Glasgow is opening the UK’s first sanctioned safer drug consumption facility, and researchers will track every consequence—from overdose rates to discarded needles on the street. This matters because people who inject drugs in the UK face extreme rates of fatal overdose, infection, and homelessness, especially those injecting in public. No UK facility has ever been allowed to let users consume pre-obtained drugs under medical supervision, so there is no domestic evidence on whether such sites reduce harm or create problems for surrounding neighbourhoods. The research team will compare health records and survey data from Glasgow against control areas, measure changes in community safety and drug-related litter, and calculate costs to the health service, criminal justice system, and local economy. If the facility reduces overdose call-outs and risky injecting without increasing crime, the findings could directly determine whether the Glasgow site stays open and whether similar facilities are adopted across the UK—potentially requiring legislative change. Mathematical modelling will also estimate long-term effects on HIV and hepatitis C transmission, helping policymakers decide where to invest next.
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Background The UK s first sanctioned Safer Drug Consumption Facility (SDCF) will open in Glasgow. People who inject drugs (PWID) experience very high morbidity, mortality, homelessness, and imprisonment. Expanding harm reduction through SDCF approaches is of major policy interest to address injecting risk and health harms, particularly among individuals injecting in public places. Aim To evaluate the impact of the UK s first SDCF on health, social, community, environmental, and economic outcomes. Methods Mixed-methods natural experiment study, with strong involvement from stakeholders and co-production with PWID, delivered through five work packages (WPs) running simultaneously. WP0 - Study coordination and integration: A systems map will inform study design and integration of findings across WPs, describing hypothesised pathways through which impacts may arise and considering how different intervention components interact together and with contextual factors. Co-produced plans for research, capacity building, and dissemination will be created. WP1 - Process evaluation: Qualitative interviews with service users, service providers, and stakeholders will explore implementation, users experiences of service engagement, barriers and facilitators to delivery, and the role of context in shaping intervention delivery and outcomes. Quantitative measures of engagement with the SDCF, referral pathways, and adverse events will be captured. WP2 - Impact on health and social outcomes of PWID: Changes in outcomes (overdose-related ambulance call-outs, other drug-related health and social outcomes, injecting risk behaviours, and quality of life) for PWID in Glasgow City pre- and post-SDCF will be assessed using health records and a national bio-behavioural survey, and compared to control areas and according to intensity of intervention exposure. WP3 - Impact on the wider community: Potential adverse or beneficial impacts on the community in which the SDCF is located will be assessed using repeated community surveys to examine trends in community cohesion, wellbeing, and perceptions of safety/crime compared to control areas. Systematic social observation will detect potential changes in the physical environment (e.g. drug-related litter) over time. Repeated focus groups with the local community will explore how perceptions evolve as the intervention becomes embedded. Potential adverse consequences on the local economy will be assessed. WP4 – Economic analysis and epidemiological modelling: Within-study cost-effectiveness and cost-utility analyses will quantify SDCF costs and value health outcomes from a health and social care perspective. A broader cost-consequence analysis will capture impacts on service users and wider community and adopt a societal perspective to quantify costs and benefits holistically (including criminal justice, housing market, and local economy). Mathematical modelling will estimate the potential long-term impacts on a range of health harms (e.g. non-fatal and fatal overdose, HIV and hepatitis C transmission) to enable a lifetime cost-utility analysis. The modelling will also consider the potential impact of implementing SDCF models in other UK settings. Timelines for Delivery 4.5 years, with WP0-WP3 running throughout and WP4 active in the last three years. Anticipated Impact and Dissemination Findings will directly determine whether the Glasgow SDCF is continued, as well as inform the adoption of similar interventions throughout the UK (including if legislative change is warranted) and generate multiple major scientific outputs.
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