslo high.
This explains why, 20 years after the Liverpool project first championed harm reduction measures such as injection rooms, needle exchange and drug prescriptions, Oslo, in a sharp departure from Norway's strong prohibitionist line, finally opened its first injection room in 2005, despite massive national opposition. And has decided to stick with it, even in the face of UN condemnation – at least for the time being.
It's too early yet to say if Oslo's injection room will contribute to reduce drug overdoses and infections in the same way as in the other countries that have set up such facilities. The drug addicts I talk to in Oslo say it restores some sense of dignity to an undignified life. But herein lies some of the danger of injection rooms as well: addicts I have talked to in such facilities on the continent say that while the injection rooms take away the stress and enables people to inject in a safe, clean environment, they are also a bit counter-productive in that they tie the drug users closer together and make it more difficult to get away from the drug scene.
In some injection rooms on the continent, services include not only free needles and supervision, but also free condoms and free, constantly updated, leaflets for prostitutes with vivid descriptions of violent and abusive customers to stay away from – everything to help the individual to stay alive.
It's a harsh and grim reality you would not wish on your worst enemy. I would like to be able to say here that all my research has showed me that injection rooms and other harm reduction measures have eradicated all the harm caused by drug abuse both to the individual and to society. I cannot. To paraphrase one of my sources these measures "do not eradicate any evils, but they do substantially reduce them, that's why we call it harm reduction, not harm eradication." END.
In its latest annual report from 2008, INCB is still criticising Norway for running drug-injection facilities. Interestingly, it notes that “in the evaluation of a project to establish a drug-injection room in Norway there is no evidence the scheme has resulted in a reduction in drug overdose rates or fatalities”.
I wonder, why is that? And if there are no positive results to refer to in Norway, why was the trial act made permanent law? I seem to recall that results from injection rooms in Germany, Switzerland, Liverpool were unequivocally positive (though I am aware there are some doubts surrounding the methodology used to measure results in the Liverpool project).
In either case, to paraphrase the title of my old MA dissertation: it’s not a neat picture, neither is it black and white, and I when looking at media's drugs coverage I'm far too often reminded of ex-BBC director John Birt’s phrase about media’s bias against understanding....