Inside the safe consumption room tasked with helping to drive down Scotland's drug deaths epidemic

It promises to be a landmark moment in the battle to rid Scotland of its ignominious record as the drug deaths capital of Europe, and help save the lives of some of the most vulnerable people in its biggest city.

After a protracted and pained wait of nearly a decade, the UK’s first drug consumption room will welcome its first service users on Monday, with authorities around the country paying close attention to an experiment it is hoped will pave the way for a wholesale shift in harm reduction.

Councillor Allan Casey, Dr Saket Priyadarshi, associate medical director for alcohol and drug services at NHS Greater Glasgow & Clyde, and Lynn MacDonald, service manager at The Thistle facility. Picture: John Devlin. | John Devlin

In a modest building in a side street off the Gallowgate in Glasgow’s east end, the facility, known as The Thistle, has rendered tangible a progressive, if imperfect, drugs policy that puts public health first. From its wide open rooms and the calm, soothing colours chosen for its walls, it is a space designed first and foremost to prevent people from coming to harm, but its ultimate goal is to not just save lives ravaged by addiction, but rebuild them.

It is evident everywhere in The Thistle’s little details. New users to the service are not grilled at the reception as to their history; they are able to remain anonymous if they choose, with bespoke ‘chat rooms’ designed to help put them at ease and engage in conversation with staff, none of whom wear uniforms. There are no clinics here; instead, there are health rooms, where people can get vaccinations, have any wounds attended to, receive podiatry treatments, and, it is hoped, dentistry services.

There is a clothing store, together with a washing machine, tumble dryer, and shower facilities, but its greatest asset is inarguably The Lounge, a large open plan area designed with the input of people with lived experience of drug misuse. It is a room with little clusters of books and jigsaws, with comfortable couches, a television, and a coffee machine, where service users can arrange meetings not just with nurses, but the likes of housing officers and social workers.

The Lounge area in The Thistle is designed as a space to help people engage with other services. Picture: John Devlin | John Devlin

There is even a small outdoor smoking area, a little green nook with seating and plants where people can go for a cigarette, or simply take a few moments to themselves. The rationale behind its inclusion speaks to how the entire facility was designed with the help of those who have lived with addiction. “If they had to walk out the building and up the road for a cigarette, they’re not turning back around,” explained Lynn McDonald, The Thistle’s passionate service manager. “Everything here is designed to keep people coming back.”

Those who persist in framing drug misuse as a criminal justice issue alone will no doubt balk at the inclusion of such features in a supervised healthcare setting bankrolled by the Scottish Government, but such reactions betray The Thistle’s fundamental purpose. This is unlike anything seen in the NHS before, and it is envisioned as a means of not just preventing drug deaths, but signposting people towards other services.

“Everything is set up to make people feel they are cared for, and to let them know that there are people here who are interested in them,” Ms MacDonald explained. “These people are no different to us. Drug use is just a tiny part of the lives of these people, and there is so much more to them. That’s what we’re trying to get to.”

The booths at the facility feature tilted windows so as to allow specialist nurses to monitor service users and help keep them safe. Picture: John Devlin | John Devlin

When it opens its doors on Monday, the facility will be supporting a population of around 400 to 500 people who inject drugs in public places around Glasgow on a regular basis. Many of them access health services only sporadically, if at all, and Ms MacDonald and her team know it will not work in isolation, especially while wider issues such as a lack of residential rehabilitation beds remain. They also know it will take time to win the trust of prospective service users, not least due to the controversy and stigma surrounding the facility’s inception.

Yet for now, a rare moment of optimism is being nurtured. “It’s wonderful to know that we’ll very soon be able to offer an alternative to people who are injecting in lanes, alleys, car parks, and bin areas,” said Dr Saket Priyadarshi, associate medical director for alcohol and drug services at NHS Greater Glasgow & Clyde. “This is a hygienic, clean, and warm environment with well-trained staff who can support people and provide them with a range of services.

“We think we can improve public health outcomes for the city, improve the health circumstances for individuals, and hopefully save lives. We can respond to people when they have health emergencies or overdoses, and by giving them an opportunity to feel a sense of positivity and hope about the future, we hope that’ll help them move forward.

Dr Saket Priyadarshi said he hoped people using the facility would feel a 'sense of positivity'. Picture: Jane Barlow/PA Wire | PA

The long-awaited opening of The Thistle also closes a chapter on an acrimonious dispute between Holyrood and Westminster. The plans for the facility were first proposed a decade ago in response to an HIV outbreak among injecting drug users, but were repeatedly blocked by the Home Office under the then Conservative government, who argued that such a service would fall foul of the Misuse of Drugs Act 1971.

With drugs policy reserved and under the control of Westminster, the SNP repeatedly argued that its aim of treating drug abuse as a public health issue, as opposed to a criminal justice matter, was being thwarted. It also faced a hurdle in the form of then Lord Advocate James Wolffe, who refused to back the plans.

However, a major breakthrough came in September 2023, Mr Wolffe’s successor, Dorothy Bain KC, said it would not be in the public interest to prosecute users of the facility for simple drug possession offences. It is a position she moved to clarify on Thursday, explaining how The Thistle can allow support services to engage with some of the most vulnerable people in society and “break cycles of harm.”

Allan Casey said the facility wouild not be a 'silver bullet', but stressed it took Glasgow - and Scotland - 'a step in the right direction' to tackling drug deaths. Picture: John Devlin | John Devlin

Not that the team behind the facility are resting on their laurels. A licensing application has already been made to the Home Office to allow for an adjoining drug testing facility to be put in place. Such a step would allow staff to identify and respond to new trends, drugs and harms, such as heroin supplies that are contaminated with highly potent opioids known as nitazenes. There are also ambitions for an indoor inhalation space that would allow people to smoke drugs, instead of injecting them.

“We’ve been campaigning for this for a decade, and my hope, and belief, is that this service will save lives,” said Allan Casey, Glasgow City Council’s convener for addiction services. “It’s not going to be a silver bullet, and it’s not going to change things overnight, but it takes us a step in the right direction.”