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The challenges of establishing drug consumption rooms in Helsinki and an evidence-based policy design

According to the latest European Drug Report, the average drug-induced mortality rate among adults in Finland above the European average (53 vs 22 deaths per million) in 2017. Drug consumption rooms are one of the effective intervention tools to reduce overdose deaths and infectious diseases. Helsinki City Council has started an initiative to establish a drug consumption room in the city. This study aims to contribute to the policy transfer process of this intervention. Although the intervention has been already implemented in many countries, policy transfer always requires structural and contextual adjustments. A solution of a country may not fit well to another country’s expectations. Public and stakeholder opinions substantively impact policy decisions and should be considered for the development of harm reduction strategies such as drug consumption rooms. However, little is known in Helsinki, particularly decisions of stakeholders such as the police and government sector. To identify resistances and concerns, a qualitative study will be held by conducting interviews with community stakeholders. Then, the results and outcomes of the previous implementation in other countries will be combined to identify the best evidence-based interventions according to the performance outcomes. The research aims to improve knowledge about the opinions of stakeholders in Finland and to develop an intervention plan tailored for Finnish settings.

Drug consumption rooms (DCR) is a novel harm reduction approach to reach marginalized and isolated people who used drugs, under the high risk of overdose deaths and infectious diseases. This research aims to evaluate the policy evaluation of the Helsinki City initiative for establishing the first DCR in Finland. A qualitative interview research method is used to evaluate the perspectives of stakeholders. By including 23 participants, we analyzed the political, social, and policy level advantages and disadvantages of the current initiative, problematization of DCRs by stakeholders, commonalities, and differences in stakeholders’ perspectives.
Our results show that the cost of DCRs, the COVID-19 burdens on public resources, the requirement of legislative change, public unawareness, potential policy failure of DCRs, and its impacts on electoral votes constitute the main policy barriers whereas an increase in drug-related deaths, economic benefits of DCR on society, its effects on street safety and public order, being a local initiative, prospectus change in national drug strategy plan and motivation to catching EU standards were underlined as policy opportunities. On the other hand, four issues, including leadership, moral perspective, social change and generational differences act as mediating factors, which are fluctuated according to public opinions and political environment.
Moreover, we have identified different solutions which show similarities and important distinctions within the DCR problematization. Since “the problem of drugs is not fixed, but rather malleable and shaped by contextual factors” , the variation of their problematization mostly reflects either their personal preferences or political context. Stakeholders tend to take their positions according to strategic considerations relating to electoral politics, expedience, and the symbolic role of policies. The overall results suggest that DCR discussions need time and more public involvement to introduce this new policy intervention.

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