Skyrocketing opioid usage indicates that as a society, we are failing some of our most vulnerable citizens. On January 7, 2017, four people overdosed on heroin in Seattle. The outcomes might have been different if the users had designated someone sober to watch over them. Seattle Police Department spokesman Sergeant Sean Whitcomb said, “From a practical standpoint, if you have to use, if you’re going to use, don’t do it alone — and don’t have the other person get high at the same time.” This is sound advice, but it is not a workable solution in a state that reported 1,094 deaths from overdose in 2015, an increase of over 10 percent from the prior year, according to the CDC.
There is a radical and promising solution that is being seriously considered by King County – the creation of safe injection facilities which offer users both a medically supervised option for shooting up and access to treatment options. This would be the first such facility to open in the United States. It would save lives and offer treatment and rehabilitation options, too.
Such facilities already exist in other countries. Germany, the Netherlands and Switzerland have created safe injection facilities as part of a pragmatic approach to protecting users and the general public. As a result, Switzerland and Germany experienced declines in HIV infection. Australia is likewise experimenting with such a facility. Safe injection facilities have been operating in Vancouver, B.C. for over a decade, offering clean supplies for shooting up as well as access to social services. It is no surprise that the King County Heroin and Addiction Task Force, formed nearly a year ago to determine how to help solve the heroin epidemic, concluded that two such facilities should open in King County.
Intravenous drug use impacts drug users, families and communities. For the users, injection-related infections, overdose and transmission of blood borne diseases like AIDS pose very real risks. For communities, discarded needles, violence, property crime and sex trade seem to follow heroin addiction. Safe infection facilities could reduce overdose deaths, eliminate many of the needles that litter alleys and decrease the emergency medical costs for addicts.
The main impediments to creation of such facilities are monetary and legal. The cost, however, would be offset by cost savings in emergency responders and police officers. The spread of HIV, Hepatitis B and Hepatitis C would likely fall. And if any state can lead the way for such facilities, Washington can. Needle exchange programs initially faced similar challenges, but they have proven to be successful.
King County distributes about 19,000 needles a day, according to Dr. Caleb Banta-Green from the University of Washington. According to Public Health Watch, needle exchanges have saved cities millions of dollars. In a recent study published in the scientific journal AIDS and Behavior, George Washington University Professor Monica Ruiz found that although the Washington D.C. needle exchange program costs $650,000 per year, the lifetime cost to care for an HIV patient is $380,000. Ruiz determined that the needle exchange prevented 120 heroin users from contracting AIDS, for a savings of $44 million. Even more significantly, needle exchange programs allow those wanting to get help the option of obtaining references from medical professionals about drug addiction treatment options. Safe injection sites are likely to reap similar rewards.
Seattle City Councilwoman Sally Bashaw offered to pilot two such facilities, one in the Lake City neighborhood and one in Belltown. The Seattle Times Editorial Board and the task force endorsed such facilities. Public health experts, King County Executive Dow Constantine and Seattle Mayor Ed Murray have each expressed support for safe injection spaces.
However, safe injections facilities remain controversial, and finding a location with agreeable neighbors may prove problematic. Opponents argue that enabling illegal and addictive behavior to continue will only exacerbate the problem. Moreover, people are concerned that such a facility would be the first step to decriminalizing heroin and de-stigmatizing its use, which are dangerous for a drug having significant adverse effects. As Bellevue College student Nora Xue said, “Heroin is medically damaging. It’s not safe, no matter what.”
There is seemingly unanimous consent about one point – the current approach to heroin addiction and use is not working. A problem exists. If the idea of providing heroin users with a place to shoot up sounds radical, consider that people are already injecting heroin and other illegal drugs, in alleys and parks across our cities. King County did not choose to be a place where people inject heroin. It can, however, choose to be the place where safe and supervised sites offer human beings the right to clean facilities and information about treatment options. It’s certainly worth a try.