The UK's first unofficial overdose prevention site: what happened in Glasgow

What is it about?

The UK government has repeatedly refused to sanction overdose prevention sites (OPS), citing the Misuse of Drugs Act 1971, despite mounting drug-related deaths and recommendations from multiple expert bodies. In response, a community-led, unsanctioned OPS operated in Glasgow city centre from September 2020 to May 2021, entirely without official permission or funding. This paper describes the operation of the service and analyses data collected on its use across 894 recorded supervised injection events. The service predominantly facilitated powder cocaine injecting, alone or with opioids, reflecting local drug trends that differ from those at many international OPS. The paper documents who used the service, how often, what drugs were used, and how the service operated, providing empirical data on a type of service that had never previously been formally evaluated in a UK context.

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Why is it important?

The Glasgow unsanctioned OPS is a landmark event in UK drug policy: the first time an overdose prevention site operated on UK soil, albeit without legal sanction. Its nine-month operation without any recorded overdose deaths among service users provides direct UK-context proof-of-concept evidence that OPS can function in a British setting and serve a population with distinct drug use patterns. The finding that cocaine rather than opioids dominated the injection profile challenges assumptions that OPS are primarily relevant to heroin users and underlines the importance of tailoring services to local drug markets. The paper provides the empirical foundation that policymakers, public health bodies and legal advocates need when making the case for sanctioned OPS in the UK, and it does so at a moment when the drug-related death crisis in Scotland was the worst in Europe. This led to the opening of the Thistle, the first sanctioned site in the UK. In memory of Peter Krykant.