Urban environments provide numerous concealed settings that may be used on a regular and frequent basis for the injection of illicit drugs. In addition to general public amenity (car parks, stairwells, toilets) these places may include derelict buildings, marginal wasteland and squats. Each of these latter examples may be typically used and frequented almost exclusively by injecting drug users who may consider such places as providing temporary safety and sufficient privacy to administer drugs without detection/interruption. When such places are made known to the relevant authorities they are typically subject to some form of sanction (closure, eviction, demolition, clearance, blocked, screened and/or fenced) that prevents further access.
However, such reactive responses may be criticised for failing to consider the needs and rationale of those frequenting such places and the physical consequences of such punitive action. One such outcome is that public injecting continues to take place beyond the site of closure and possibly in yet more marginalised, more concealed and more claustrophobic, unhygienic conditions. Further, those injecting in such places are typically some of our most vulnerable members of society experiencing a wide range of social problems and dependency issues, and consequently have to ‘seek out’ alternative injecting sites. To make matters more complicated, the state’s left hand provides the means to inject (via needle and syringe programmes) whilst the heavy right hand smashes the street-based settings of public injecting (via clearance etc). As such, harm reduction intervention is problematised and made more difficult for vulnerable people to actually apply.
There is perhaps a need to further consider the way in which such concealed sites of injecting are more appropriately ‘managed’ by authorities; in a manner that considers both public health of the community concerned and the individual health concerns of affected injecting drug users. One such consideration may involve a complementary, proactive response to the inevitable reactive response of closure and sanction? For example, following the imminent closure of a given location used for injecting purposes, the following procedures may be considered as exemplars to reduce the harmful effects caused by and/or associated with displacement:
There is nothing radical or subversive in any of these suggestions. Each suggestion listed above currently exists as standard practice within existing local policy and procedures with regard to other issues (which may/not be drug-related). Instead, these suggestions have been ‘resituated’ within the context of public injecting in which the needs of vulnerable people and the potentially harmful effects of displacement have been more ‘considered’.
Stephen is a Research Fellow at the National Addiction Centre at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London. His most notable ethnographic work relates to a multi-site study of street-based injecting drug, drug-related litter and associated harm and hazard from the perspectives of people who inject drugs and frontline staff who encounter such issues in their daily employment. The views expressed in this article are those of the author and do not necessarily reflect those of his employer.