This is what it looks like inside a safe injection site in Vancouver, B.C.
This is what it looks like inside a safe injection site in Vancouver, B.C. City of Seattle

King County could become the first region in the nation to open safe drug consumption sites. The sites, recommended by a task force of drug use experts today, would allow people to inject and smoke drugs under medical supervision and offer them access to treatment and other services.

"If this is a strategy that saves lives, if there are people who are going to die if we do not do this," King County Executive Dow Constantine said today, "then regardless of the political discomfort I think it is something we have to move forward with."

This morning at Harborview, the Heroin and Opioid Addiction Task Force, convened by Seattle and King County, presented its recommendations. Those recommendations include a call to open two pilot safe consumption sites called "community health engagement sites," one of them outside Seattle. Importantly, the task force recommends safe consumption sites, not just safe injection sites, meaning users could also smoke drugs at these locations.

"We don't want to push people further along into harm," said Brad Finegood, one of the co-chairs of the task force and the director of the county's Behavioral Health and Recovery Assistant Division. "Once someone starts using an injection needle, their risk for other types of communicable diseases goes up exponentially."

While heroin deaths fell in King County last year, the Seattle Times reports heroin was involved in 132 deaths in the county last year, higher than the 99 in 2013, and that admissions to heroin treatment programs surpassed alcohol admissions for the first time.

North America's only public safe drug use site, Vancouver's Insite, is injection-only, but several European countries have opened sites that allow smoking. Such sites have been shown to decrease the fatality of overdoses without increasing drug use. Advocates who've been pushing for safe consumption sites were happy to see the recommendations today, but careful to say it will take continued pressure to make sure they actually open. VOCAL Washington, the American Civil Liberties Union of Washington, the Public Defender Association, and other groups have formed a coalition promising to push for safe consumption sites. In a statement today, they pointed to efforts in other cities, including San Francisco and Portland to open safe consumption sites, saying there's a "growing consensus about the need for supervised consumption spaces."

Seattle Mayor Ed Murray said today he supports safe consumption sites and pledged to overcome neighborhood "blowback," though he offered no specifics about where a consumption site might be located or when he would begin the process of opening one.

"My experience is that when we [open a sanctioned] homeless encampment, the certain neighbors [who] tend to go sideways on us, that's not the whole neighborhood," Murray said. "Yes, there's angst, yes there's fear, but generally most folks want to find a way to move forward."

Murray said he plans to visit Vancouver's safe injection site. He has also been pushing for federal money to fight the heroin epidemic.

King County Executive Dow Constantine and other local leaders convened the heroin task force earlier this year.
King County Executive Dow Constantine and Mayor Ed Murray are endorsing a task force's recommendation to open safe drug use spaces. HG

Although the safe consumption sites will be the most controversial news announced today, the task force issued several other significant recommendations. The group recommends increasing access to overdose-reversal drugs like Naloxone, including for individual drug users, their social circles, and pharmacies. (The Seattle Police Department is already carrying the drug.) The task force also recommends increased education about the dangers of drug use and a significant increase in on-demand drug treatment—a massive and expensive undertaking that will require money and legal changes to make opening treatment centers easier.

"We know that people who have to wait for treatment are much less likely to engage in treatment," said Finegood. "It needs to be available at any point that somebody with substance use disorder touches, whether that's at the jail, whether that's at a community health clinic whether that's at a behavioral health agency."

The exact costs and next-steps for the recommendations are not clear.

"We spent a lot of time and energy and put a lot of thought into all of these proposals," Shilo Murphy of the People's Harm Reduction Alliance, which runs a needle exchange and also distributes meth pipes, told local politicians today. "We don't want them to die in committee. We don't want them to be forgotten... We've given you a framework to change the game in our community."

Throughout, task force members emphasized the need to treat drug use as a public health issue, a sentiment that is becoming more common as the nation confronts the failure of the war on drugs.

Drug use is "not a moral deficiency and it's not a character flaw," said Finegood, whose brother died of a drug overdose.

"To tell a homeless drug user in the U-District they have to go to south Seattle to get methadone treatment once a day and they don't even have money for bus fare and you expect them to be successful, you're putting them up for failure," Murphy said. "And then you're prosecuting them and punishing them because you didn't give them the tools [to succeed]. And they started using heroin through oxycontin that their doctor prescribed them. So, let's be honest about the brutality of the system."