The Complexity of Drug Consumption Room Policy and Progress in Finland

Drug consumption rooms (DCRs) have been established to reach high-risk people who use drugs (PWUDs) and reduce drug-associated harm. Despite effectiveness, their establishment requires strong advocacy and efforts since moral perspectives tend to prevail over health outcomes in many countries. DCRs have generally emerged as a local response to inadequate central government policy. Likewise, the initiative of the Municipality of Helsinki in 2018 opened up a discussion between central government, society, and local actors in Finland. This would be the first DCR in Finland, which makes the policy process and the progress of the initiative interesting for analysis. In this article, the identification of agents, structures of interactions, environmental challenges, and policy opportunities are analyzed within the framework of complexity theory. Our results show that the initiative faces policy barriers that have mainly arisen from the conceptualization of DCRs in moral frameworks that result in the prolongation of political and professional actors to take a position on DCRs.

Outcome and characteristics of patients in methadone maintenance program depending on whether they are or not drug consumption room users

IntroductionIn January 2012, a drug consumption room (DCR) opened in an outpatient treatment center for alcoholism and drug abuse (CADA) to reach people who inject drugs (PWID) who did not seek treatment.Objectives/aimsTo evaluate the characteristics and evolution of 76 patients undergoing methadone maintenance treatment (MMT) during a year in a CADA, depending on whether they are DCR users or nonusers.MethodsA retrospective cross-sectional observational study was conducted by reviewing data collected from patients in MMT during 2015, performing a statistical comparison between DCR users and nonusers. Outcome was evaluated through urine controls, considering a poor outcome when positive to heroin > 20%.ResultsOf the 76 patients in MMT, the average age was 40 years, 21% were women, mean dosage of methadone was 48.2 mg/day and more than a half were DCR users (52.63%). Of the 40 patients, which formed the DCR user subgroup, the average age was 36.4 years, 20% were women and mean dosage of methadone was 47 mg/day. The outcome of all the patients in PMM was successful in 48.68% of the cases, presenting differentially the nonusers a 91.67% of good response and the users only a 10%.ConclusionsInclusion of a drug consumption room in an outpatient treatment center for alcoholism and drug abuse, which facilitates accessibility for people who inject drugs to treatment, poses new challenges in order to improve the effectiveness of the PMM.Disclosure of interestThe authors have not supplied their declaration of competing interest.