Disability commission recommends safe consumption sites

Jin-Ah Kim is a recovering opioid addict who only got clean when every single person she knew cut her off.

She detoxed on her brother’s floor, miserable and cold. She doesn’t want other addicts to go through such a painful process to get clean. She’s a member of a small but vocal vanguard trying to get at least one safe consumption site built in King County. The county has approved the funding of two of these sites in its 2017-2018 budget, but that’s far from a sure thing.

Kim is a member of the Seattle Commission for People with Disabilities’ Public Safety Subcommittee, and has used her story both as both a tool to help others and to convince opponents about the need for safe consumption sites in King County. She is running for Shoreline City Council, and if she wins, Kim said she will be the first recovering opioid addict on a city council in the country.

She was raised in a military family in Alaska to Catholic Korean parents.

“I never thought I would be an addict, I was a good kid,” Kim said. “I had a dental surgery and I became addicted to opiates.”

She claims that safe needle exchange sites were the only reason she avoided HIV, hepatitis C or any other intravenously transmitted disease. Despite her own backstory with friends and family, Kim said that safe consumption sites are necessary in Seattle, where someone dies of an opioid overdose every 25 hours. Not every addict has the support system she did.

The public safety subcommittee agreed, and chair Shaun Bickley said that the opioid crisis is one which directly impacts Seattleites with disabilities.

“We’re more susceptible to drug addictions, just as we are more likely to be impacted by poverty,” he said at the subcommittee meeting on Capitol Hill. “Opioids do fall under the purview of public safety.”

Only four members of the subcommittee showed up on a rainy Monday night, and one of those was a non-voting member. All three voting members recommended a motion to approve safe consumption sites in King County.

That motion will go to the full Seattle Commission for People with Disabilities, and -- pending changes to language made there -- will then proceed as a recommendation to the King County Council. The Seattle City Council approved safe consumption sites earlier this year and King County Councilmember Jeanne Kohl-Wells has been fairly supportive of the idea after working with the King County Heroin and Prescription Opiate Addiction Task Force.

A safe consumption site is a centralized location where addicts can go and “safely” consume drugs. They are also sometimes referred to as Community Health Engagement Locations, because they are more than a place to take drugs. Ideally, Kim said, these sites will have social workers, treatment professionals and drug counselors as well as medical professionals on site to revive any users who overdose on what can be incredibly powerful opioids.

“Heroin isn’t heroin anymore,” Kim said. “Normally heroin is cut with other things. The next step up is Dilaudid, which is about 10 times more powerful than morphine. After that is Fentanyl, which is about 100 times stronger. Even more powerful than that is Carfentanil, which was originally marketed as an elephant tranquilizer.”

The safe-consumption sites also might have a way to test the drugs so users can avoid drugs cut with enough synthetic opioid to kill.

Many of these more powerful, cheaper and easier-to-get synthetic opioids are smuggled to the United States from China. A small grain of Carfentanil is more than enough to kill an adult man, so it is incredibly easy to smuggle, Kim said. Many users of heroin are actually using these synthetic opioids and a higher percentage are overdosing. A total of 332 died of overdoses in King County in 2016. To revive an overdosed person, many police departments and hospitals around the country are carrying a nasal spray known as Narcan. The power of these synthetic opiates requires four or five doses of Narcan, meaning even users prepared with one or two doses might still die of an overdose if their drugs are cut with synthetics.

Vancouver, B.C. and Sydney, Australia have had safe consumption sites for years (14 and 16, respectively) and neither site has ever had an overdose death on site.

“Addicts are already going to public places to use, just in case they overdose,” Kim said. “Addicts are already making safe sites of their own.”

Anthony Miceli, a member of the public safety subcommittee and recovering addict, said Washington needs to do more to help addicts.

“I could talk about the efficacy of these safe consumption places, and how people don’t die of overdoses there,” he said. “Addicts who use in the same location survive. Those who have to go to a different place to use don’t.”

Currently, only the Seadrunar center in White Center is a dedicated treatment facility for those addicted to opiates and it has just 16 beds. The Recovery Centers of King County on Seattle’s First Hill closed without any warning in 2015, taking away the 27 beds for treatment it provided.

Miceli said the nearest youth treatment center is in Yakima, making it difficult for King County youths to get any effective treatment close to home.

The sites remain controversial, with state legislators and city governments claiming they will promote drug use and increase overdoses. State Sen. Mark Miloscia, R-Federal Way, tried to pass a bill this legislative session banning the establishment of safe consumption sites in the state of Washington. Initiative 27 has qualified for November’s ballot, but several King County cities have already banned the sites, including Bellevue and Federal Way.

Kim said that in a way, these councils are doing what they think will help addicts.

“A lot of times their whole caring message is not to enable,” she said. “They think that by allowing these sites, more people will do more of these hard drugs. These are not bad people. They want to help addicts, and many of them have friends and family who have been affected by opiates.”

Both Kim and the rest of the public safety subcommittee know they have an uphill battle, but she said that she’s faced a daunting task before.

“You can’t die from opiate withdrawal,” she said. “So you’re always the lowest priority. I never saw the inside of a detox center, and I tried more than once. You’re on the bottom, and sometimes you need help.”