When policy and opportunity meet: Barcelona's first gender responsive shelter for homeless drug users

Abstract

Issue/problem Drug policies in Barcelona have been guided by the Barcelona City Drug Action Plan (PADB). This four-year plan aims to prioritise and evaluate drug policies. The need to have a low-threshold residential resource for homeless people using drugs (HPWUD) is an objective that had been present in successive plans, but unfortunately could not be realised so far. In Spain, the covid-19 pandemic led to a total country lockdown. A great intersectoral coordination effort involving Barcelona City Council and the Public Health Agency of Barcelona together with third sector organisations resulted in the opening of the first gender responsive low-threshold residential resource for HPWUD in Barcelona. Description of the problem Pending a broader evaluation, quantitative indicators are available for 6 months (3 April to 3 October 2021), informing about: How many people were accommodated? What are their profiles? What drugs do they use? How many overdoses were reverted? How many successful discharges? How many people confined/isolated due to covid-19? What are the challenges? Results Preliminary results showed that during first 6 months, 120 people (74 men, 42 women and 4 non-binary) were accommodated. All places reserved for women were covered. About 44% were Spaniards; being opioids and alcohol, the main used in the HPWUD. Thirty overdoses reverted (60% due to stimulants). There were 39 people confined and 2 residents isolated due to covid-19. The challenges are to continue to improve the new alcohol harm reduction program, work on adherence and mainstreaming gender. Lessons Barcelona PADB is instrumental to guide evidence-based interventions to reduce health and social inequalities in highly vulnerable and underserved population. This new gender-responsive residential setting for HPWUD with a comprehensive harm reduction program together with health and social care is unique in Barcelona. Key messages Drug policy to guide evidence-based interventions to reduce health and social inequalities in highly vulnerable and underserved population. First low-threshold gender responsive residential resource for homeless people using drugs has opened in Barcelona.