January 19, 2017

Seattle: Supervised Injection sites get OK from King County health board

Drug Consumption Room Insite

The King County Board of Health endorses supervised injection sites for drug users, a strategy to reduce overdose deaths. A final decision on the sites, which would be the first of their kind in the nation, is expected soon.

King County is moving closer to opening at least two public sites where drug users can inject heroin under supervision.

The county’s Board of Health voted unanimously Thursday to endorse the sites, which would be the first of their kind in the nation.

A task force, made up of experts on heroin and opioid abuse, recommended the supervised injection sites in September, as a way to reduce the wave of overdose deaths that has wracked Seattle and King County in recent years. 

Thursday’s vote is an endorsement of the task force’s recommendations — which go beyond the injection sites, calling for increased opioid treatment and prevention programs — but it does not represent a final decision.

Seattle Mayor Ed Murray and King County Executive Dow Constantine are expected to weigh in with a decision on the sites in the next several weeks.

Both have supported the sites in the past.

Murray said he’d support them if they could be established “in a way that reduces the negative impacts” on neighborhoods, and Constantine said he’d be supportive “regardless of the political discomfort” if the sites saved lives.

No specific locations have been publicly identified.

Seattle City Councilmember Sally Bagshaw, who voted for the sites, was hesitant when asked if she would like to see one in her downtown district.

“I wouldn’t be adverse to it, but I’m not declaring there’s a site available,” she said in an interview after Thursday’s vote.

Supporters say the sites would reduce overdose deaths and public drug use, meaning fewer used needles littering sidewalks. The sites also would be a place where users could access health care, long-term treatment and other social services.

The sites were endorsed by King County Prosecuting Attorney Dan Satterberg, who said that health care, not criminal justice, should play the primary role in addressing the opioid crisis.

He compared the debate over the injection sites to the decades-old debate over needle-exchange programs. Needle exchanges, which initially sparked much controversy, have been effective in reducing the transmission of HIV and other infectious diseases, if not in reducing drug use.

Courtney Large, a public health student at the University of Washington and a volunteer at a Seattle needle exchange, spoke in the public comment period before the vote, which was dominated by supporters of the injection sites.

“We give people clean needles and then send them into alleyways to overdose,” Large said.

King County Councilmember Jeanne Kohl-Welles cited her 97-year-old mother who became addicted to prescription painkillers before she died, and her 26-year-old nephew who died of a heroin overdose last year.

“People are doing it anyway,” she said. “What’s the solution? To ignore it? Is the solution to pretend it doesn’t happen?”

Although no such sites exist in the United States, Vancouver, B.C., has had one since 2003. Drug users come to get clean needles and inject in a safe, supervised environment. The sites have naloxone — a drug that reverses the deadly effects of opioid overdoses — on hand. It is used multiple times a day and is credited with preventing nearly 5,000 overdoses at the site in Vancouver.

But the site has not stopped overdose deaths outside its walls. There were 914 overdose deaths in British Columbia, which has about double the population of King County, in 2016. That’s a record number, one largely driven by the rise of fentanyl, a powerful synthetic painkiller that is as much as 100 times more powerful than morphine.

Heroin overdoses killed 132 people in King County in 2015. The death toll rises to 209 when overdoses from prescription opioids — which are, molecularly, virtually identical to heroin — are included.

The task force recommended at least two injection sites in King County — one in Seattle and another outside the city. The sites would be a three-year pilot project and would collect data on things like how many drug users go on to seek treatment. No funding source has been identified.

Opponents say the sites encourage and enable drug abuse.

Gretchen Taylor, with the Neighborhood Safety Alliance, told the board that money would be better spent on increasing access to naloxone, rather than the injection sites.

“Funding of consumption takes away millions of dollars that could provide treatment,” Taylor said.

State Sen. Mark Miloscia, a Federal Way Republican, introduced a bill this week to ban supervised injection sites.

In addition to the safe injection sites, the task force also called for expanding drug- treatment programs, increasing access to naloxone and increasing access to opioid- treatment drugs like Suboxone.

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