Abstinence Is for Quitters
Illustrations by Daniel Peacock
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 theyre 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). INDROs 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.
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L.A. WEEKLY: Whats the motivation behind DKRs? What are you trying to achieve?
RALF GERLACH: Obviously I dont 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 dont 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.
To people living in the U.S., it might seem that you are encouraging the use of drugs.
In the 1970s and 80s, Germanys 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 theyve completed their sentence, theyve had access to an abundant drug market and theyve been subjected to the prison subculture, which if they werent 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 peoples 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.
How do you prevent crime and drug trade around your facility?
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 dont 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.
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.
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.
What is your prognosis and what would you like to improve?
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 hadnt 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 wont 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.