The Thistle, which opened as a three-year pilot in Calton in Glasgow in January 2025, allows people to take drugs under the supervision of NHS staff.
Upon arrival, users receive a needle, spoon, swabs and advice on injecting technique – an infrared vein scanner is used to help people locate safe injection sites. There are eight mirrored booths, where they can inject their own drugs – mostly cocaine, heroin or both (“snowballing”). Staff check they haven’t overdosed.
Users, for whom the facility offers an alternative to unsafe, unsanitary public spaces, can then move to a recovery area equipped with comfortable chairs. After that, they can visit the lounge area, which has a kitchen, TV and board games, as well as showers and laundry facilities. Here nurses, mental health workers and other staff offer support, from treating wounds to referrals for rehabilitation or housing services.
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Why was The Thistle opened?
The first drug consumption room (DCR) opened in Bern, Switzerland, in 1986. Now, there are more than 100 operating worldwide, mostly in western Europe, Canada and Australia. Such rooms are designed to prevent overdose deaths and the spread of needle-borne diseases; to help connect “hard to reach” users with services that might help them; and to reduce public nuisance (discarded needles, crime, and so on).
Calton, a deprived area of Glasgow’s East End, has a high concentration of homeless drug users. The Thistle was first proposed in 2016 in response to a major HIV outbreak among drug users. By 2018, Scotland had Europe’s highest drug death rate per capita. It still does today, while Glasgow’s rate is more than double the national average.
How is the facility legal?
The Misuse of Drugs Act 1971 makes not just possession of drugs but the supply of drugs paraphernalia an offence; and, though this is a grey area, the occupiers of buildings where drugs are used may also be liable. Holyrood was supportive of The Thistle, but drug laws are reserved to the UK Parliament, and the Home Office was opposed. After a decade of wrangling between Holyrood and Westminster followed, Scotland’s Lord Advocate cleared the way, by issuing a statement that it is not in the public interest to prosecute individuals inside the facility for possession of drugs.
How many people use it?
So far, some 752 individuals have used the service, almost 80% of them male. In its first year, The Thistle made more than 600 referrals to health and social services, and delivered 13,000 care interventions. Seven in ten injections at The Thistle are of cocaine – linked to 52% of Glasgow’s drug-related deaths in 2024.
Demand for the service has risen sharply: monthly visits climbed from 336 in January 2025 to 1,533 in May 2026 – a 356% increase. Overdose figures there rose in tandem: in May 2026, staff responded to 19 overdoses, usually by administering oxygen or the drug naloxone. Yet after more than 13,600 injections, and 186 emergencies, no one has died in the facility (a man died outside in March, in circumstances not yet explained).
So it helps prevent drug deaths?
While a detailed evaluation is ongoing, Scotland’s policing inspectorate has already credited the facility with a “small but significant” reduction in local drug deaths. The research suggests DCRs are effective in this respect. According to the most recent studies, no death has ever been recorded inside one, though tens of thousands of overdoses have occurred. Sydney’s DCR alone has overseen more than 1.35 million injections and responded to over 12,000 overdoses without a single fatality in 25 years. By comparison, one study found that outside DCRs around one in 15 overdoses were fatal, rising to one in eight with heroin.
Advocates stress, however, that The Thistle is “not a silver bullet” for citywide and national issues. Drug deaths in Scotland actually rose in 2025. Public Health Scotland identified an influx in nitazenes, a synthetic opioid much more potent than heroin, as a likely factor.
What do critics of The Thistle say?
DCRs are a “harm reduction” strategy. Opponents argue that they sustain addiction at the expense of rehabilitation. “We have to take out addiction as a norm,” says Dr Carlton Brick of the University of the West of Scotland. “If all we can do is intervene to keep them alive when they overdose, I think that is a problem.” The Thistle is also relatively expensive, with annual running costs of £2.3 million; it spent £5,000 on two needle bins. Critics argue this money could be better spent promoting recovery.
In 2025, its costs worked out at more than £4,000 per person – approaching the £6,000 starting price of a standard 28-day private rehabilitation. The Thistle is also unpopular among some local residents, who argue that it attracts drug users and anti-social behaviour. In its first four months, 175 complaints were made about needles left near the facility, although the council said drug litter found at local hotspots actually fell by 79% between May and November.
Will more DCRs be rolled out?
While the Home Office says it will consider “any evidence” the pilot produces, it has shown little appetite for supporting DCRs. Its longstanding position is that it opposes them, owing to concerns that they break the Misuse of Drugs Act, pose ethical quandaries for medical staff, and could create a “honeypot effect”, attracting drug users to a particular area. Even The Thistle’s fate is itself unclear, and will depend on an independent evaluation, which will continue until late 2029.
In 2024, the last year for which figures have been released, England and Wales recorded their highest rate of drug-related deaths since records began: 63 per million. The EU average is around 25. Scotland’s is still exceptionally high, at 191 per million. The next highest in Europe is Estonia, at 135 per million; the USA’s is around 230.
