Joe Kennedy stepped out of the Abbey Chemist in central Glasgow and zipped up his jacket to ward off the winter chill. A dose of methadone from the pharmacist coursed through his body.
He’s been trying for years to kick a heroin habit that has cost him his job, his family and nearly his life. But addiction runs deep, and he barely got out the door of the small pharmacy where he comes for supervised methadone prescriptions when a friend approached him with a packet of diazepam, which is sold legally as Valium. She offered him a few tablets and he accepted eagerly.
He used to work as a nurse, but access to painkillers proved too alluring and he was fired. Then his cousin introduced him to heroin and now, at the age of 52, Mr. Kennedy is one of the hundreds of drug users living on the streets of Glasgow, the overdose capital of Europe. “I’ve been on it for 25 years,” Mr. Kennedy said. “I’ve never had a life. It’s just an existence.”
Discarded needles and drug paraphernalia are a common sight on the banks of the Clyde, the river that runs through Glasgow.
Like a lot of Glaswegians, Mr. Kennedy is hard-pressed to explain why this city of 635,000 people has such a persistent drug problem. “I wish I knew myself,” he said, shaking his head. “I’ve been taking drugs a long time. I think it’s just so available.”
Last year 1,172 people died from drug overdoses in Scotland; the number is on track to be even higher this year. On a per capita basis, Scotland’s rate of drug deaths is 2.7 times higher than England’s and nearly 10 times above the average for the European Union. Nowhere is the crisis more acute than in Glasgow.
Government efforts to address the crisis have failed to slow the rise in drug deaths. Now, in an attempt to reach the most at-risk users, city health officials are about to open Britain’s first supervised injection site.
“We have the highest drug deaths anywhere in Europe so we know that we can’t continue to do the same,” said Allan Casey, a city councillor who oversees addiction services.
Walk almost anywhere in Glasgow’s east side and the amount of drug use becomes all too clear. Used needles line the sidewalk behind an abandoned school and litter the grass along the banks of the River Clyde. Drug users beg for money in the main shopping area and shop owners complain about theft. When city officials installed a needle disposal bin in an alley last year, they collected 5,000 drug-related items in the first six months.
“It’s the worst it’s ever been,” said Belinda Price, 57, a former police officer who lives in a condominium in Trongate, a neighbourhood long associated with drugs. Ms. Price said she regularly encounters people injecting themselves in the building’s stairwells, hallways and entrances. Fights over drug stashes are common, she added, and dealers ply their trade in the open.
“It’s all day, every day, not just at night. It’s quite open,” she said during a brief walk around the neighbourhood. She stopped at one street corner and pointed to a spot where someone died from an overdose.
Belinda Price sees the human toll of the drug crisis all around her in Trongate, where she lives in a condo.
Experts differ on why Scotland – and Glasgow in particular – has fostered such a drug culture.
Most point to deindustrialization in the 1980s, which led to soaring levels of poverty and the emergence of a heroin epidemic popularized in the 1996 film Trainspotting. Life expectancy in Scotland remains lower than anywhere else in Britain and it’s even lower in Glasgow, at 73.6 years for men and 78.3 for women.
The city’s Safer Drugs Consumption Facility is scheduled to open on Jan. 13. It will be housed in a health centre in Trongate that offers drug treatment programs such as prescribed heroin.
The facility, known as the Thistle, has eight injection booths that will be available every day for 12 hours. Around 30 staff from the National Health Service will be on hand to respond to other health needs and provide counselling.
It’s took nearly 10 years of debate and legal wrangling to win approval for the project. Officials finally got the go-ahead last year when Scotland’s Lord Advocate, essentially the chief prosecutor, cleared the way for people to use the supervised consumption site without facing prosecution for possession.
“It’s not a silver bullet on its own. It’s part of a wider system of care,” said Dr. Saket Priyadarshi, Glasgow’s associate medical director of alcohol and drug services, who will oversee the centre. The Thistle will target those who have the highest risk of overdosing, he added, and will benefit the local community by decreasing public injections on the streets.
'I’m in favour of treating people decently,' community advocate Patricia Fort says of the Thistle project.
Reaction among local residents has been mixed.
Patricia Fort, 74, who heads a community association in Calton, a part of the city that includes the Thistle, said members generally support the facility. “I’m in favour of treating people decently,” she said during a recent walkabout of the area. She’s hopeful that the centre will help make streets safer and get drug users on a path to recovery.
But others, including 68-year-old Linda Watson, said the facility has already brought trouble. Drug users and dealers have been drawn to the site, and prostitution, shoplifting and other crime has increased, she said.
“I mean, they’re just openly in the street, just pulling down their trousers and shooting up in front of people. They just do not care,” she added. “All we want is that our area is clean and safe for our families.”
Ms. Watson said there has also been confusion about how much policing will be around the Thistle. The centre’s advocates have encouraged police to take a cautious approach so as not to discourage people from using the site. But Ms. Watson said that leaves residents vulnerable. “How far out from this facility are you going to be before you get prosecuted for dealing?”
Mr. Casey said there has been extensive local consultation but acknowledged that officials need to demonstrate that the Thistle will make a difference to the community. The goal, he said, is “to try and make that area a better place to live.”
Ontario has 23 supervised drug-use sites, like this one in Toronto's Kensington Market, but the province is set to close some of them.Fred Lum/The Globe and Mail
B.C. was the first province to permit supervised drug use. This site in Victoria is unsanctioned: Physicians set it up in November to oppose what they called political inaction by the province.Chad Hipolito/The Globe and Mail
Critics have also pointed to Canada, where supervised consumption sites have been around for 20 years but are now facing a backlash over concerns about rising crime, social disorder and drug use.
Ontario is about to close 10 such sites and debate is growing in some other provinces about whether there has been too much focus on harm reduction strategies – such as supervised consumption, needle exchanges and prescribed heroin programs – instead of treating addiction.
Mr. Casey has followed the debate in Canada and believes shuttering centres would be a mistake. “I think that marks a sort of dangerous regression, and potentially losing and reversing years of progress based on public-health policies that have ultimately saved lives and supported local communities,” he said.
Several countries, including Ireland, Switzerland and Australia, are opening new sites, he added. “We believe that what we are doing is going to be successful.”
But even some people who work on the front lines of the drug crisis do not share that view.
“It is not going to address the problem in any way, shape or form at all. It’s an admission of failure from the Scottish government,” said Annemarie Ward, 52, who used to be addicted to drugs. She founded Faces and Voices Of Recovery, a non-profit that advocates for rehabilitation services.
The city devotes only a small fraction of its drug treatment budget to programs that help people kick their addictions, Ms. Ward said. The people running the Thistle “are addiction experts. They are not recovery experts,” she said. “It’s two very different schools. We know you need both. We’re asking for balance.”
Ricky McAddock, who co-founded a charity called Street Connect, understands the importance of rehabilitation but, given the scale of Glasgow’s problem, believes the Thistle is worth a shot. “I think we’ve got to try something different,” he said with exasperation.
Mr. McAddock, 45, has seen the drug crisis up close and watched it change over the years.
He’s part of the Trainspotting generation of drug users who got hooked on heroin in the 1990s. His brother and three cousins also became addicted; two of the cousins died from overdoses. He was on and off heroin and diazepam for seven years, until he overdosed after one long bender. After that, he got clean with the help of a church organization.
He’s been free from drugs for 15 years and at Street Connect heads a team of 25 outreach workers who support drug users living on the streets.
But even he’s surprised at the amount of drugs in Glasgow. He recently went out with a staff member and “within five seconds of being off the main street we looked down a smaller alley and there were two girls injecting into their groins just behind the car. Another guy came walking down with a loaded needle.”
The drug of choice is no longer heroin, he added. Cocaine has become far more available and less costly. But it’s also more worrying. While heroin addicts tend to use twice a day, someone on cocaine might need 15 daily injections. “They’re just constantly thinking about cocaine and getting it, so nothing else matters,” he said.
Not everyone in Street Connect supports the consumption facility, and many doubt it will be frequented by the most addicted drug users, who largely prefer to shoot up at home, and often die there.
But from what Mr. McAddock has seen, the city doesn’t have much of a choice. “I think trying something different, there’s no harm in that,” he said. “And I guess we’ll see over time how effective it is.”
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