Above the metal booths, the rules hang stark and simple: do not inject others, do not sell or share psychoactive substances, do not bring firearms. Christian Camilo Amaya leans against one of the cubicles, his leather jacket covered in studs and badges, a skull pierced by a syringe inked on his left arm.
“I started taking cocaine in 2014, when a US punk band toured in Medellín. Back then I didn’t know anything about the risks,” he says. “Later it became a dependency.”
Before long, Amaya was injecting on Colombia’s streets – until June 2023, when Latin America’s first supervised drug consumption room opened in Bogotá.
“I was in a dangerous place, sharing needles,” the 34-year-old says. “But when this place opened, we could get clean needles, we could get information. Now I haven’t needed the room in a year.”
Eighty-eight people are registered at the centre, known as Cambie, Spanish for “Change”. Its location is discreet: a plain, unmarked building with an entrance tucked behind a black metal gate. Its manager, Daniel Rojas, says the first objective is to “avoid and reduce the number of deaths”, and the second to “take it out of the streets, so the children don’t see how people inject.”
I meet Amaya and Rojas on the sidelines of the Harm Reduction International conference, a forum showcasing the latest drug policy research. This year’s event marked the first in Latin America in three decades, and coincided with leftist president Gustavo Petro’s push to overhaul the UN-led global drug regime.
“Colombia has suffered the most from prohibition,” says Julián Quintero, director of Acción Técnica Social, a civil society organisation that runs the consumption room. “We have experienced the failure of fumigation, the failure of extradition, of war, of imprisonment, of substitution, and nothing has been able to stop the increase in cultivation, processing and consumption.”
He adds that a “world without drugs is impossible… We have to learn to live with them. The most powerful drug pandemic in 150 years is not being solved by going after Mexican drug traffickers or imposing tariffs on China. It is being solved by community-based harm reduction coming from the bottom up,” he says.
Colombia, the world’s largest cocaine cultivator, has long suffered from the US-led “war on drugs”. Critics at the conference argue that it has always targeted users rather than prioritising public health, punishing the poorest and most vulnerable. And they say it has failed: there is more production, consumption and trafficking than ever.
While Colombia was an early pioneer of decriminalisation – allowing possession of up to one gram of cocaine and 20 grams of cannabis for personal use since 1994 – Petro’s pro-reform government has gone further.
In October, the president launched a 10-year national drug policy aiming to shift the narrative around psychoactive substances. The plan focuses on rural development, reducing coca crops, and helping small farmers transition to the legal economy – and it explicitly incorporates harm reduction.
In March, his government also led a resolution at the UN commission on narcotics, calling for reforms to the 60-year-old drug control system. Laura Gil, Colombia’s ambassador-at-large for global drug policy, tells me at the conference: “We need a more pragmatic and realistic approach to drugs.”
Each booth at the Cambie centre contains a red needle-disposal bin, mirrors so staff can monitor for overdoses, and posters with instructions on how to inject. A nurse, Betty García, is also always on site to treat users, offer guidance, and administer naloxone in the event of an overdose. Rojas says they have now gone one year without one.
But most important, according to Sam Rivera, the executive-director of OnPoint – a nonprofit organisation in New York City that also runs supervised consumption rooms – is that users form a “community” when using the centres. “They talk to each other, they use less, they decide they want to stop,” he says. “It creates safety for their family. The people who are trained to respond to an overdose are there. These centres literally slow down the use.”
Harriet Barber is a freelance journalist covering human rights abuses, migration, women’s rights and politics in South America
