Opinion | Injection rooms save lives

Michael Lodborg Olsen argues that the mobile injection room will keep addicts safe – and off the streets
The Copenhagen Post (Denmark)
Thursday, October 13, 2011

On Monday September 12 Denmark’s first mobile injection room made its maiden voyage, driving from Victoriagade to Reventlowsgade behind Central Station. The room is actually an outdated German ambulance that has room for three intravenous drug addicts, and a doctor and a nurse who can give first aid or other medical assistance. The introduction of the mobile injection rooms draws to a close 35 years of pointless drugs policies in Vesterbro.

On the first evening alone seven addicts took advantage of the ambulance’s offer of shelter from the elements and a place where they could avoid the glances of passers-by. Syringes and other tools of the trade are discarded in medical waste containers, and the volunteer healthcare personnel are standing by to help.

Since its first night, the mobile injection room has driven the streets of Vesterbro three nights a week. Most addicts in the area are aware of the ambulance and have expressed their enthusiasm and gratitude for the initiative. They feel respected. The facility gives a sense of dignity to a group of people who would otherwise be forced to feed their addiction in public. It also creates a sense of trust between a marginalised group and us – a society and a welfare state that can help if the confidence and trust is there.

Years of working to establish an injection room in Vesterbro have finally paid off. That payoff includes over 100 addicts shooting up in a clean environment, no overdose deaths, and 65 litres of used needles.

Since that first night, a second ambulance has been donated by Falck, and the Injection Room Association now has everything it needs to offer drug addicts a safe place to shoot up: a calm, hygienic environment, clean needles, light, heat and staff that want to help. We’re even certain of the initiative’s legal footing. A number of leading law experts, including Vagn Greve and the organisation Street Lawyers, say unequivocally that injection rooms and so-called harm reduction initiatives are permitted under domestic and international laws. But, we do not receive financial support to operate the vans from either the national or the city government. For the time being, we rely on donations to make sure we have enough money to keep two ambulances and 50 volunteers on the street.

Why do we need an injection room? Injection rooms give addicts a clean, supervised place where they can shoot up, which is decisive for reducing the spread of infectious diseases and deadly overdoses. About 300 people die of an overdose in Denmark each year – more deaths per capita than in most other European countries. Other cities have already set up injection rooms, and the results of the 92 existing facilities clearly show that not only are there fewer deaths, there is also a decrease in the amount of fewer needles littering streets and lower crime rates. The most recent studies document that injection rooms are better at helping people drop their addiction.

It all boils down to a question of human dignity. Are we, as a society, willing to let young people die right in front of our eyes, under the degrading conditions that substance abuse brings with it, or will we use our common sense and take responsibility? Will we continue to drive some of the most marginalised members of our society into the courtyards and stairwells of Vesterbro, or will we find the resources to create a place where someone can keep an eye on them.

The Injection Room Association was established as a desperate reaction to a political machine that puts the system before the people, but the new government will support an injection room. The overwhelming support in favour of injection rooms spans from the far left to the ultra-liberal. But until they get a chance to vote, we’ll still be out on the streets of Vesterbro. With the help of socially conscious volunteers and with financial support from businesses, we can help bring life, dignity and cleaner streets to Vesterbro.

Michael Lodberg Olsen - The author is the president of Forening Fixerum (the Injection Room Association) and the organiser of the Mobile Injection Room.

Fix on wheels

The city's new mobile injection room is on the streets. Come along for a ride on a former ambulance volunteers hope can continue to help save lives

Silence pierces the air as the needle pierces his skin. A concoction of heroin and cocaine is injected slowly but purposefully into the left arm and then the right one. A small amount of blood is sucked back up into the syringe, tainting the colour of the off-white liquid.

This isn’t the first time Kristoffer has shot up, but in his 29 years as a drug addict, it is the first time he’s done so in a mobile injection room.

On the corner of Little Istedgade in the heart of Vesterbro, Copenhagen’s capital of vice, is the mobile injection room. The former ambulance, once used for administering life-saving drugs, is now being used to allow people to administer class-A drugs to themselves.

Tonight is only the 12th time the mobile injection room has opened its doors to the public. Its primary purpose is to give addicts a private, hygienic and safe place to shoot up, with medical professionals on hand in case they overdose. The room is kitted out with everything an addict needs: needles, sanitary wipes, small cups for mixing and cotton wool. The only thing the room doesn’t provide is the drugs.

Before the van rolled out in September, Copenhagen had no facility where drug addicts could shoot up under the supervision of health professionals.

Over the past six years attempts have been made to establish an injection room but have been met with opposition. In 2005 the Social Democrats made the first push, but the Health Ministry concluded injection rooms were illegal. A year later another attempt was blocked by the Liberal-Conservative government. This March a private injection room in the basement of an apartment building near Central Station was prevented from opening after a judge ruled it was illegal to offer public health services from a private residence.

A mobile injection room was then seen as the best legal option. Michael Lodberg Olsen, the man responsible for setting up both the permanent injection room in March and the mobile injection room, still sees a permanent room as the best option. He expects that with the recent change of government it will be possible to establish a room with funding from the local council.

Kristoffer talks non-stop, but the volunteer nurse manages to stop him long enough to ask him the routine questions: his name, the drug he’s injecting and how long he’s been an addict. He quickly blurts out that in 29 years he’s never overdosed. But he’s one of the lucky ones – 300 people die from drug overdoses every year in Denmark, giving the country one of the highest mortality rates in Europe.

That’s the primary motivation for having the room, according to Olsen.

“There are over 90 injection rooms around the world, and they have shown that it reduces the number of deaths by between 35 and 70 percent. The rooms create better conditions for the drug addicts and better conditions for the local community.”

And with 500-600 addicts shooting up in the Vesterbro district each day, he said the chance of serious complications is high.

This isn’t the first time Olsen, who describes himself as a social entrepreneur, has pushed for better conditions for drug addicts. In 1989 he began assisting street children in Romania before returning to Denmark to work with addicts in Herlev. The last two years have seen Olsen working for DUGNAD Vesterbro – a grassroots organisation working for better conditions for the district’s drug addicts.

Lit by only three fluorescent torch lights, the injection room feels like something out of a Hollywood movie. As Kristoffer moves the needle around in his arm, another addict quickly steps into the room. Looking no more than 25 and speaking Danish with a heavy east European accent, the Ukrainian is impatient to get his fix.

He breathes a sigh of relief as the heroin reaches his veins. A small drop of blood falls to the ground from where the needle has punctured his arm. The spot is surrounded by a dark blue bruise – a sign he’s shot up many times before.

But unlike many addicts, this young man didn’t take long to find a vein and shoot. Volunteer nurse Maria Bonde explained that many addicts “find it extremely difficult to find a vein to inject in as they disappear after they have been used a few times”. She added that one of the benefits of the injection room is that “addicts don’t feel rushed and can therefore take their time to find a vein to inject in, instead of rushing and injecting into an artery.”

The injection room boasts a team of 70 volunteers, 18 of whom are doctors and nurses. Much of their motivation stems from the fact they live in the area and are fed up seeing addicts shooting up in inappropriate places and under unsanitary conditions.

“The room offers a little dignity for them while the local community can walk the streets without bumping into used needles,” Bonde says.

But sitting inside the little room, watching the young Ukrainian man with his whole life ahead of him, it’s hard not to question whether the room encourages his habit. But according to Olsen this isn’t the case.

Olsen pointed out that most addicts have been users for over 20 years, and added that the open dialogue that goes on inside the room can actually lead to someone seeking treatment. “When you treat people with respect you get a very good dialogue. When you say to people: ‘Okay you take drugs, it’s okay, but instead of sitting outside, why don’t you come inside,’ that’s recognition, and it’s been documented that this helps people get off the drugs.”

For another addict, Katrina, one of the biggest motivating factors for seeking out the mobile injection room is the respect the volunteers show her. A prostitute who’s been addicted to heroin for over 30 years, she confided: “It’s hard to gain respect from anyone, but the people in the room respect me – they’re lovely people.”

The injection room also offers her that slice of dignity she desperately longs for.

“You can imagine how we feel. We sit outside and throw the needles around and it’s not good when you see the kids. I like the privacy. I know it’s a problem to have my trousers down [to inject heroin] when there’s a family coming.”

That didn’t stop her from pulling her trousers down right there beside the van, revealing a 10cm blackberry-coloured bruise at the top of her thigh.

Olsen claimed the addicts aren’t used to seeing people trying to create welfare services that suits their needs. They therefore have a lot of gratitude for what the injection room team are doing.

With winter now on its way, the room is becoming much more sought after.

“The room is great because we don’t have to sit in the cold on the stairs and shoot up,” enthused Kristoffer.

Cocaine addict Michael was also keen to make the most of the room over the winter. After just shooting up he came across the van for the first time on his way home.

“If I knew this was here I wouldn’t have shot up out on the street.”

That’s exactly the response the injection room is hoping to achieve.