The waiting area is bright, airy, welcoming, and – on a freezing January day – warm.
The only giveaway for the building’s unusual purpose a reception desk festooned with leaflets like ‘What are nitazenes?’ (answer: a highly potent form of synthetic opioid) and ‘Know the score: legal highs’.
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The facility, officially known as The Thistle, is located 10 minutes east of Glasgow city centre in Hunter Street.
It has been a decade in the making but will finally open on Monday, January 13, with the goal of reducing fatal overdoses and drug-related harm at a time when Scotland’s drug deaths are by far the worst in Europe, increasing more than five-fold from 319 in 2003 to 1,172 in 2023.
A report eight years ago estimated there were around 400-500 high risk drug users injecting in Glasgow city centre.
Not all of them will come to the Thistle, but service manager Lynn MacDonald said excitement is building.
She said: “Everybody is already talking about it. The feedback we’re getting is that people can’t wait.
“Initially I think we thought there would be a really slow trickle. The reality is I think we’re going to be busy really quickly.
“If you look at services like this internationally, once they’re established they can see 200 people a day sometimes.
“Once it opens, the onus is on us to make sure people get a really warm welcome and that it’s a really valuable service for them, so that they then spread the word.”
Service manager Lynn MacDonald said she expects the facility to be busy soon after it opens (Image: Gordon Terris/Herald&Times) While drug users will not be “pushed” towards recovery services, anyone wanting to quit can be helped to apply for services such as an NHS-funded rehab bed for which there is usually a waiting list of several weeks.
The objective, said Ms MacDonald, is to “save lives”, although she cautions that it is unlikely to have an overnight impact on the drug death statistics.
She said: “The reality is it’s a small service in Glasgow compared to the whole of Scotland, so it will have a limited impact on those wider figures.
“You hear people talk about this as an ‘overdose prevention service’. It’s not – people will overdose in this building – but what it will do is prevent those becoming fatal overdoses.
“But it will also stop people catching HIV, it’ll stop people dying of sepsis because they’re wounds are so infected, and it’ll keep people out of hospital.”
A tray containing the free equipment which will be provided to drug users to ensure they can inject safely and hygienically (Image: GordonTerris/Herald&Times) At the core of the building is the much-hyped consumption room, where drug users will be able to self-administer the illicit drugs they bring with them – such as cocaine or heroin – under the supervision of nurses.
Each of the eight mirrored booths is wheelchair accessible and comes complete with a sharps disposal bin and a tray stocked with a clean needle, syringe, acid, antiseptic swabs, water and a spoon.
Overdoses are expected – the facility is equipped with crash mats, oxygen, and treatment rooms – but in a population with complex co-morbidities other medical emergencies, such as cardiac arrests, respiratory problems, or diabetic complications, are likely to be almost as frequent.
From the consumption booths, drug users will move to a recovery area where their blood pressure, oxygen levels and pulse rate can be monitored, before exiting through to the lounge.
In the kitchen, they can access hot drinks or snacks such as cereal or cup-a-soup, or relax with books and jigsaws in the seating area.
The Thistle is located around 10 minutes walk from Glasgow City Centre, in Hunter Street, in the east end (Image: GordonTerris/Herald&Times) It is also seen as a space for “opportunistic healthcare” – checking whether people are up to date on vaccinations – or putting them into contact with third sector organisations, such as homelessness or mental health charities, who are partnering with the facility.
An outdoor smoking area – for cigarettes only – is available, as well as showers, a clothing store, and washing machines and tumble dryers where clothes can be laundered.
Councillor Allan Casey, Glasgow city’s convener for drug and alcohol policy, is keen to see the facility retrofitted with an “inhalation space” where drug users can smoke substances such as cannabis or crack cocaine.
Councillor Allan Casey wants to see an inhalation area and drug checking service added to the facility (Image: GordonTerris/Herald&Times) The latter is increasingly being cited in toxicology reports as one of the main drivers behind fatal overdoses, but Scotland’s indoor smoking ban means The Thistle would require a special exemption from the law.
Mr Casey said “positive” talks are ongoing with the Scottish Government.
He added: “When we’ve been speaking to our partner cities, one of the key learnings is that an inhalation space is really vital to the work that they do.
“People who are using their spaces are both injecting and smoking drugs. Here, people will have to leave the service to go and smoke drugs.
“For me, if you’re really promoting harm reduction then moving people from injection to inhalation reduces harm dramatically, because it gets people into a safer way of taking drugs.
“It’s fundamental to what we need to do next.”
The lounge area in The Thistle, which includes a seating area, television, books, and a kitchen (Image: GordonTerris/Herald&Times) In addition, The Thistle is seeking licensing from the Home Office to create on-site drug testing so that substances can be analysed for signs of contamination or dangerous potency levels, or just to verify that it is what it purports to be.
This is “absolutely vital”, said Mr Casey.
He said: “If we are able to monitor what people are taking, we can give real-time harm reduction advice.
“But actually, if there’s dangerous and potent drugs on the market, we can also put out an alert to the wider community to help keep them safe, because a lot of people will be injecting at home.”
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Saket Priyadarshi, NHS Greater Glasgow and Clyde’s associate medical director, said the pilot – which is funded with £2.3 million from the Scottish Government for year one – will also have wider benefits for the NHS in the form of reduced ambulance callouts and hospital admissions.
He said: “We know that the population we’re going to be working with have very high rates of drug-related harm.
“They’re hotspots for ambulance callouts, and really difficult wound infections.
“We have a number of hospital presentations and admissions, and operations, in relation to wounds. At the extreme end, amputations, but even a stay in hospital for intravenous antibiotics is expensive.
“And the lifelong treatment for HIV is so expensive that even preventing a few HIV infections a year is enough to justify the cost of this service.”