CNN
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A radical public health experiment is underway in the quiet corner of Glasgow’s East End. For the first time in the UK, people injecting illegal drugs such as heroin and cocaine can do so in a safe environment and indoors under medical supervision.
There have been no arrests. There is no judgment. There are no questions about where the medicine came from. Only a way to make lethal use less.
The facility, known as thistle, opened in January amid growing political and public health pressures to tackle Scotland’s deepening drug crisis. Scottish health officials say the highest drug-related mortality rate in Europe is sought for a more practical and compassionate response.
Funded by the delegated Scottish government, pilot-safe drug consumption facilities modeled after more than 100 similar sites in Europe and North America, show a significant deviation from the UK’s traditionally punitive approach to illicit drug use.
Dorothy Bain, who heads the Scottish prosecutor’s office and advises the government, told the UK Parliamentary Committee in May that “it would not be in the public interest to prosecute users of safer drug consumption facilities in Glasgow for possession of drugs for personal use.”
She added that this approach will be retained during review to ensure that it does not cause any difficulties, raise the risk of further criminality, or have an illegal impact on the community.
Supporters describe it as a long-standing shift towards harm reduction. Critics warn that there is a risk that the addiction that is not treated and harmful is maintained.
Located in a low-haired clinical building near the city centre, thistle is a space where individuals bring their own medicines, prepare them on-site, and inject them under the careful eyes of trained staff.
This service does not provide substances and does not allow drug sharing between users. Instead, what it offers is clean equipment, medical surveillance, and protected environments for the population that may be used in alleys, public toilets, or dumpster sheds, with risks associated with itself and the wider community.
“We had about 2,500 injections on the facility,” thistle clinical lead, Dr. Saket Priyadarshi, told the CNN team who visited the facility in early June. “This is 2,500 fewer infusions in communities, parks, alleys and parking lots.”
Dr. Saket Priyadarshi talks to CNN about the types of drug use in thistles
Dr. Saket Priyadarshi talks to CNN about the types of drug use in thistles
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All users must register before receiving support and only provide initials and date of birth. Staff will ask which medications are planned to be used and how to do it. And they observe that they are ready to act in an emergency.
“We had to manage more than 30 medical emergency situations within the facility,” Priyadarsi said. “Some of them were severe overdose that would likely lead to death if they didn’t respond right here.”
The nurse will work with the patient to reduce harm as much as possible and advise on injection techniques, equipment and vein placement.
“We’ll spend a bit of time with them, just (and) trying to get the venous finder to work,” said Lynn McDonald, the facility’s service manager.
“People often learn the technique from other people who use it, but that’s not particularly good,” she told CNN. Using devices such as Vein Finders, thistle staff said that “better” injection sites can be highlighted to “reduce harm and make injections safer.”
The Scottish government told CNN that the service already has results from a public health perspective.
“Thistle services are already saving lives through staff’s ability to respond promptly in cases of overdose,” said Neil Gray, Scotland’s Health Secretary. The service “helps people to protect against bloodborne viruses and helps to steal second hand needles from the street,” he said.
Thistles are hardly similar to clinics. There are no fluorescent white light, clinical uniforms, and barren white rooms. Language is also being rethinked. Users are not brought to the “interview room”, but are welcome to the “chat room”.
The space itself is soft and intentional, with books, jigsaws, warm lighting and a cafe-style area where people can sit, drink tea, shower, and wash clothes.
“The whole service is designed with the spirit of feeling a little dignified, a little respectful of people, and bringing them in and welcoming,” McDonald told CNN. “We want them to leave knowing that someone cares about them, and we look forward to seeing them safe and look good again.”
For Margaret Montgomery, whose son Mark began using heroin at the age of 17, thistle presence offers some degree of comfort that he once felt impossible.
I’m now in my 50s and I don’t use the Mark anymore, but it took years to get there.
“My son has been treated, but it seems like six weeks, three months, six months. That’s not enough. There’s no aftercare,” Montgomery told CNN.
She added that she asked her son if he had used thistle “years ago.”
“He said, ‘Yes, they probably used it for the other facilities they have provided there,'” Mark refused to speak to CNN himself, but was pleased that his mother would share his experiences.
For Montgomery, what thistle represents is a grace rather than an approval. “I don’t think kids are taking drugs everywhere,” she said. “You have to have parents sitting there and they go.
Her support is unflinching and practical. She is the chairman of the Family Support Group, who was consulted about thistle.
“I think thistle that happened in Glasgow is the best thing,” she told CNN.
“Ethical and Moral Questions”
Others view the institution as a quiet surrender rather than an act of compassion.
After 27 years of recovery, Annemarie Ward believes that without a clear route to abstinence, harm reduction will become an institutionalized form of maintenance.
“Have we given up trying to help people? Are we trying to keep people addicted now?” she told CNN.
World, from Glasgow, is the CEO of Charity’s Face and Voice, and is the voice of the campaign for better access and treatment choices for those seeking help in addiction, who are calling for better access and treatment.
For ward, the danger is not what thistle does, but it omits: a vision of freedom from dependence. Without it, she argues that the ethics of such facilities are blurred.
“If our entire system is focused on maintaining people’s addiction and not giving them the opportunity to withdraw from that system,” she said.
Thistle “just prolong the pain of addiction,” she said. “If you know someone who is suffering like that, or who loves someone who is suffering like that, you’ll see how inhuman this is actually.”
However, Glasgow City Council says the facility is one chain of a broader strategy.
The council said thistle has not been diverted “from other essential alcohol and drug services in the city,” adding that local governments are “investing heavily in treatment, care and recovery services.”
“Comparing these interventions is useless,” the council said in a statement. “All services are equally important and necessary to ensure that they can support those who need them the most.”
The idea itself is not new.
The world’s first safer drug consumption room opened in Switzerland in 1986. Since then, the model has spread across Europe from Portugal and the Netherlands to Germany, Denmark, Spain, and Canada and New York City.
Thistle, the UK’s first iteration, operates 365 days a year and shares its facilities with its addiction services and social care teams.
As of June, cocaine accounts for 71.9% of the drugs injected inside, with heroin making up an additional 20%. The users are overwhelmingly male. Most have been injected for years. Everything is at risk.
Still, resistance remains. CNN spoke with several people in the area who were worried about the facility’s opening and said it encouraged more drug users to come to the area six months since the opening.
But others told CNN that since the clinic opened, they noticed fewer needles on the ground and fewer discarded drug tools.
Scotland Police Chief Max Shaw told CNN the unit “is aware of the long-standing issues in the area” and “is committed to reducing the harms associated with problematic substance use and addiction.” He added that executives will continue to work with the community to address concerns.
For nurses, doctors and support staff working in the building, the mission remains instant. Provides life-saving support to those in need.
