In the wake of a perpetual international drug issue, the Latin American “War on Drugs” has only increased in intensity – particularly in Colombia, the world’s primary international cocaine supplier, where drug-related influence is historically pervasive. According to the American Journal of Public Health, Colombian drug overdoses have increased by 356% from 2010 to 2021. SIVIGILA, the national public health surveillance system, found similar statistics from the same timeframe, reporting 127,087 substance-use-related overdoses among Colombian people ages 10 and older. These intervals reflect an upward trend in drug overdoses that has been unfolding over the past three decades.

Survey

Additional reports found that Colombian drug overdoses significantly increased in young women between 2018 and 2021. This likely links to the widespread emotional distress prompted by the COVID-19 pandemic and a corresponding increase in prescription administration. According to Think Global Health, many users are transgender (potentially using drugs to serve as an emotional coping mechanism for their social isolation).

In grouping overdoses by substance type, the Committee on National Security Systems administered a Colombian household survey; substances most frequently associated with Colombian overdose were “tranquilizers/sedatives/antidepressants (43%), cannabis (16%), stimulants (16%), alcohol (16%), and opioids (6%),” according to Columbia University. This data neglects to include Colombian drug use among homeless or incarcerated individuals who did not receive the survey.

Colombia’s Response to the Increase in Drug Consumption

In 2022, Colombia became one of 34 countries to implement take-home naloxone programs (used to reverse the repercussions of opioid usage). Later in 2023, Colombia joined 17 other nations in the institutionalization of drug consumption rooms (DCRs), together with international contention over establishing DCRs, which made international government sanctioning difficult to acquire.

These peer-run facilities oversee the safe consumption and injection of illicit drugs, essentially arguing that safe consumption is preferable to any alternative overdose. Facilities provide access to sterile supplies (i.e., syringes), on-site medical personnel, and resources on recovery; employees are either medical personnel or recovered users.

Cambie, the first official Colombian DCR

“Cambie,” which directly translates to the English word “change,” takes action that is intentionally and deeply rooted in the meaning of its name.

Not only is “Cambie” the first safe injection site sanctioned in Colombia, but it is also the first of its kind to exist in all of South America. The facility strictly injects heroin and follows an empathy-based model of care. In its first year, it effectively prevented 14 heroin-based fatalities, according to Think Global Health.

The Process

Upon entering the facility, clients receive a survey that allows Cambie to approximate the client’s safest dosage and injection site; its services are comparable to approximately 200 other international institutions. Based in the Santa Fe neighborhood of Bogóta, Colombia, the institution bolstered 87 clients within its first two years of operation. Resultedly, the surrounding community has experienced a reduction in public heroin use, injection litter, rates of sexually transmitted diseases, and overdose deaths, without experiencing a correlated increase in the frequency of crime or drug use.

Cambie is also spearheading research on injection supplementation; Psychologist and coordinator at Cambie, Daniel Rojas, conducted a study by providing 10 heroin users with hammer pipes, known for their substance-optimizing abilities, Think Global Health reports. The trade-in for hammer pipes welcomes the opportunity for users to manipulate a mechanism less likely to be riddled with contaminants. This may show particular benefits, considering how Cambie’s annual 2025 report indicated that the leading causes of overdose in users were abrupt  “dose escalation,” unawareness of dosage, abrupt post-abstinence use, and “concomitant use with other depressants.”

A Colombian “Good Samaritan” Clause

There is a critical distinction between personal administration and trafficking, the former of which is not reinforced by DCRs. Nonetheless, in an effort to reduce Colombian drug trafficking and overdose frequency, the Colombian 2023 National Drug Policy allocated $49.5 million in assets towards funding of small projects, like injection sites and DCRs.

The approach to drug administration resembles Massachusetts’s “Good Samaritan Clause,” a clause that reduces the stigma and criminalization of underage, by eliminating the risk of persecution when reporting a medical emergency as an indoxicated minor. The ultimate goal – prioritizing the social emphasis on wellbeing rather than indictment.

Conclusion

Harm reduction is not just a form of health intervention, but a safeguard of human rights. Not only do DCR facilities protect critical sanitary needs of drug users, but they also consider the emotional underpinnings of drug use and recognize the drug epidemic as a reflection of systemic inequity in health care access. The government has effectively protected some of its most vulnerable communities by approaching the Colombian drug epidemic through this empathy-based lens.

– Talia Gitlin

Talia is based in Natick, MA, USA and focuses on Good News and Politics for The Borgen Project.

Photo: Flickr