Benefits and barriers: a rapid-ethnographic study on the perspectives of potential and actual clients of Athens’ drug consumption room

Background
In April 2022, a new Drug Consumption Room (DCR) opened in Athens’ city centre. To date, no qualitative research has evaluated the operational strengths and weaknesses of the site from the viewpoint of people who use drugs locally, including those who use the DCR and those who use in street-based settings who do not access the DCR.

Methods
Rapid-ethnographic fieldwork was conducted over a seven-week period. This comprised an initial five-week period of non-participant observation (≈ 200 h) followed by a community consultation regarding the research design and question protocols. Qualitative data were then collected through five focus groups with 24 regular DCR clients and 25 street-based interviews with non-DCR clients who consume drugs in street-based settings.

Results
Regular DCR clients reported increased physical, structural, and emotional safety and increased connection with auxiliary health and social services and staff and peers. Those who did not use the facility could see potential benefits but noted several operational and contextual barriers including anticipated stigma within the service and contextual and operational barriers.

Conclusion
Addressing DCR barriers could increase service access, reduce the presence and visibility of street-based drug use, and improve public health outcomes for people who use drugs in Athens. Indeed, some of these barriers have been addressed since the research was conducted (e.g. by expanding operating hours, increasing the number of staff with lived experience, offering on-site drug checking), illustrating the value of evaluating DCRs and subsequently adapting design and delivery based on the perspectives of actual and potential clients.