A task force established to combat a heroin epidemic in the Seattle metropolitan area has endorsed a strategy of establishing places where addicts would be allowed to take drugs without fear of being arrested. At these sites, called safe consumption facilities, addicts would receive clean needles and syringes and would be permitted to inject heroin, smoke crack cocaine and take other addictive drugs under the supervision of trained authorities.
Drugs would not be supplied by the facilities themselves, said Dr. Jeffrey Duchin, the health officer for public health in Seattle and King County and a chairman of the task force. The group was formed in March by the mayor of Seattle, Ed Murray, and the executive of King County, Dow Constantine, in response to increasing heroin use in the region.
Dr. Duchin said the facilities would “serve a marginalized population, those who really have nowhere else to go.”
“They inject publicly and outdoors, they’re homeless and/or unemployed, and basically debilitated by their addiction,” he said.
Dr. Duchin said the facilities could offer a doorway to addiction treatment and primary medical care, as well as reducing addicts’ risk of infections like H.I.V. and hepatitis. Such facilities, he added, could also help decrease the amount of publicly discarded needles.
Neither Mr. Murray nor Mr. Constantine would comment on the endorsement, as the task force’s final report will not be delivered until mid-September. Mr. Murray and Mr. Constantine will then decide whether to follow its recommendations. A spokesman for the Seattle Police Department also declined to comment, saying that the department deferred to the mayor’s office on the subject. The task force’s endorsement was reported this week by The Seattle Times.
Deaths by heroin overdose in King County skyrocketed in 2014, killing 156 people in the county, which includes Seattle, an increase of nearly 60 percent from the year before. Dr. Duchin said that the number of deaths from overdose were similarly high in 2015. The deaths are part of a national crisis of heroin and opioid-related overdoses, which experts have compared to the H.I.V. crisis of the late 1980s and early 1990s. Policy makers in several states, including New York, Maryland and California, are considering the kind of sites recommended by the task force in Seattle. Kathy Lambert, a Republican councilwoman in King County, did not respond to a request for comment on the policy.
Patricia Sully, a lawyer at the Public Defender Association in Seattle and a member of the task force, said that such sites would be “a natural next step” for a city that has had a clean needle exchange program since 1989.
“Once you have a city that’s already adopted syringe exchange and is talking about these things, it makes sense at some point that people say, ‘Hey, maybe if we’re going to give people syringes, maybe we don’t send them out to a dirty alley to use them,’” she said.
The idea is not a new one. Similar facilities have operated for at least a decade in Australia, the Netherlands and Canada. In 2003, a safe-injection site called InSite opened in Vancouver, British Columbia, in response to an overdose epidemic in the city’s Downtown Eastside neighborhood. It was the first such facility in North America.
The sites are typically associated with a broader slate of what are often called “harm reduction” policies, which focus on the mental and physical health of those addicted to drugs and present an alternative to the more punitive policies associated with the war on drugs. Liz Evans, who was the executive director of the nonprofit that operated the InSite facility in Vancouver when it opened, said it was created in response to a citywide acknowledgment that a drug policy that was tougher on addicted people was failing the city.
InSite “countered this whole idea that if we’re just hard on people, they’ll hit rock bottom and they’ll pick themselves up by the bootstraps and they’ll recover,” Ms. Evans said. “The opposite was happening around me every day,” she said. “People were hitting rock bottom, and they were dying.”
While InSite is a supervised injection facility, the task force in Seattle endorsed the idea of a supervised consumption facility, which would also permit drugs that are smoked or consumed orally. Ms. Sully emphasized that a supervised consumption site would help alleviate traditional differences in the way that users of different kinds of drugs have been treated.
“Injection is not the only way that people consume drugs,” she said. “Crack cocaine is predominantly smoked, and crack cocaine enforcement really drove a lot of the racial disparity that we saw in the criminal justice system.”
Dr. Duchin and Ms. Sully said that they expected opponents in Seattle to argue that such sites would enable potential drug abusers and that there could be additional pushback when it came to placing the specific sites. But Dr. Duchin emphasized that such sites had not been associated with increases in drug use and that there was “little to no evidence that they cause increases in crime or public safety problems in the vicinity where they’re located.” He also stressed that the endorsement of such sites was not a “magic bullet” but rather “one piece of a larger, more comprehensive approach to the heroin epidemic.”
He and others said the sites were a potential answer to a problem that required fresh solutions.
“The number of people dying from drug overdoses is greater than the number of people dying from car accidents,” Ms. Evans said. “It’s time to think about different approaches.”
By Jonah Engel Bromwich - The NY Times/Aug. 25, 2016
Photo: David Ryder, reuters
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