In this article, I would like to draw attention to and comment on the potential problems caused by fluorescent blue lights upon the health of injecting drug users.

These lights are perhaps commonplace in many towns and cities throughout the UK (and beyond) and are typically found in public conveniences in settings such as shopping centres/mall, travel stations, cinemas and other socially oriented venues. As many reading this will already be aware these lights have usually been installed with the express purpose of preventing injecting drug use from taking place therein (regardless of any history of such activity) and are considered as a measure for removing the public amenity they provide to injecting drug users by denying access to the temporary sanitation, privacy and semi-protective environments they afford. This is achieved by the electric blue illumination emitted from the lights that problematise vision of all attending such toilets and consequently make the visibility of veins more difficult for injecting drug users (IDU).

However, as many may be less aware, public toilets may provide temporary respite for those experiencing unstable accommodation, long term drug dependency and an urgent need to self-medicate withdrawal symptoms. Accordingly, from a harm reduction perspective, those conveniences fitted with blue lights may be considered as a deliberate attempt to exclude individuals from attending to their immediate health (and hygiene) requirements.

Similarly, during the course of my travels throughout the UK, I have become increasingly aware of limited knowledge amongst the public how these lights are designed to disperse injecting drug users. There is typically recognition that the lights are somehow connected to ‘druggies’ or ‘drugs’ but seemingly little awareness of the way in which they restrict vision of physical injecting sights (i.e. veins).

This is not the case amongst those involved in harm reduction services and especially so amongst service users of needle/syringe programmes. Indeed, there is perhaps widespread acknowledgement amongst both service providers/users regarding the function and design of such lighting.

However, even within these ‘risk-aware’ populations there may also be limited understanding of the way in which IDU may respond to facilities equipped with such lights. In my work on public settings used by IDU, I have considered these particular environments and obtained views and experiences of 31 individuals with knowledge and experience of such settings in one particular UK city. Of these 31 IDU, only 13 stated that blue lights would deter access to such toilets – because they were concerned that they could not see their veins. The majority however (18/31) were not deterred, or only partially deterred, and described various strategies to counter the problematising effect of the blue light intervention. These included:

• Injecting in particular body sites considered more dangerous (eg groin)
• Requesting peer assistance with injection
• Pre-preparing solutes prior to visiting (and complete the process within such toilets)

One individual stated that this was specifically a preferred setting because it was a place where authorities would not expect injecting to take place (and thus felt ‘safer’ from detection and interruption).

It is also interesting to note that those less deterred by blue lights were also IDU with longer injecting careers (typically over 10 years) and felt that they could inject ‘blindfolded’ regardless of the actual environment in which they were placed. This is therefore a ‘skill’ that has been developed as a result of sustained injecting episodes and is skill that can be employed in settings that are designed to minimise, and distort sight and vision. As such, the use of settings equipped with blue lights may be considered as environments that increase particular forms of injecting-related risk taking and those taking such risks are perhaps amplifying the potential for harm and hazard to occur during such episodes.

My stance on these lights are that they are a public health/community safety nuisance – as they not only affect IDU – but also make such public conveniences for all visitors an unpleasant and uncomfortable experience especially for:

• People with epilepsy (or sensitive to strobe-like lighting)
• Those that may be physically disabled
• The elderly and the infirm
• People who already have impaired vision

From a harm reduction perspective, they are perhaps slightly more sinister! In a society that considers itself equitable, ‘fair for all’ and sensitive to the needs of vulnerability, why such lighting that purposefully discriminates and promotes health inequality amongst marginalised populations is considered ‘legitimate’ confounds me. Such lighting also serves to disrupt the harm reduction intervention provided by NSP in simultaneously establishing particular ‘no-go’ and ‘high-risk’ areas for service users that may be experiencing socio-economic hardship and exclusion. That is, in the context of injecting drug use, blue light areas purposely create ‘disabling’ and ‘risk-taking’ environments, and this may be consolidated by the view that they are not necessarily effective amongst longer-term injectors. A more cynical (or possibly sociological) way of considering these lights is to equate them with garlic and holy water! That is, they are perhaps a curious 20th /21st century talisman designed to keep the ‘vampire’ from crossing your door – a way of maintaining social division and keeping the ‘unacceptable/unclean’ body from the more (self-proclaimed) righteous!

*Apologies to Paul Weller and The Style Council for such a shameful mis-appropriation of this song title.