Remembering the victims of drug abuse

"A lot of the people I used to know are now dead," said Gonzo, a very slim man with watery eyes and tidy clothes. When he spoke, it was easy to pick up a Hamburg accent. Gonzo himself has been using drugs since the age of 16. Today, he's 55.

He was sitting in what is part of a so-called consumption room in Hamburg. The name of the project — Abrigado — translates from Spanish as "sheltered." It's a space where people who need drugs — mostly heroin and cocaine — can consume them in a clinically clean environment.

They can also take a shower, get any wounds treated by a health care worker or grab something to eat and drink. What's more, they can link up with a social worker who will accompany them on one of those visits to local government offices that can be so distressing.

Herman and Oli are on staff, and part of their job is to get things prepared for the afternoon when up to four people at a time can take the drugs they've brought with them. On this day, Oli was washing the spoons that had been soaked in a disinfectant solution overnight, while Herman prepared the sealed syringes, alcohol swabs and Band-Aids.

After a short staff meeting, the doors opened at around 1:30 p.m. Dozens of people were already waiting in the yard. Some disappeared quickly into the room where they are allowed to consume their drugs. Most people come here regularly and know the rules: First, put on a mask, then get signed in, and, if the room is full, wait patiently for your turn. 

Gonzo was among the first to turn up. Not surprising, given that he's been coming to Abrigado since it was founded 28 years ago. "I'd probably be dead if this place had never existed. I'd have been in some filthy backyard brewing up my heroin. I never used to clean my hands. Or use disinfectant. But here, they make sure you do. They keep an eye on what you're up to," he told DW.

More and more drug deaths

The number of drug-related deaths in Germany rose for the fourth year in a row in 2021, a total of 1,826 men and women. The main lethal drugs were heroin and opioids.

"These numbers make me very sad. They're shocking. And they make it very clear that we can't just go on as before in our policies on drugs," said Burkhard Blienert, the government's narcotics commissioner.

It's a problem that is far from uniquely German. For years, the United States has also been plagued by an opioid crisis, in which one life is lost to an overdose every five minutes. 

At Abrigado this year, the first months of spring — March and April — were particularly distressing. Users prefer to call each other "guests," and the social workers create a book of condolences for each "guest" who dies. "The problem was, we couldn't keep up: the books were just lying there. It was awful," said Oli. "Really tough," Herman agreed.

Each year, the community marks International Drug Users' Remembrance Day on July 21. A grief speaker delivers a funeral address, and guests and staff lay down stones bearing the names of those who have died.

Ready for emergencies

So far, there have not been any fatalities inside the rooms that make up Abrigado. It has always proved possible to avoid the worst emergencies by employing trained staff and rehearsed strategies, and making sure that crucial equipment such as pulse monitors and ventilators are on hand. 

"The first emergencies I experienced really pushed me to my limits," remembered Herman. "Now I know what I need to do because I've been there before. So, I know I can find a solution."

But the fatalities that take place outside the project can't be prevented, a real burden for the two men. Oli recalled the death of the first person he took care of after becoming a qualified social worker. "It hit me really hard. I can still feel it," he said.

His colleague Herman put it like this: "A person you've been involved with on a more or less daily basis suddenly becomes just another case in a file." Often, the social workers only find out what's happened to someone through other guests, he said. They might not know how they died, or where they are buried.

A different approach?

It's often said that stricter drug policies lead to more deaths, but it's not that straightforward. That was made clear in a recent fact-checking report by the Bavarian broadcaster Bayerischer Rundfunk, which found that strict laws do not necessarily mean more deaths. However, it also concluded that more liberal laws and easier access to support systems could indirectly save lives — and did.

Heino Stöver from the Institute of Addiction Research in Frankfurt is an expert on addiction prevention. He advocates policies that do not criminalize small-scale drug use.

"In Germany, we have on the one side very permissive policies on alcohol and tobacco. Very liberal I would say. Very unregulated. But then there's the other side. And when it comes to illegal drugs, we are very repressive. This divided approach is to be found right at the heart of Germany's drug policies," Stöver told DW.

While consumers of small quantities of cannabis could find themselves confronted with the full force of the law, there was no strategy for tackling mainstream drugs such as tobacco and alcohol, he said. "Each year, an estimated 127,000 deaths are linked to tobacco and some 74,000 deaths are due to alcohol. And they, too, are drug deaths," he said.

But maybe change is coming. A new government came into office in 2021 and the legalization of cannabis is on its agenda. Pilot projects are probing the impact of naloxone, a nasal spray that can stop a heroin overdose with immediate effect.

Meanwhile, in a trial phase, street drugs are being evaluated in some consumption rooms to verify their declared purity. The new government does appear to be open to rethinking drug policies and moving away from the mere criminalization of users. However, the conservative Christian Democrats remain critical, saying that cannabis poses a danger and arguing that legalization will open the way for harder drugs.

Keeping memories alive

The social workers at Abrigado welcome the changes. "I'm optimistic," said Oli, while still deploring the lack of funding for projects such as his own and others.

Abrigado doesn't try to convince the guests in its consumption room to choose a life without drugs, he explained. "And if someone does pass away — be it due to an overdose or because of long-term consumption — then the team doesn't see it as their personal failure to get that person off drugs before it was too late. Instead, they see it as another sad story: someone has died and gone from among us. And I believe that should be one's first thought."

Nevertheless, both Oli and Hermann insist the "guests" are well aware that their lifestyle can lead to an early death. Gonzo, too, sees people around him dying. People he has known for many years.

"I know that I'm not going to live to 90," he said, adding that he would use this year's memorial ceremony to remember those who had died of drug abuse. It was only a couple of months ago that he had found an old friend dead in his bed. He still doesn't know what the exact cause of death was. Or where he lies buried.

This article was originally written in German

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