Drug Consumption Rooms in Finland

In 2020, 258 people died as a result of drugs. This was more than the number of traffic-related deaths, standing at 223. According to the latest European Drug Report, Finland had the most drug-related deaths among people under 25 that year, compared to the rest of the European Union, Norway, and Turkey. The number of drug-related deaths has been growing at an alarming rate, almost doubling since the turn of the century.

On February 8th, 2022, a citizens’ initiative was submitted to combat the issue. It proposes the introduction of drug consumption rooms. On July 25th, the initiative reached 50 000 signatures, meaning it could be submitted to Parliament for consideration. Now, waiting for the initiative to be processed, Sanna Kailanto – Senior Specialist at the Finnish Institute of Health and Welfare (THL) – elaborates on the issue.

Drug consumption rooms in a nutshell

To those who do not yet know, drug consumption rooms are places where drug users are allowed to use illicit substances under the supervision of trained staff. They are specifically designed for the problematic drug use population – people over 18 addicted to injection drugs or with a long history of using other hard drugs. The purpose of these facilities is to reduce the amount of drug-related infections (e.g., HIV and hepatitis B and C viruses) and deaths by teaching visitors how to use these substances more responsibly and providing them with a safe and hygienic environment to apply this knowledge.

The first drug consumption rooms in Europe were introduced four decades ago, in the 1980s. Many opposed them at first, fearing they would increase the use of illegal drugs. However, this did not turn out to be the case. The introduction of drug consumption rooms produced promising results. Today, they are found in roughly 90 locations across 12 countries worldwide. This number is likely to grow in the foreseeable future, with the introduction of drug consumption rooms being currently discussed in several countries.

The benefits of drug consumption rooms in a nutshell:

1. Safe and hygienic drug use
2. Increased access to social and health services
3. Reduced public drug use and waste

Questions with no immediate answer

The drug culture in Finland is unique. Therefore, it is too early to say what the Finnish model would look like if there were to be one. Unlike in many other countries where most drug users die from fast drug overdoses, in Finland, the biggest problem is the combined effects of opioids and sedatives. This type of polydrug use tends to be life-threatening only hours after consumption, most likely after a person has left the drug consumption room. With this in mind, there are many factors decision-makers would need to consider when determining what actions must be taken.

Other factors that must be taken into account include:

• What services are provided in the facility?
• Where are the services located? What are the opening hours? What is the maximum capacity?
• Who is welcome to visit the facility? Does their current state matter?
• What kind of team of health care professionals must be present at all times? How would staff members’ roles be determined? Would nurses help visitors inject drugs?
• How much would everything cost? Who would be paying for it?

Kailanto’s biggest fear is that drug consumption rooms are not planned well enough, will not work as intended, and as a result, will end up being more or less useless. She hopes the Finnish model would be as comprehensive a service as possible. Ideally, it would be an addition to current social and health services without posing cuts to existing substance abuse services.

Where we are now

At this point in time, drug consumption rooms are illegal in Finland. However, much has been done to change this, especially after THL officially recommended their introduction in January 2022. A citizens’ initiative was submitted, which has now progressed to the stage for politicians to determine what is the next step.

Some might think the introduction of drug consumption rooms requires the decriminalization of all drugs first. According to Kailanto, however, this is not the case. In Germany, for example, drug use is illegal and drug consumption rooms are still in operation. It is about technical legal solutions. Certain places could be excluded from criminal law. Many services do not depend on legislative changes; much can be achieved within the framework of existing laws, but not everything.

Something to consider

According to Kailanto, the term drug consumption room is not the best way to describe these facilities; it is too restrictive and does not convey their true purpose: to mitigate the ramifications caused by problematic drug use. It would be better to talk about them as harm reduction facilities or overdose prevention centers. However, Kailanto acknowledges that the current name is widely ingrained and therefore is unlikely to change.

In the end, people who have been excluded from social and health care services as a result of severe drug addiction would be the ones who benefit the most from the introduction of drug consumption rooms. However, this does not mean that others cannot benefit too. Other members of society, as well as the environment, will see improvement if problem-causing drug use moves from public spaces (e.g., library toilets) to monitored safe spaces. All in all, the problematic drug population should be helped not only for ethical reasons but for social and environmental reasons as well.