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Amid record spike in overdoses and with money to spend, Seattle and county still working on plan for ‘supervised consumption’

(Image: yestoscs.org)

Supervised drug consumption sites have been a bone of contention in the city for years, but could Seattle see progress this year?

The Seattle City Council included in its 2021 budget $1.12 million specifically for health services for drug users after approving funding earmarked for facilities meant to give space to use opioids or other drugs with medical supervision multiple times in recent years, but that was never spent.

Councilmember Lisa Herbold, who chairs the council’s Public Safety & Human Services Committee, noted that while the council can allocate these funds, it has no power to spend them, a power reserved for the mayor.

“This is really in the hands of the mayor’s office right now,” Herbold told CHS earlier this month. Herbold said she has been involved in conversations with Mayor Jenny Durkan on consumption sites — most recently in December — but Durkan has not made commitments to move forward. At the same time, Durkan has not expressed she wants to reallocate this money against the council’s wishes, so Herbold “remain[s] optimistic.”

Kelsey Nyland, a spokesperson for the mayor, said that the mayor’s office and representatives from the city’s Human Services Department planned to meet with Public Health — Seattle & King County.

“HSD will continue to work with Public Health – Seattle & King County to implement a proposal to expand access to drug treatment and increased services for people experiencing substance use disorders,” Nyland said in an email. She did not have specifics yet on what this might look like, saying that would likely come out of the meeting.

This comes amid a recent spike in overdoses, with the King County Medical Examiner’s Office reporting 42 suspected or confirmed overdose deaths between Dec. 27 and Jan. 9.


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This is the most overdoses in a two-week period ever documented in King County.

Advocates have moved away from pushing for stand-alone safe-injection sites, also known as Community Health Engagement Locations, in favor of a less expensive approach that places similar services inside existing healthcare facilities where people already go for assistance. Under this plan, HSD would contract with PHSKC to work with possible nonprofits that could provide supervised consumption services.

PHSKC spokesperson Sharon Bogan confirmed that specifics on how the money would exactly be used haven’t yet been decided.

The project could still face legal hurdles as well as public backlash. Implementation of a supervised consumption site has been stymied because of possible legal challenges from the Department of Justice. In Philadelphia, an appeals court ruled this month that a local nonprofit’s attempt at a safe consumption site violated federal law.

Both Seattle City Attorney Pete Holmes and King County Prosecuting Attorney Dan Satterberg signed an amicus brief last summer that supported a lower court’s move to not criminalize the nonprofit leading the charge for the site.

Following Trump administration policy, Brian Moran, the U.S. Attorney in Seattle who took office in January 2019, has said that he would not allow the city to open a consumption site. Advocates hope the new approach — putting consumption services within existing facilities — could skirt legal jeopardy because the locations are already serving individuals. Herbold has requested a legal review of this approach by the city attorney’s office, her office said.

At the same time, other large cities in King County, like Bellevue and Renton, have banned the sites.

(Image: yestoscs.org)

In 2016, a heroin and opioid task force convened by top local officials called for the creation of a “three-year pilot project that will include at least two locations where adults with substance-use disorders will have access to on-site services while safely consuming opioids or other substances under the supervision of trained healthcare providers.” Under the plan, one of these sites would be in Seattle and the other in another part of the county. King County Executive Dow Constantine and then-Mayor Ed Murray endorsed the recommendations of the task force.

“In general, Public Health would support approaches that are in line with the Heroin and Prescription Taskforce recommendations,” Bogan said in an email. “Safer use and overdose prevention practices are one piece of that approach.”

Meanwhile, deaths from drug and alcohol poisoning in the county have been rising every year since the task force’s recommendations, with 430 in 2019 and 415 in 2018, PHSKC’s Brad Finegood said during a September city council meeting. Heroin and methamphetamine are more prevalent in overdose deaths in Seattle, while fentanyl has been wreaking havoc in the rest of the county.

One peer-reviewed study found that after a supervised-injection site opened in Vancouver, B.C. in 2003, overdose death rates dropped by 35% in the next two years in the area. An August 2020 letter published in the New England Journal of Medicine noted there were 33 overdoses, but zero deaths in five years at an unsanctioned consumption site in the United States.

“These are life-saving services,” Herbold said. “When you have a loved one or somebody that you care about whose addiction puts their life at risk, your primary concern is that they have services that can help save their lives.”


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caphiller
caphiller
1 month ago

Honest question as I’m not familiar with the research and policies around this. Are those suffering from heroin addiction and living on the street likely to use a “safe injection site”? Why bother going to a site like that when you can shoot up on the sidewalk or in the park as you always have with little consequence?

61stMama
61stMama
1 month ago
Reply to  caphiller

Research shared when SCS were originally recommended by the King County Taskforce stated that people would travel 6 blocks or less. And the sites are not 24/7. So it’s a very expensive and non-scalable solution that has many neighborhood impacts and more overdoses in near vicinity than the data showcases. Also high liability (high potential of lawsuits) and difficult to insure. Seattle/King County could save more lives and do far more with the $$ if they stopped stubbornly clinging to the concept. (For starters, how about way more widespread treatment and follow-up support? How about accessible sobering sites throughout the city?)

caphiller
caphiller
1 month ago
Reply to  61stMama

Thanks. Makes sense. The whole SCS concept didn’t quite pass the smell test for me.

The Geez
The Geez
1 month ago
Reply to  caphiller

To answer the original question, they would go there so they could use safely and not worry about dying. Some people want to believe that opioid addiction makes users into mindless animals, but this is not the case. By and large the people who go to supervised facilities still value their lives, have dignity, and wish for a better future.

Ladybug
Ladybug
1 month ago

The homeless shelter at Bailey Boushay has been a de facto SCS for a while. They only lose the occasional client to overnight exposure in neighborhood parks and doorways.

61stMama
61stMama
1 month ago

Are you aware of the 2020 Alberta report demonstrating negative impacts/outcomes/discrepancies in Canada’s safe consumption site approaches? Strange that it is not mentioned but the very dated 2003 Vancouver study is. https://www.alberta.ca/supervised-consumption-services-review.aspx

CHqueer
CHqueer
1 month ago
Reply to  61stMama

Thank you for the link to a much more current study. The state of the science around safe injection sites has evolved over time based on more data. Unfortunately, the local discussion has not. Rather, it is based on cherry-picking from a 17-yr-old study to prop up an an ideological narrative that we now know is false. It is more of the same from the Seattle City Council. The safe injection site approach only works in societies that also enforce rules and have mandatory treatment for people that are a hazard to themselves and others. In Seattle, it would obviously just increase the flow of drug addicts and dealers into the city from surrounding areas to live in tents in the park near such facilities. The Seattle response to this failure will be to add more safe injection sites, and the downward spiral will continue.

BetterDays
BetterDays
1 month ago
Reply to  61stMama

That report has been widely criticized for being biased and flawed and unable to pass the most basic peer review smell test. Like your comment, the study was a piece of political propaganda.

https://www.cbc.ca/news/canada/edmonton/alberta-s-safe-consumption-review-biased-and-flawed-researcher-says-1.5867053

Will
Will
1 month ago

Please no! Take a walk through Vancouver’s Safe Injection Site (when you can), or just look at the multitude of videos and comments from other city councilers who looked there for hope. Such a concentration of misery, with little focus on treatment.

Moving On
Moving On
1 month ago

Such a perfect encapsulation of where we are as a city.

Let’s take this one highly questionable and controversial idea, turn it into a litmus test, and pretend it’s a comprehensive strategy, meanwhile doing none of the obvious things we could do right now. Who benefits from this approach?

If we want aspirational, how about we adopt the Portugal strategy as a whole? Including both the progressive parts like decriminalization, and the not-so-progressive parts like mandatory registration of drug users, trespassing them from known drug areas, and enforcing quality of life laws?

CHqueer
CHqueer
1 month ago
Reply to  Moving On

I used to take comfort and pride in the fact that Seattle was an educated and progressive city. The rest of the country might be be in the dark ages, but at least we could model a better way forward. Unfortunately, over the last decade, Seattle’s intellectualism and progressivism were replaced with ideological tribalism, purity tests and Anarcho Marxism. Instead of a model of progressive leadership, we have become a dystopian failed state that undermines the progress and values we once championed. The tactics, propaganda, and denial of reality coming from the far left now mirror far right extremism. The goal seems to be an unraveling of society to the point that it leads to a revolution and civil war, not solving problems and lifting people up.

RWK
RWK
1 month ago
Reply to  CHqueer

One recent example of the far-left’s dishonesty/propaganda is their claim (seen on posted flyers on Capitol Hill) that the police welcomed the rioters to the D.C. Capitol on January 6th and facilitated their destructive acts. Nothing could be further from the truth! As is obvious in numerous videos, the outmanned police fought bravely to try and repel the invaders and protect our Congressmen, Senators, and staff. Many were injured and one killed by the rioters.

There is a lack of truth, and an unfortunate trend of violence, at both ends of the political spectrum.

CHqueer
CHqueer
1 month ago
Reply to  Moving On

I agree with adopting the Portuguese model as a whole if it is implemented by the Portuguese rather than the Seattle City Council and anarcho Marxist aid organizations. I recall reading that when the architect of the Portuguese model visited Vancouver, he was very disturbed with the shitshow and made a strong statement distancing himself from Vancouver’s approach of enabling drug use with no rules approach.

In the Know
In the Know
1 month ago

The Institute for Clinical and Economic Review (ICER), a nonprofit independent think tank that assesses (as the name implies) the clinical effectiveness and cost-effectiveness of health care interventions in the US, just published in December their findings on supervised injection facilities. U-Dub researchers did the economic analysis. While it’s correct to say that the evidence in favor of these sites is sparse (given the current illegality in the US… so only a small sample size of mostly Canadian facilities to draw conclusions from), it’s clear that (a) nobody dies at one of these places, (b) there are potentially substantial cost-savings to local health care systems from avoiding expensive ambulance rides and hospitalizations by reversing ODs as they happen, and (c), on net, the benefits outweigh the costs. This is not saying that a person who injects at the site on certain days isn’t going to inject and OD out on the street on another day… but in aggregate from a public health standpoint, it seems to make a lot of sense if we can collectively get over our NIMBY tendencies. Also important to note that access to the sites exposes people who inject drugs to the treatment pathways that some OPs think is the magic bullet here (which it is not… opioid addiction is a powerful hold that is incredibly difficult to beat, even with medication-assisted treatment). In sum, I for one think that they are a compassionate approach that tends to address more problems than they introduce.

antiwokeone
antiwokeone
1 month ago
Reply to  In the Know

Wise fool.

The Geez
The Geez
1 month ago
Reply to  antiwokeone

Says the opinionated poster who’s probably never made a decision that didn’t originate in their gut.

SpareUs
SpareUs
1 month ago
Reply to  In the Know

“Non-profit Independent Think Tank.” LOL. “Independent” and “Non-profit” do not equate to “objective,” “ apolitical,” or “politically neutral.” I understand many people probably do not recognize the purpose of think tanks, but even in traditional academia, there is still this pesky little thing called the Replication Crisis that calls into question the utility of limited research—especially in the social sciences, where controlling variables is next to impossible. It doesn’t help that there is a severe asymmetry in the political affiliations of academics. See Duarte et al, 2014 (I recognize the irony, here). To quote “[L]ack of political diversity can undermine the validity of social psychological science via mechanisms such as the embedding of liberal values into research questions and methods, steering researchers away from important but politically unpalatable research topics, and producing conclusions that mischaracterize liberals and conservatives alike.” Research should not be used as a bludgeon to force through misguided policies. This isn’t college debate class, or even college in general; it’s the real world. You know, the place where a significant contingent of your fellow citizens already lack trust in our institutions and feel unheard. Maybe listen to and appreciate the concerns of those who do not agree with you.

The Geez
The Geez
1 month ago
Reply to  SpareUs

LOL, so what does equate to objective and apolitical? Those descriptors give me more confidence than the alternatives. Also by your logic, nobody should ever research anything ever and all big decisions should be based on how people like you feel, not based on any rigorous process that collects and analyzes available evidence. We can’t rely on the trained research professionals to do their jobs because they’re politically biased. That’s such a solid strategy! Look, researchers rarely if ever make policy decisions. They are in the “business” of providing evidence, information, and expertise. The decision makers may then do what they will with it, and you have a voice in who those decision makers are. So stop painting the good citizens of this country who choose a life of service to truth and evidence simply because many of their conclusions don’t square with YOUR politics. That’s what we’re talking about here.

A.Joy
A.Joy
1 month ago

Don’t knock it till you try it. If it’s saving lives this is a success. At the same time it would be nice to see some reform to not only access to treatment but how it’s run. I could be wrong, but the way I understand (from many years of many friends with this sickness), is a person is generally put through a quick detox period, then a 20-30 day inpatient program (at a high price) where you are supposed to get the “tools” and footing you need to be a sober person. Problem being while treatment places are doing great financially, at the end of 30 days or whatever people are put back out with very little for a safety net if anything. Coming off the streets as a homeless addict becomes a cycle instead of treatment. Yes we need triage treatment (detox centers) but if we are going to put so much funding towards treatment, and I believe we should, we should also be asking for treatment to be an access point to housing, GED and or beginning process to enroll in school or job training program. If people were to get out of treatment with a solid plan that has been started and fostered while in treatment and then had solid access to further therapy (set up in treatment) with a place to call home and a reason to keep working for it, rather than let out at the end of 30 days with a folder full of “resources” and places to contact to obtain a place, and therapy etc…
I think we should try both. Obviously whatever has been being let happen isn’t working.

DSeattle
DSeattle
1 month ago

Question is… the safe injection site saves addicts from overdosed death, but the 17- year old Vancouver study from 2003 did not address what’s the quality of life of those survived the overdose. How many % of the people actually ended sober and got their lives back on track, or the program simply prolonging their suffering and enabling them in the vicious cycle of drug addiction. I would think a mandatory rehab and counseling/job training would be much more humane and compassionate.