Between chaos and care in a harm reduction setting: micro meetings between staff and clients of Danish drug consumption rooms

    Publikation: Konferencebidrag uden forlag/tidsskriftPosterForskningpeer review


    Background: Since 2012 drug consumption rooms have been part of the national Danish drug policy and five drug consumption rooms (DCR) are currently running. The environment in and around drug consumption rooms is often challenging for establish relationships between staff and people who use drugs. DCR clients often face stressful living circumstances, like unstable housing as well as physical and mental health issues. Despite this, the staff establish relationships with clients and build bridge to health care facilities, social services and addiction therapy.
    Aim: The purpose of this study was to illuminate the meetings between staff members and drug users in the drug consumption rooms
    Methods: This national study of the five existing DCRs in Denmark consists of data from 250 hours of participant observation, followed by qualitative interviews with 42 clients and 25 staff members. We coded field notes and interviews using NVivo10 computer software and through analysis themes emerged. We followed ethical guidelines and obtained informed consent from all interviewees. Informational posters about the project were visible in the facilities during the period of data collection. The Danish Data Protection Agency approved our study before data collection.
    Results: Despite the short time and hectic environment, the staff succeeded in establishing relationship through what the researchers coined “micro-meetings”. The micro-meetings facilitated an opening where staff continuously worked to build relationships and met clients in a non-judgmental, accepting and educational approach. Clients expressed feeling safe, socially accepted and seen as human beings. In this setting, between chaos and care, staff established rapport and positive referrals to both health and social sector as well as addiction therapy. Analysis from this study also showed, that DCRs provide a frame for harm reduction services in relation to hygiene, safer injection techniques and prevention of potential overdoses as well as interventions in overdose situations. Furthermore, the clients valued the staff's education and some clients changed habits towards safer drug practice.
    Drug users’ perspectives on DCRs:
    ‘Freedom - from being hunted by the police’
    ‘Security – if I get something too strong’
    ‘It means more safety’
    ‘It works like a safe haven’
    ‘It’s a free space – a capsule’
    ‘It is very pleasant. You can talk to people at eye level without feeling ashamed that you are a drug abuser’
    ‘You get something human, you know eye-to-eye contact. Some of the staffs even know my name. A little smile to the world’
    ‘You get clean needles and you can sit inside in the warmth instead of outside like we used to do’
    'Of huge importance. You get peace and quiet, and you are accepted as you are'
    Establishing trust: Staffs’ perspectives
    “The DCR’s are a fantastic offer. Both in relation to health and social aspects to these highly marginalized people. We can offer something that makes it possible to improve their health just a little bit and give them a room where they have comfort and peace”
    Nurse, DCR

    Micro meetings
    “The relation starts when they enter the door. It’s created by the fact that we have to hand them the needles. I say “Hi” and if I don’t know their name, I ask. That’s the start. The conversation takes off from there.”
    Nurse, DCR
    Publikationsdato16 maj 2017
    StatusUdgivet - 16 maj 2017
    Begivenhed25. th Harm Reduction International Conference: At the hearth of the response - Montreal, Canada
    Varighed: 14 maj 201717 maj 2017


    Konference25. th Harm Reduction International Conference