Pubdate: Fri, 22 Aug 2003
Source: LA Weekly (CA)
Contact:  2003, L.A. Weekly Media, Inc.
Website: http://www.laweekly.com/
Details: http://www.mapinc.org/media/228
Author: Jessica Schaefer
Bookmark: http://www.mapinc.org/find?142 (Safe Injecting Rooms)

ABSTINENCE IS FOR QUITTERS

But Germany's "Drug-Consumption Rooms" Keep Addicts Safe Until They're Ready To
Kick -- Or Not

In 2000 the German Parliament signed into law an amendment to the Narcotics Act
legalizing "drug-consumption rooms," or Drogenkonsumräum (DKRs). These
facilities, operated by nonprofits, provide space where hard users can take
drugs in a safe environment under medical supervision. In the years since the
amendment, drug-related deaths in Germany have decreased by 25 percent. Similar
facilities have opened in Vancouver, B.C., and Australia, where they're called
"safe injection rooms." But in Germany they are explicitly legal.

Ralf Gerlach is the deputy director of the Institute for the Promotion of
Qualitative Drug Research (German acronym, INDRO). INDRO's Drogenkonsumräum in
Münster was the first to be established, in April 2001, after the initiative
had been signed into law. An annual statement of its work can be found on their
site.

L.A. WEEKLY: What's the motivation behind DKRs? What are you trying to achieve?

RALF GERLACH: Obviously I don't speak for the German government, but for our
nonprofit only. The idea was primarily to help people survive addiction and
decrease drug-related deaths. Our target group consists of hard users of
heroin, cocaine and other drugs who don't find their way to treatment programs
and who are not in substitute programs, such as methadone treatment. Most of
them have been submerged in the drug scene for a long time, and are
consequently disconnected from "normal" society.

L.A. WEEKLY: To people living in the U.S., it might seem that you are
encouraging the use of drugs.

RALF GERLACH: In the 1970s and '80s, Germany's fight against drugs consisted of
inpatient abstinence programs and stricter law enforcement. During that time we
learned that putting people in jail improves nothing. You simply lock them
away, and by the time they've completed their sentence, they've had access to
an abundant drug market and they've been subjected to the prison subculture,
which -- if they weren't criminals already -- gave them all sorts of tools to
become criminals.

We discovered that most deaths occurred after release from prison or abstinence
programs. We attributed this to a change in people's physical level of
tolerance to opiates after a long period of not using. In all the planning,
nobody had considered that people might continue drug use after their release.

The goal of abstinence is not off the table. But we know now that one approach
is not enough. DKRs are merely one of a variety of methods to reach as many
people as possible.

L.A. WEEKLY: How do you prevent crime and drug trade around your facility?

RALF GERLACH: In our case the concern about creating yet another drug scene
around the DKR has so far been unsubstantiated. Of the 24 DKRs that currently
exist, all have to comply with strict legal guidelines. Dealing drugs or
selling stolen goods is prohibited.

Our visitors have to fill out a sign-in sheet, stating their age (no one
younger than 18), certifying that they are not in a substitution program [such
as methadone] and that they are not first-time users. An introductory
conversation follows in which they have to show us their drugs and tell us the
amount they intend to use.

We do not provide any drugs, but we give them clean syringes. We also have a
smoking booth for those who don't shoot up. Then they have 15 to 20 minutes to
utilize the facility. All of this happens under the surveillance of our
medically trained social workers. It is often during that time that the user
strikes up a conversation with the social worker, and we are able to reach
people and eventually refer them to other drug-treatment programs.

L.A. WEEKLY: If there were a plan for a DKR in my neighborhood, I am not sure
my love for mankind would prevail. How does your immediate neighborhood
respond?

Only after a city has voted to approve a DKR is the facility realized on a
local level. You have to assume this only happens if there is a strong
consensus within a community. A council is formed of law enforcement, health
officials, commerce, community representatives and the organization that runs
the facility. We meet on a monthly basis to exchange information and to compare
notes.

RALF GERLACH: DKRs are not located arbitrarily. They are often close to the
open drug scene, which in a lot of cases happens to be close to the central
train stations, which are vital for the drug trade.

Since the police already keep a close eye on the open drug scene, there is an
increased police presence around our facility. I should mention that the police
unions are strong supporters of DKRs. You cannot avoid all crime, but the
incidents of crime around the DKRs are isolated instances and not the norm.

L.A. WEEKLY: What is your prognosis and what would you like to improve?

RALF GERLACH: Approximately once a day a visitor loses consciousness at our
facility. I am not saying all of these cases would have resulted in death if
there hadn't been medical assistance, but definitely lives have been saved.

Sadly, however, we just had the first fatality in a DKR. The cause of death was
anaphylactic shock. Obviously, years of drug use takes a toll on the body, but
sometimes also people simply die.

There are also people who won't be reached by any effort to get them off drugs;
for them, we have to legalize drugs and tax them. This would reduce the amount
of impure drugs on the market, which often kill people. Then also the whole
dilemma of related criminal activities would significantly subside.
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