Call to amend Misuse of Drugs Regulations to make it easier to pilot overdose prevention centres

In the United Kingdom, in 2020, there were 4,517 deaths related to illicit drug use; the highest rate of drug related deaths since records began. It is necessary to provide the full range of evidence-based drug treatment and harm reduction interventions to prevent these deaths.

Overdose prevention centres are healthcare facilities where people consume their own drugs under the supervision of trained staff who intervene in the event of an overdose. These sites are provided in at least 13 countries, but not the UK. International evidence demonstrates they reduce drug related deaths, encourage safer injecting practices to prevent infections and increase engagement with wider drug treatment and support services.

In December 2021, the Faculty of Public Health published an open letter calling for pilot overdose prevention centres in the UK. This call was supported by 84 leading organisations, including Royal Medical Colleges, public health bodies, drug service providers, academic and third sector organisations; and numerous individual signatories.

In response, the Government argued that there is no legal framework to run overdose prevention centres in the UK. Although there is no law which specifically bans such services, offences such as drug possession would be committed within them. Under the Misuse of Drugs Regulations 2001, some acts that would otherwise be controlled by the Misuse of Drugs Act 1971 are already exempt from criminalisation, in order to enable services that reduce harms.

Over the past year, the Drug Science Enhanced Harm Reduction Working Group has been researching the feasibility of setting up pilot overdose prevention centres in the UK. This work has demonstrated there is a clear need for the services in areas with high levels of drug related harm, and cross-agency support for their introduction.

We call on the Government to amend the Misuse of Drugs Regulations 2001 to make it easier to establish pilots of overdose prevention centres. This is an easy step that would not require primary legislation. It would help local agencies to build the evidence base and save lives.

Sign the letter here.

20 June 2022

Academy of Medical Royal Colleges

Academy of Medical Royal Colleges and Faculties in Scotland

Royal College of Anaesthetists

Royal College of General Practitioners

Royal College of Obstetricians and Gynaecologists

Royal College of Pathologists

Royal College of Physicians

Royal College of Physicians and Surgeons of Glasgow

Royal College of Physicians of Edinburgh

Royal College of Psychiatrists

Faculty for Homeless and Inclusion Health

Faculty of Intensive Care Medicine

Faculty of Pharmaceutical Medicine

Faculty of Public Health

Faculty of Public Health Drugs Special Interest Group

Faculty of Sexual and Reproductive Healthcare

Association of Directors of Public Health

British Medical Association (BMA)

British Psychological Society

English Substance Use Commissioners Group

National HIV Nurses Association (NHIVNA)

Royal Pharmaceutical Society

Royal Society for Public Health (RSPH)

All-Party Parliamentary Group for Drug Policy Reform

Drugs, Alcohol & Justice All-Party Parliamentary Group

Green Party

1 Call Care C.I.C

Addiction Professionals

Alcohol Focus Scotland



Blackpool Council

Bristol City Council

Bristol Drugs Project (BDP)

British HIV Association (BHIVA)

British Journal of General Practice

British Viral Hepatitis Group

Build on Belief Ltd

Canadian Drug Policy Coalition

Capital 10X

Cardiff Rapid Access Prescribing Service

Change Grow Live

College of Mental Health Pharmacy

Conservative Drug Policy Reform Group (CDPRG)


Correlation - European Harm Reduction Network


Crew 2000 Scotland

Criminal Justice Alliance

Drug Policy Interdisciplinary Network

Drug Science



European Network of People who Use Drugs (EuroNPUD)

Figure 8 Consultancy Service Ltd

Forward Trust


Fundacja Global Public Health Network

Global Law Enforcement and Public Health Association

Global platform for Drug Consumption Rooms

Harbour Housing

Harm Reduction International

Health Poverty Action




International Drug Policy Consortium (IDPC)

International Network of Drug Consumption Rooms

Kaleidoscope Project


Labour Campaign for Drug Policy Reform

Law Enforcement Action Partnership UK

London Borough of Hackney

London Network of Nurses and Midwives Homelessness Group

Midlands Partnership NHS Foundation Trust

National AIDS Trust

National Needle Exchange Forum

NHS Grampian



Pharmacy Declares

Prisoners' Advice Service

Probation Institute

Project 6


Renaissance UK Ltd

Restorative Thinking

Revolving Doors

School and Public Health Nurses Association

Scottish Drugs Forum


Single Homeless Project

Students for Sensible Drug Policy UK

SUIT (Service User Involvement Team)

The Central Club Podcast

The Connection at St Martin's

The Corbett Network

The Hepatitis C Trust

The Loop

The Queen's Nursing Institute

The Wallich

Transform Drug Policy Foundation

Transform Justice

UCL Collaborative Centre for Inclusion Health

UCL Institute of Epidemiology & Healthcare

University of Bristol Tobacco and Alcohol Research Group

We Are With You

Alan Brown MP

Alison Thewliss MP

Allan Dorans MP

Alyn Smith MP

Caroline Lucas MP

Christine Jardine MP

Colette Stevenson MSP

Crispin Blunt MP, Co-Chair, All-Party Parliamentary Group for Drug Policy Reform

Dave Doogan MP

Dr Philippa Whitford MP

Foysol Choudhury MSP

Gillian Mackay MSP

Gillian Martin MSP, Conveyor of the Health, Social Care and Sport Committee in the Scottish Parliament

Hannah Bardell MP

Jeff Smith MP, Co-Chair, All-Party Parliamentary Group for Drug Policy Reform

Joanna Cherry QC MP, Deputy Chair Joint Committee on Human Rights

Joe FitzPatrick MSP

Maggie Chapman MSP, Scottish Greens Spokesperson on Equalities, Human Rights, Justice and Economy

Marion Fellows MP

Martin Docherty-Hughes MP

Martyn Day MP

Mercedes Villalba MSP

Monica Lennon MSP

Neale Hanvey MP

Patrick Grady MP

Paul McLennan MSP

Paul Sweeney MSP

Pauline McNeill MSP

Peredur Owen Griffiths AS/MS

Rachael Maskell MP

Rhys ab Owen MS

Ronnie Cowan MP

Stuart McDonald MP

Tommy Sheppard MP

Andrew Boff AM, Member of the London Assembly

Caroline Russell AM, Member of the London Assembly

Adam Daniel Hillmann

Adam Waugh, PsyCare U.K. - Welfare and Harm Reduction

Adam Whitehouse, Substance Service Team Leader,  

Aimee Hodgkinson

Alice Gregorie, PhD Student

Alice Wiseman FFPH, Director of Public Health

Alina Louise Kruszyna, Training Officer, Crew2000

Alison Douglas, Chief Executive, Alcohol Focus Scotland

Alison Eadie, Health Psychologist, NHS Tayside

Alison Henderson

Alistair Flowers, Development Manager (Complex Needs), English Substance Use Commissioners Group

Allison Brindley, Assistant Professor

Alyn Smith MP

Amie Frayne

Andrew Garraway, Development Manager, NHS Highland

Andrew Perkins 

Ani Hohmann, Organisation and Development Manager, Build on Belief

Anna Brook, Public Health Specialty Registrar

Anna Lewis, Team leader, Barod

Anna Powell, PhD Student in Psychology and Neuroscience

Anthony Lehane, Policy Consultant, Cranstoun & LCDPR

April Stoneman, Substance Use Health Nurse/Street Nurse, NHS

Arfon Jones, Former Police & Crime Commissioner for North Wales

Ben Corken, Harm Reduction Senior Practicioner, Change Grow Live

Ben Matthew Corken, Harm Reduction Senior Practitioner

Ben Scher, PhD Student, University of Oxford

Bernadette Guthrie, RMN

Beth Costelloe

Blaine Stothard, Writer, Editor and Consultant on Drug Policy

Bograkou Tzanetakou Aikaterini, Scientific Collaborator, School of Medicine, European University Cyprus

Brian Reed, Anyone’s Child

Carla Hobart, Public Health Specialty Registrar

Carla McCaffrey, Social Worker - Harm Reduction

Cassandra Powers, Public Health Specialty Registrar

Cath Hoskins

Catherine Shuttleworth, Public Health Speciality Registrar 

Catriona Watson

Charles Mack, CEO, Cranstoun

Charlotte Percival, Service Manager, Kaleidoscope

Chris Haslam

Chris Paling, Drug Worker 

Chris Rintoul, Service Development and Innovation Advisor, Cranstoun

Claire Chandler, Campaigns & Communications Officer, Kaleidoscope

Clara Anderson, Community Pharmacist

Clara Bale, Family Mediation 

Clare Jackson, Public Health Specialty Registrar

Cllr Elie King, Cabinet Member for Public Health and Communities, Bristol City Council

Cullan Mais, Outreach Worker, Kaleidoscope

Daniel Ahmed, Clinical Partner, Foundations

Daniel Jones, Public Health Specialty Registrar

Daniel Roy Alexander  

Daniel Stewart, Public Health Specialty Registrar

David Badcock, Chief Executive Officer, Drug Science

David James, CRAFT & ITC Family and Friends Meeting Facilitator, Alternat+ves

David Leeman, Public Health Specialty Registrar

Deb Hussey, Harm Reduction Manager, Somerset Drug and Alcohol Service

Dee Cunniffe, Policy Lead London Joint Working Group, London Joint Working Group on Substance Use and Hepatitis C

Denise Rooney

Derek Petrie RMN, Community Mental Health Nurse

Dr Adam Holland, Co-Chair, Faculty of Public Health Drugs Special Interest Group

Dr Alex Armitage, Consultant Paediatrician

Dr Alexander Thomas Boyd Moir

Dr Alison Bedford Russell, Consultant Neonatologist

Dr Alison Potts  

Dr Andrew McAuley, Reader in Public Health, Glasgow Caledonian University

Dr Andrew Turner, Consultant in Public Health, Cheshire East Council

Dr Anna Humphreys, Public Health Specialty Registrar

Dr Arif Rajpura, Director of Public Health, Blackpool Council

Dr Becky Metcalfe, Sexual Health and HIV Consultant, NHS GGC

Dr Cathal Gallagher, Reader in Healthcare Ethics and Law

Dr Charlotte Parbery-Clark

Dr Chris Ford FRCGP

Dr Christine Haigh, Junior Doctor, Swansea Community Drug & Alcohol Team

Dr Christopher J Byrne

Dr Ciaran Kennedy, Academic Clinical Fellow and Public Health Specialty Registrar

Dr Dan Lewer, Public Health Specialty Registrar

Dr Daniel Jones, Public Health Specialty Registrar

Dr David Barr, Infectious Diseases Clinician,  

Dr David Watkin, Public Health Specialty Registrar

Dr Dean Connolly, Central and North West London NHS Foundation Trust

Dr Ellie Messham

Dr Emilia Crighton, FFPH, FRCP, Interim Director of Public Health, NHS Greater Glasgow and Clyde

Dr Emily Crick

Dr Emily Tweed, Clinical Lecturer in Public Health and Honorary Specialty Registrar

Dr Euan Lawson, Editor, BJGP

Dr Fay Dennis, Goldsmiths, University of London

Dr Gabriella Morley, Public Health Specialty Registrar

Dr Gillian W Shorter, Lecturer in Clinical Psychology, Queen's University Belfast

Dr Hannah Barton, Public Health Specialty Registrar

Dr Hannah Carver, University of Stirling

Dr Hannah Maiden, Public Health Specialty Registrar

Dr Helen Zealley, Retired, formerly Director of Public Health, Lothian NHS

Dr James Nicholls, Senior Lecturer in Public Health, University of Stirling

Dr Jamie Fagg, Public Health Specialty Registrar, Royal Free NHS Hospital Trust

Dr Jenny Scott, Senior Lecturer, University of Bath

Dr Jo Kesten, Research Fellow, University of Bristol

Dr Judith Yates, Retired GP, International Doctors for Health based Drug Policies (IDHDP)

Dr Julie Cavanagh

Dr Katharine Whittingham, Associate Professor

Dr Kerry Bailey, Public Health Consultant, Public Health Wales

Dr Lucy Potter, Academic GP, Homeless Health Service and University of Bristol

Dr Magdalena Harris, Associate Professor, London School of Hygiene & Tropical Medicine

Dr Majel McGranahan 

Dr Margaret Douglas, MPH Programme Co-Director, University of Edinburgh

Dr Mark A Aldersley, Consultant Hepatologist

Dr Mark Monaghan, Reader in Criminology and Social Policy, University of Birmingham

Dr Michelle Croston, Associate Professor of Nursing

Dr Miles Mack

Dr Olivia Maynard, Senior Lecturer, Psychological Science, University of Bristol

Dr Peter Murray MB BS, Psychiatry Doctor - Addictions, NHS

Dr Philip Broadbent, Public Health Specialty Registrar

Dr Plinio Ferreira, Research Associate, Imperial College London

Dr Rachel Thomson, Public Health Specialty Registrar

Dr Rosie McNee, Public Health Specialty Registrar

Dr Saket Priyadarshi, Associate Medical Director, NHS GGC Alcohol and Drug Recovery Services

Dr Sally MacVinish, Faculty of Public Health

Dr Sarah Stacey, Clinical Psychologist

Dr Scott Berwick, Specialist Trainee in Anaesthesia, NHS Scotland

Dr Sharon Greenwood, Lecturer in Public Health, University of Glasgow

Dr Simon Ferris

Dr Stefanie Gissing, Public Health Specialty Registrar

Dr Stephen Willott, GP and Clinical Lead, Windmill Practice and Public Health Department, Nottingham City Council - Conference Chair, RCGP Managing Drugs and Alcohol Problems in Primary Care

Dr Steve Glazzard, Alcohol and other drugs worker,  

Dr Suzanne Tang, Public Health Specialty Registrar

Dr Tim Wyatt OBE, FFPH, FRCPath, FRSB., Consultant Microbiologist, NI Public Health Agency

Dr Tom May, Research Fellow, University of Bristol

Dr Tom Yates, Clinical Lecturer in Infectious Disease and General Medicine, University College London

Dr Wulf Livingston, Reader in Social Sciences

Dr Zara Hansen, Public Health Specialty Registrar

Ed Addison

Edward William Davies, Data Scientist

Elwyn Thomas, Co-Production Lead, Kaleidoscope

Emine Jane Omer

Emma Clark, Service Manager, Kaleidoscope

Emma Cookson

Eve MacLeod

Fintan Dominic Smith

Fionnuala Casey

Fran Bury, Public Health Specialty Registrar

Francis Mitchell 

Gabriel Alterman  

Gabriel Stoltz

Gareth Morgan

Georgia Threadgold, Senior Project Manager (Hepatitis C Elimination)

Gilda Nunez, Public Health Lead, Drugs and Alcohol, Local Authority

Greg Cooper, PhD student 

Guy Rainey, Director of Business Development, Change Grow Live

Harri Lloyd-Williams, Public Health Practitioner

Harry Shapiro, Director, DrugWise

Hazel Close, Lead Pharmacist Public Health, NHS Fife

Helen Benson, Public Health Specialty Registrar  

Helen Rodgers, Service Manager St Anne's Harm Reduction Social Support Team, St Anne's Community Services/Forward Leeds

Helen Thompson Jones, Hepatology Clinical Nurse Specialist

Iain Cameron, Manager Harm Reduction Services, Extern

Ian Hamilton, Associate Professor of Addiction, University of York

James Bunn, Head of Operations, Drug Science

James Edmondson, Service Development Manager, Forward Trust

Janet Thompso

Jason Kew (Hon MFPH), Senior Innovative Practice Lead, The Centre For Justice Innovation

Jeanette Ann Walker, Councillor, Middlesbrough Council

Jeanne Mackay

Jeremy Ferris, Anti Social Behaviour Officer, Local Government, Northern Ireland

Joan Brown

Joanne Bramald

John Jolly, CEO

John McLuskey, Associate Professor of Nursing

John Mooney FFPH, Consultant in Public Health, NHS Grampian

Joseph Holloway

Joshua Torrance, Criminology teacher (University level), University of Bristol

Julian Surey

Kadeem Marshall-Oxley, Community organiser, No More Exclusions

Kate Fay, Young Person's Substance Misuse Worker, ROADS - Bristol Drug Service

Kate Halliday, Executive Director, Addiction Professionals

Kate Moss, Business Development Manager, Harbour Housing

Kate Newberry, Senior Housing Intervention Worker, Kaleidoscope

Kate Shethwood, Public Health Specialty Registrar 

Kath Davies, Kaleidoscope

Katherine Watkinson

Keiran ogier, Director of services / Responsible Individual, 1Call Care C.I.C.

Kendra Schneller, Homeless and Inclusion Health Project Lead, The Queen's Nursing Institute

Kerry Littleford, Public Health Specialty Registrar

Kieren Olds, Peer Coordinator, Hepatitis C Trust

Lady Corbett, Founder, The Corbett Network

Laura Roberts, Assertive Outreach Practitioner, Kaleidoscope

Leanne Ellaway, Social Worker, AWP

Leighton Lovell, Peer Champion, Gwent Drug and Alcohol Service

Leila Reid, Director of Corporate Services, The Hepatitis C Trust

Leonie Roberts, Consultant in Public Health

Lesley Parkinson, Restorative Thinking

Lianne Edwards

Lisa Byrne, Changing Futures Surrey / English Substance Use Commissioners Group

Lisa Meredith, Gwent APB

Lisa Rigby, Drop-In Services Coordinator, Crew 2000

Louis Palfreyman

Louisa Chowen, Service Manager for Drug and Alcohol Services Bristol

Lucy Denvir, Consultant in Public Health

Luke Ogden, Helpline Manager, Betsi Cadwaladr University Health Board

Luke O'Neil 

Luke O'Neil, Gwent Drug and Alcohol Service

Maggie Boreham MBPsS, MSc, London, English Substance Misuse Commissioners Group

Maija Sarkkama, Drug Counsellor, Crew2000

Marcus Johnson, Project Co-Ordinator, MBACP

Maria Evans, Substance Misuse Commissioner, Gwent APB

Marisha Wickremsinhe, Research Fellow, London School of Hygiene and Tropical Medicine

Mark Adley

Mark Pearson, Assistant Professor in Mental Health, University of Nottingham

Martin Blakebrough, CEO, Kaleidoscope

Martin Drewry, CEO, Health Poverty Action

Martin White

Mat Southwell, Project Executive, European Network of People who Use Drugs

Matt Jones, Voices Action Change

Matthew Cox

Meg Jones, Director for New Business & Services, Cranstoun

Melanie Kelly

Michael Wakelyn-Green, Drug & Alcohol Recovery Practitioner

Min Na Eii, Acute Medicine Pharmacist

Miriam Swithinbank, Drugs and Alcohol Practitioner /Team Manager (RMN)

Miss Claire Bissett, Forward Trust

Nadine Edey, Housing Intervention Worker, Kaleidoscope

Naomi Miall, Epidemiologist, University of Glasgow

Natalie Dale

Natalie Savery

Ned Aitken

Neil Potter, Harm Reduction Practitioner

Nick Glynn, Senior Program Officer, Open Society Foundations

Nicola Ainsworth, Public Health Specialty Registrar

Nicola Singleton, Former Director of Policy & Research, UK Drug Policy Commission

Paddy Costall, Company Director, Knowledge Action Change

Paula Hymphreys, Housing Intervention Worker, Kaleidoscope

Peter Furlong, National Harm Reduction Lead, Change Grow Live

Peter Krykant, Project Lead, Cranstoun

Philippa Morris, Young Person's Drug/ Criminal Justice Worker, We Are With You

Philippe Bonnet, Chair, National Needle Exchange Forum

Pip Farman, Consultant in Public Health

Prof Al Story, Co-Director, UCL Collaborative Centre for Inclusion Health

Prof Alex Stevens, University of Kent

Prof Andrew Hayward, Director UCL Institute of Epidemiology and Health Care, Co-Director UCL Collaborative Centre for Inclusion Health

Prof Andrew Percy, Professor of Quantitative Criminology, Queen's University Belfast

Prof Anthony David Lane

Prof Charlie Lloyd, University of York

Prof Claire Anderson, President, Royal Pharmaceutical Society

Prof David Nutt, Imperial College London and Drug Science UK

Prof Debra Lapthorne, Retired, formerly Regional Director of Public Health 

Prof Fiona Measham, University of Liverpool & The Loop

Prof Gerry Stimson, Emeritus Professor Imperial College London

Prof Harry Sumnall, Professor in Substance Use

Prof Joanne Neale

Prof Katy Holloway, Professor of Criminology

Prof Lindsay Forbes, Professor of Public Health, University of Kent

Prof Michael Eddleston

Prof Michel Kazatchkine, Member, Global Commission on Drug Policy

Prof Patricia Hudson

Prof Rob Ralphs, Professor of Criminology and Social Policy, Manchester Metropolitan University

Prof Ross Coomber, University of Liverpool

Prof Roy Robertson, Professor of Addiction Medicine and Medical Practitioner, University of Edinburgh

Prof Sue Atkinson CBE MB BChir BSc MA FFPH, Faculty of Public Health

Prof Tessa Parkes, Professor of Substance Use and Inclusion Health, University of Stirling

Prof Toby Seddon, Professor of Social Science, University College London

Rev Cris Watkins, Minister of Religion, S.N.C.D.

Rich Amos, Detox and Aftercare, I.P.E.D lead, Gwent Drug and Alcohol Service

Richard Beastall

Richard Hanford

Rick Stephens, Voices Action Change

Rondine Molinaro, Kaleidoscope Project

Rosemary Jennings, Community Recovery Worker (Drug & Alcohol)  

Roz Gittins, President, College of Mental Health Pharmacy

Ruth Goldsmith

Ruth Merriman, Recovery Worker

Ryan Jarvis LLB (Hons), Founder, CEO & Independent Advocate, Conviction, Criminal Justice Hub, Autism in the CJS

Sally Amor, Public Health Specialist

Samantha Facey, Senior Staff Nurse, Local Hospice

Sarah Dommett, Support Worker, Doorway Project

Sarah Macfarlane, Specialist Pharmacist in Substance Use, NHS Fife

Sarah Peat, Emerging Trends Training Coordinator, Crew 2000

Sarah Perman

Sarra Naylor

Scott Murphy

Scott Rowland, Substance Misuse Outreach Worker, Gwent Drug and Alcohol Service

Sebastien Payan

Selena Gray, Emerita Professor of Public Health

Serena Luchenski, BSc, MSc, FFPH, Clinical Research Fellow and Honorary Consultant Public Health

Simon J Greasley RMN, ENB931, V300, Dip Hyp, Nurse practitioner

Sir Nick Clegg, Member, Global Commission on Drug Policy

Stephanie Rye, Rapid Access Prescribing Service, G4S

Steve Rolles, Transform

Susan Evans, Teacher

Susan Grabt, Homelessness worker

Tessa Vallely, Healthcare Assistant, NHS

Tim Sampey, Chief Executive, Build on Belief

Tom Gilbert

Valerie Little

Vicky Sander, Special Educational Needs Inspector (Retired)

Victoria Cooling, Public Health Specialty Registrar

Violet Carey-Barnes, Criminal Justice Worker

Wayne Gault, Lead Officer, Aberdeenshire Alcohol and Drug Partnership, NHS Grampian

Wendy Taylor, Cranstoun

Zehra Tahtakilic, Substance Misuse Recovery Worker, NHS