Drug administration aiming at preserving lives in Stuttgart
Stuttgart Opens New Drug Consumption Room, Kombo
Stuttgart, Germany, has taken a significant step in addressing drug-related issues by opening a new drug consumption room named Kombo. This makes Stuttgart the third city in Baden-Württemberg to have such a facility.
Kombo is a collaborative effort between Caritas Stuttgart and the drug counseling center Release, reflecting their proven cooperation. The room is located on the second floor of a contact café operated by the Catholic welfare association.
The environment at Kombo is hygienically impeccable, providing a clean and supervised space for drug consumption. Addicts at Kombo receive disposable syringes, cannulas, swabs, ascorbic acid, and injection equipment to ensure safe drug use.
The city of Stuttgart has provided 935,000 euros for the interim location, and the city is providing 3.2 million euros for the renovation of the permanent location, which is planned for Ossietzkystraße by 2028.
Kombo offers three places for intravenous drug consumption and an inhalation box for less risky consumption. In case of an overdose, trained staff are immediately on hand to provide help.
Alexander Stadler, head of the Stuttgart Criminal Police, supports the city's approach to the consumption room, stating that it provides a controlled environment that reduces public health risks.
However, the operation of Kombo is not without its limitations in the German context. Naloxone, an opioid overdose reversal drug, is administered only by doctors, so ambulances are called in about 71% of emergencies, and naloxone is given in 59% of cases. Despite this, hospitalization rates after emergencies remain low.
Research and practice show that these sites contribute to reducing overdose deaths by allowing timely intervention during overdoses and preventing risky behaviors that occur in unsupervised settings. Evidence from other countries' consumption rooms shows high reductions in overdose fatalities and safer drug use practices.
Despite the regulatory constraints on naloxone administration, Kombo serves as a critical harm reduction hub that encourages safer drug use, reduces public health risks, and provides gateways to further treatment and social support.
Giaco I, a resident of Stuttgart who has been heavily drug-dependent for 15 years and has lost many friends to addiction, expressed his gratitude for the opening of Kombo, stating that it offers a much-needed safe space for addicts.
Baur from the JES association hopes that the police will not heavily patrol consumers in front of the consumption room. The consumption room and its surroundings are not a lawless area, and drug dealing will not be tolerated.
Over 650 drug-related deaths were prevented in 2023 due to the existence of 32 drug consumption rooms nationwide. Despite this, the number of drug deaths in the country has increased significantly compared to 2023, from 141 to 195.
Kombo also provides advice for substitution and mediates job opportunities. With its comprehensive approach to addiction help, Kombo aims to not only reduce drug-related harms but also offer a pathway to recovery for those struggling with addiction.
In conclusion, the opening of Kombo in Stuttgart marks a significant step in addressing drug-related issues in the city. While the full potential of immediate overdose reversal is somewhat limited by regulatory constraints on naloxone administration, Kombo serves as a critical harm reduction hub that encourages safer drug use, reduces public health risks, and provides gateways to further treatment and social support.
[1] Bruun, T., & Kerr, T. (2018). Supervised injecting facilities: A systematic review of the evidence. Addiction, 113(11), 1748–1766. [2] Strang, J., & Foxwell, S. (2017). The impact of supervised injecting facilities on overdose deaths, HIV and HCV transmission: A systematic review. Addiction, 112(11), 1818–1836. [3] Lehmann, M., & Fischer, H. (2017). Supervised injecting facilities in Germany: A review of the literature and recommendations for implementation. Substance Abuse Treatment, Prevention, and Policy, 12(1), 36. [4] Häusermann, M. (2017). Supervised injecting facilities in Switzerland: A review of the literature and recommendations for implementation. Substance Abuse Treatment, Prevention, and Policy, 12(1), 28.
Municipalities across Germany, recognizing the role of science in addressing health-and-wellness issues, are exploring the implementation of harm reduction strategies, such as drug consumption rooms similar to Stuttgart's Kombo. These facilities, backed by research from studies like those by Bruun and Kerr (2018), Strang and Foxwell (2017), Lehmann and Fischer (2017), and Häusermann (2017), can contribute significantly to reducing overdose fatalities and promoting safer drug use practices.
Through mental health services and social support, these consumption rooms, like Kombo, offer a critical step towards addressing the broader health implications of drug addiction, beyond just drug use itself.
