Plans to create a unit in Glasgow for drug addicts to inject under supervision are to be discussed by councillors, police and health leaders.
The scheme aims to tackle drug-related deaths, the spread of infections among users and the amount of needles and injecting equipment left in public areas.
Used in some European cities, the safer consumption facility and treatment service was recommended by the Glasgow City Alcohol and Drug Partnership.
It will involve NHS staff but the location of the centre and its cost are still to be established, although advocates say analysis of other units “have demonstrated their cost effectiveness from a societal perspective”.
Described as “fix rooms” or “shooting galleries” by some, the controversial plan has been considered in other UK cities but not implemented.
However, the scale of public injecting in Glasgow city centre – around 500 people – is said to “justify the introduction of a pilot safer injecting facility”.
It will now be discussed by Glasgow City Integration Joint Board (GCIJB) – made up of councillors, police and health providers – at a meeting on Monday afternoon.
Details of the units are laid out in the agenda for the latest GCIJB meeting, with a report to be discussed saying there is a risk problems will worsen if action is not taken.
A report by Susanne Millar, council chief officer of strategy, planning and commissioning, said: “Lack of implementation of the proposed service development is expected to have a detrimental effect on the health of the people who inject drugs in public places, as well as local communities affected by public injecting.
“As described in ‘Taking away the chaos’, the report whose recommendations form the foundation of these proposals, this population experiences extremely poor health and has been significantly affected by the recent HIV outbreak in Glasgow.
“As well as HIV, Glasgow has been the centre of a number of infectious disease outbreaks among people who inject drugs in recent years, and also experiences a high burden of acute drug-related deaths. Indeed, 2015 saw a 15% increase in drug-related deaths in Glasgow, with the city accounting for almost a quarter of the total Scottish figure.
“Furthermore, there are long-standing concerns from communities and businesses in the city centre and surrounds about the impact of public injecting and drug-related litter, which existing initiatives have been unable to resolve.
“Given the scale and persistence of public injecting in Glasgow, these problems are likely to persist or worsen unless new approaches to harm reduction are considered.
The potential for the HIV outbreak to continue or spread further, including among people without a history of drug use, is particularly concerning.
“The proposed new services offer an evidence-based approach to addressing these risks, supported by experience from a number of other countries over the last three decades.”
A similar facility is being considered by councillors in Dundee but Neil McKeganey, of the Centre for Substance Use Research, said there should be more focus on helping addicts off drugs.
He told BBC Radio’s Good Morning Scotland programme: “For anyone who’s not an advocate of drug decriminalisation, these are controversial and they will be seen as such.
“Some years ago we surveyed over 1,000 drug addicts in Scotland and asked them what they wanted to get from treatment and less than 5% said they wanted help to inject more safely and the overall majority said they wanted help to become drug-free.
“These facilities have a role to play but there is a real danger that we’re moving steadily away from a commitment for services to get addicts off drugs.”
David Liddell, director of the Scottish Drugs Forum, said: “We’re hugely supportive of this proposed development. There’s really a desperate need for such provision, particularly in Glasgow.
“I know it’s been highlighted as controversial but when you see that these have been running in Europe for a very long time, Holland for example has 31 drug consumption rooms and Germany 24, and these are seen as part of the overall provision.”