The plan to help drug users avoid overdosing by letting them shoot up at a supervised site is failing because nobody wants it in their neighborhood (especially if there’s only one). Here’s a way around that.
Recently I was moderating a debate between Seattle political candidates when the loaded subject of government-run, heroin-injection sites came up.
Basically everyone in Seattle politics supports what the Europeans bluntly call “fix rooms,” and what we are calling “community health engagement centers.” Either way, they are places where addicts can shoot up in supervised settings instead of out in alleys or under bridges or, yes, in suburban bedrooms.
I decided at the debate to try to pin the mayoral candidates down on an even hotter-button issue. Fine, you all support this. But where should we put it?
“Well, what neighborhood do you live in, Danny?” responded Jenny Durkan.
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That was a joke (I think.) But I’m highlighting it here because it’s a joke that reveals an awkward truth about our progressive town: Everybody expresses support for social experiments like this, but that doesn’t mean people want it on their block.
I pressed on. Seriously, I asked, where are you going to put a facility where 500 drug addicts a day come to shoot up?
Candidate Cary Moon would only say that she’d hold an inclusive-listening process to help pick a site. Durkan hinted there were two neighborhoods in particular she had in mind. But she refused to name them.
I get it: It’s not in any politician’s interest to get too honest in the final weeks of a campaign. But in case people haven’t noticed, this innovative attempt to be the first region in America to start treating drug addiction like a public-health issue, rather than a criminal one, is dying before it even starts.
So maybe a little more straight talk is in order?
Essentially it’s dead already outside Seattle. The plan was to try to open two injection sites, one in the suburbs. But the suburban cities killed that off pronto. The Top Five cities for overdose deaths after Seattle all voted to bar any injection sites (they are, in order of most deaths, Auburn, Kent, Renton, Federal Way and Bellevue, and Kent’s ban is for six months.)
Inside the city, the chances are better. But opening just a single injection site in a county of 2 million people is putting enormous pressure on that one community. At Vancouver, B.C.’s, injection site, it’s estimated that up to 20 percent of the 500-plus users a day come from outside the city. Again, what neighborhood is going to sign up for that?
Our mayoral candidates won’t say. Which is about all the answer you need.
The political system is so bollixed up on this that last month a church nonprofit in the University District announced it may launch its own private-injection site. So it’s possible the government’s timidity and dysfunction will indirectly cause the sites to spread willy-nilly.
What to do instead? Here’s my simple idea to re-energize this stale debate: Let’s put the injection sites at hospitals instead.
Think about it: We already have more than a dozen sites, our major hospitals, that are staffed with doctors and nurses who are familiar with injection and even treat overdosed addicts in emergency rooms. The sites are scattered around the county yet easy to get to. Not only does this make sense in terms of delivering health care to addicts — which is the whole point — but the hospitals are high-volume, 24-hour operations already. So adding “fix rooms” would scarcely be noticeable from a land-use perspective.
It could start at the public hospitals, which are also geographically spread around the region.
I didn’t think of this (all of my best ideas are stolen). I first saw it in a Bellevue letter-to-the-editor from R. Francis Crerand, who is the former head of Providence Health Systems. Then I ran across an Op-Ed in The New York Times from a doctor, titled “Let Opioid Users Inject in Hospitals.”
He noted that his fellow doctors are not going to be easy to convince either, but it’s “a new world in health care as America grapples with an epidemic of opioid drug abuse.”
A new world demands new thinking. This week Seattle argued in court that this is such an emergency-level health crisis that even voters shouldn’t have any say over injection sites. Well if that’s the case, where better to tackle a health crisis than the hospital?
Correction: A previous version of this story misidentified the government that argued in court that voters shouldn’t have any say over injection sites. It was Seattle.