Neil McKeganey: Good sense kills the not-so-safe injecting centre

Last week Scotland’s leading law officer, the Lord Advocate, brought a shuddering halt to a proposal from Glasgow City Council to develop a safe injecting centre in the city. Such a centre would have required a change in UK drug laws to enable individuals in possession of illegal drugs to use those drugs within the centre without fear of prosecution. Supporters of this initiative will be disappointed by the outcome, but they need to recognise that the provision of some level of legal protection covering the possession of illegal drugs within the injecting centre would also, by implication, need to be extended to all of those who might claim, legitimately or otherwise, that their drug possession should be green-lighted because they were en route to the injecting centre. In effect, such an initiative would deliver what many of its supporters actually desire – the legalisation of illegal drugs within at least some part of the UK.

In his judgement, the Lord Advocate has not ruled against setting up a centre where doctors can prescribe opiate drugs to addicts. Rather he has simply pointed out that he is not prepared to offer legal protection to a centre where illegal drugs are being used. The Glasgow proposal sought unwisely to tie the proposal for a doctor-led heroin prescribing clinic, which would be legal, with a setting where individuals are allowed to use illegal drugs which would break UK drug laws. There will be many who rightly question the wisdom (and the cost to the public purse) of linking those two proposals.

It is often said by the supporters of these centres that where they have been established in other countries no individual has actually died in a drug consumption room. That might be so, but the lack of such deaths is not the high-water mark of success for drug treatment services. The rise in addict deaths in Scotland and in England shows that we need to do much more by way of engaging drug users in services. Doing more should entail taking services to drug users themselves wherever they are living and wherever they are using illegal drugs. Setting up a city-centre location where people can use illegal drugs under some level of legal protection betrays a worrying lack of knowledge both about Glasgow itself and about the life of an addict. Glasgow is a territorial city par excellence and there are addicts who cross into different parts of the city at their genuine peril. Similarly, when addicts secure the drugs they so desperately need their first thought is not ‘How do I travel to a city-centre location where I may use these drugs without fear of prosecution?’ but ‘Where is the needle that will enable me to inject now?’ It is for both of those reasons that we should be talking about how to take services to the addicts rather than how to get the addicts to go to the services.

Glasgow’s addiction services have been slow to adopt a focus on recovery, and even to date they are unable to report how many drug users they have treated have managed to overcome their addiction – this despite having a strategy which for the last ten years has emphasised the importance of enabling drug users to become drug-free. That strategy is now being reviewed by the Scottish Government with the real risk that the commitment to abstinence-based recovery will be diluted in preference to the much woollier goal of seeking to reduce the harm associated with addicts’ continued drug use.



Within Scotland we spend more than £100million a year on drug treatment. We should be asking why our services seem to be achieving so little in terms of getting addicts into long-term recovery and why, in the face of that failure, public officials are seeking to promote centres where illegal drug use can take place without fear of prosecution. Injecting on the streets is a terrible reality but the response to that problem should not be the provision of a centre where injecting can occur beyond public view, but actively to discourage injecting at all.

The reason we need to be doing much more to discourage drug injecting is because the substances addicts are injecting are often manufactured, stored, and transported in dreadfully unhygienic conditions with the result that they often contain serious and potentially fatal bacterial contaminants. These drugs do not become safe when they are used in a drug consumption room, but remain harmful wherever they are injected. We need to do all we can to discourage drug use, to discourage injecting, and to ensure that as many addicts as possible are in contact with services focused on assisting their recovery. We need to be very wary of developing initiatives that run the real risk of normalising illegal drug use and driving a possible further increase in the number of people using illegal drugs.

Professor Neil McKeganey is Director of the Centre for Substance Use Research, Glasgow

Neil McKeganey

  • Giving drug abusers more of the same will never work. Merely sweep it under the carpet and turn the state in to the ‘dealer’, responsibility being shifted from the individual. Users may not die in ‘consumption rooms’ but they will die outside of them. Heroin users are notoriously pathetic at regulating their usage – and simply will overdose out of site as they do with the methadone program.

  • David R

    Why not adopt the obvious solution to the problems associated with ‘hard’ drugs? Legalise their use use, sell them in pharmacies at reasonable prices, and don’t over-tax them. This would at a stroke eliminate the enormous profits made by organised crime, the smuggling, and the majority of the petty crime indulged in to get the money to pay for the drugs. It would also eliminate the temptation of the forbidden and in fairly short order eliminate most of the extreme addicts. A win all round.
    The only downside would be the lack of young people who are “recovered addicts” on whom praise can be heaped. and to whom awards given.

    • Glass 9/10 empty

      Too many people now make a substantial portion of their living from dealing with the effects of illegal drugs for them to be legalised. The police, lawyers, the courts, prison officers, probation officers, doctors, councillors, various charities, etc, etc. This is, of course, taxpayer money and it is the taxpayer who would benefit the most from your proposal but, as ever, the taxpayer has little say in these matters.

    • This is something that I could support. And if they put a leaflet inside the package like the ones that I get with my prescription drugs it could easily put them off for life!

    • a misplaced modifier

      I can only echo what Blk Byro says above. This idea is madness.

    • Bob

      I do see the logic of your suggestion. However, the biggest drug problem the UK has is with alcohol, which is legal, taxed, controlled and very accessible.

    • davidraynes

      Sadly yours is yet another nonsense post, there are far too many such abour drug policy. Made by ignorant people who either do not understand the history or have another mischievious , (drug legalisation) agenda.

      The UK for many years enabled supply of heroin/morphine and cocaine to addicts, with every Doctor able to supply prescriptions. That system stemmed from the Rolleston Committee findings of the 1920s.

      It is true that for many years that system just about contained use.

      What it could not cope with and why it was abandoned, was drugs use as mass market lifestyle choice, which started in the late 50s early 60s.

      Prescribed heroin did not stop smuggled heroin (Chinese Number 3 and 4 at the time) and a black market existed alongside legal supply.

      More than that, oversupply by corrupt physicians fed legal heroin into the black market. It did not elminate any extreme addicts, it maintained them with many addicts dealing to support their own addiction, even selling some of their legally supplied drug to novitiate, unregistered addicts.

      So your “eliminate the enormous profits” etc is just utter stupidity. There is no logic in your post. It is fiction.

    • Politically__Incorrect

      People don’t take drugs just because dealers sell them. it’s the result of an addictive personality; Dealers just feed off that weakness. Take away these middle men and you still have the problems associated with drugs; AIDS, mental health breakdown, and the inability to live as a normal (non-addicted) human being. I suspect the only solution is an individuals personal determination to kick the habit. Not many seem able to achieve that unfortunately. They need an incentive to to quit and part of that incentive has to be stick rather than carrot. The stick is not making it easy for them to continue taking drugs. The carrot is the reward of a repaired life.

  • Bik Byro

    Don’t facilitate that which you want to stamp out.

    • greencoat

      But they don’t want to stamp it out. They want to promote and normalise it as they have done with so many modern horrors.

  • John Thomas

    I strongly recommend reading Theodore Dalrymple’s book The Knife Went In (2017), about prisons and medicine, particularly the part where he exposes and debunks the whole assumption of ‘addiction’, particularly page 37-40.

  • davidraynes

    The Lord Advocate is not in fact in a legal position to offer protection to a “Shooting Gallery”, For obvious reasons the policy is not held by the Scottish Government, it is national policy and national law that applies.

    Anyone running or attempting to run premises, designed to facilitate the taking of ILLEGAL drugs, is committing the criminal offence of “Permitting premises to be used” (for the taking of illegal drugs) an offence under the Misuse of Drugs Act 1971. This provision would also deal with, for example, “Crack Houses” or “Opium Dens”. That is the restraining provision in law.

    Professor McKeganey is otherwise correct and far from addicts getting their supplies elsewhere then travelling to a “safe injection site” to use”, one of the arguments against “Shooting Galleries” is that they have a honey pot effect for dealers, who would know that they had a ready supply of potential customers around one place.

    Even the bringing together of large numbers of addicts and users, around one place, has dangers, while it is true that clean needles can be provided, there is a high risk that addicts brought together who might otherwise not meet, will cross contamimate each other with HIV, Hepatitis and other serious disease through unprotected sex.

    Shooting Galleries cost a huge amount of money and do nothing to treat addiction. I am always struck that the most ardent fans of them seem to be those who want or are funded to support, widespread drug legalisation. We should be very suspicious of the motives of such people.

  • UKCitizen

    I would be quite happy with everyone having the freedom to do whatever drugs they want, so long as they give me the freedom not to have to pay for the consequences of their decisions.