The King County Board of Health, on Thursday, Jan. 19, unanimously approved a final report by the Heroin and Prescription Opiate Addiction Task Force.
The 101-page report released last September is filled with recommendations for curbing the drug crisis here, including a pilot program for at least two safe drug consumption sites, which has been the most contentious proposal to come from the task force.
These Community Health Engagement Locations (commonly abbreviated as “CHEL sites”), also sometimes called safe consumption/injection sites, exist in several parts of Europe and in Australia, with Insite in Vancouver, British Columbia, being the first and currently the only such facility in North America.
CHELs provide places for people suffering from addiction to safely use drugs under supervision, and are also places where people can be connected to treatment programs and other social services. People can discard of syringes and also receive medical attention should they accidentally overdose.
The task force report recommends two CHEL sites be piloted, one outside of Seattle.
Residents speaking in opposition to the CHEL pilot ahead of the health board vote on Jan. 19 said they do support increased funding for heroin and opioid addiction treatment.
Gretchen Taylor with the Neighborhood Safety Alliance of Seattle said funding CHEL sites would take away money for drug treatment, encouraging the county focus on that, as well as increasing the availability of naloxone, a medication used to block the effects of opioids.
The Seattle Police Department has made a point to announce every time naloxone is used by an officer during an overdose incident since an initiative started last March to equip 60 bike officers with the medication. Researchers at the University of Washington are working with SPD to analyze information gained from this program.
Seattle resident Elizabeth Krenke said she does not support Community Health Engagement Locations in Lake City and Belltown — a proposal made last year by Seattle City Councilmember and BOH Commissioner Sally Bagshaw — as she believes they will attract addicts and drug dealers there and also cause a spike in property crimes.
King County Sheriff John Urquhart supports the creation of safe consumption sites, as does County Prosecutor Dan Satterberg.
“I want you to know that in this drug crisis, unlike the response to crack cocaine in the 80’s and 90’s, that I believe that the criminal justice system should not take a primary role,” Satterberg wrote to the health board in a statement read to commissioners by Mark Larson, chief deputy prosecutor in the criminal division and a task force member, “ and that instead we should follow the lead of public health professionals. I pledge the support of my office to the Task Force recommendations, including the establishment of a safe consumption site for drug users.”
There were 229 heroin and prescription overdose deaths in King County in 2015. Heroin succeeded prescription opioids as the primary cause of opioid overdose deaths in 2013, according to the task force report. “Increases in heroin deaths from 2013 to 2014 were seen in all four regions of the County, with a total increase from 99 to 156,” the report states.
Public Health-Seattle & King County chief health officer Dr. Jeff Duchin told the health board during its third and final briefing on the task force report that there are more than 20,000 people injecting in King County.
Patricia Sully with the Public Defenders Association and coordinator for the Washington chapter of Voices of Community Activist Leaders (VOCAL-WA) said all of the task force recommendations combined form a comprehensive plan for addressing the heroin and opioid crisis.
“They’re a public health response to a public health problem,” Sully said.
The task force report states another case for safe consumption sites is the number of published evaluations of SCSs that not only show a reduction in overdose deaths, but behaviors that cause HIV and hepatitis C infection, such as sharing needles and other supplies.
Seattle LGBTQ Commission member Hannah Johnson told the health board said too many members of the LGBTQ community have been lost to HIV infection and overdose.
“We deserve safe consumption sites for our loved one,” said Johnson, who is also the sibling of a meth addict.
University of Washington public health student Courtney Large, who also volunteers at a needle exchange, said implementing the practice in King County back in 1989 helped reduce HIV infections, but not drug overdoses.
“We give them clean needles to take into alleys and inject and often overdose and die,” she said, adding there have been zero overdose death in safe consumption spaces.
Capitol Hill resident, recovering addict and VOCAL-WA advocate Tony Radovich said he has benefited from harm-reduction programs in Seattle, and that just offering treatment isn’t the answer.
“Recovery often happens incrementally,” he said, “it doesn’t just magically happen.”
He added when needle exchanges were first proposed, there were concerns about them similar to comments made about safe consumption sites.
“And now it is a practice that is nationwide,” he said.
A mental health and substance abuse professional speaking in support of safe consumption sites said she has a child attending Lowell Elementary in Capitol Hill, which has had an issue with dirty needles. A troubled city-owned pathway crossing the Lowell campus remains closed, the Seattle Department of Transportation missing a November target date for addressing the issue further. The Capitol Hill Times is still waiting for SDOT chief of staff Genesee Adkins to return its calls for an update on this effort.
Addressing the heroin and opioid crisis in King County was particularly personal for Brad Finegood, assistant division director of Behavioral Health and Recovery at the King County Department of Community and Human Services, and Health Commissioner Jeanne Kohl-Welles.
Finegood, whose brother died from a drug overdose 12 years ago, explained through tears that he wore his brother’s tie for the occasion.
The co-chairman for the task force, Finegood said almost all of the recommendations were approved unanimously, except for expanding the availability of naloxone and CHELs. Naloxone had one dissenting vote, he said, and CHELs had three.
Finegood said someone recently asked him if he would have supported his brother using a Community Health Engagement Location.
“My answer to him was, ‘I would give anything to have him alive today - absolutely.’”
Kohl-Welles said growing up she thought of the addicted as deviants. Then her mother became addicted to fentanyl and oxycontin, she said.
“We didn’t know what was happening, and eventually we put it all together,” Kohl-Welles said, “and it was very scary.”
Her mother, who died at 97, was weaned off the drugs by a doctor, Kohl-Welles said. Another relative died from a heroin overdose last year.
Heroin is problem in her Belltown neighborhood, she said, all the way to Shoreline. Kohl-Welles said she was ready to pass the task force report and being the piloting of two CHEL sites, adding they will be carefully monitored and subject to changes.
“I would much rather know that those who have addiction issues have a place in Belltown,” she said. “It’s fine if it keeps them from having to use in public and we don’t have dirty needles lying around and we’re providing help.”
No sites have been selected for the CHEL pilot, and cost assessments will be conducted prior to moving forward with establishing those facilities, Duchin said.
• Eighty-seven dropboxes for King County residents wanting to get rid of their unwanted or expired medications came online Jan. 17, with 13 more scheduled for installation. This work was done by the MED-Project, a stewardship organization representing 378 drug companies, according to a King County Board of Health staff report.
BOH passed a rule in 2013 that such a program be funded by drug producers making sales in King County. ReturnMeds LLC was another approved stewardship plan, but it dropped out last April.
Participating locations include 17 law enforcement offices, 29 medical clinics (13 Group Health sites) and 37 retail pharmacies, with QFC accounting for 20 of those.