A county in Washington state could embrace heroin injection centers - but not everyone is on board
Posted October 9, 2016
With the heroin epidemic raging across America, a county in Washington state is proposing an effort that is sure to spark controversy: government-run injection centers where people can use the drug under medical supervision.
The goal of the proposed program, according to Dr. Jeff Duchin, health officer of Public Health in Seattle and King County, is to launch a new and experimental tactic for tackling heroin addiction, NPR reported.
A 32-member task force composed of law enforcement, health providers and social service workers recently recommended that officials create two centers, one in Seattle and another in a designation area outside of the city.
Officials are calling these locations "safe-consumption sites" or "community health engagement sites" — places where heroin or opioids could be used under the supervision of a doctor.
"In a nutshell, the idea is not really to give people a place to inject drugs and then go about their lives but really a way that they can inject safely off the street, out of doorways, out of alleyways — hygienic conditions to minimize their risk of infection, such as HIV," Duchin told NPR.
The clinics would also lower users' "risk of overdose" as well as the "stigmatization and social rejection that keeps a lot of these people out of the health care system in the first place," he added.
It's a proposal that comes amid heroin-related deaths in King County, with 99 dying in 2013, 156 in 2014 and 132 in 2015, according to the Seattle Times.
While these clinics would be the first of their kind in the United States, there are similar clinics that have operated in Vancouver, British Columbia, over the past 13 years; those clinics reportedly haven't had any overdoses unfold inside.
A Canadian facility known as InSite was launched in 2003, becoming North America's first injection facility; it now serves 800 people every day, offering needles and allowing for the use of heroin, according to The New York Times.
The clinic says that overdoses have decreased in the nearby area since its creation, with the British Columbia Center for Excellence in HIV/AIDS producing a study that found that people who use such sites are 70 percent less likely to share needles; they are also 30 percent more likely to enter treatment programs.
There's also a clinic called Crosstown, where addicts are given diacetylmorphine hydrochloride — heroin's active ingredient — up to three times a day by nurses; proponents say the program helps people get their lives back on track by stopping them from engaging in risky street behaviors to secure drugs.
As for the proposed program in Washington state, Duchin told NPR that the safe-consumption sites wouldn't give drugs and would only offer health care, including "clean injection equipment" to help prevent the spread of disease.
"Treatment is really the main bottom line that we're trying to promote as the most effective, you know, population-wide intervention," Duchin said. "We want people getting in long-term treatment. And this is just one doorway that we can use to get people into treatment."
He said that the effort offers users a safe place where they can use without fear of arrest, being attacked or other negative ramifications.
But as the Seattle Times noted, there are hurdles to see such a plan come to fruition in Washington state, particularly when it comes to financing the effort and to the illegal nature of substances like heroin.
And while many support heroin injection sites and other related programs, there's also push-back among those who believe these programs are harmful.
San Francisco Mayor Ed Lee, for instance, made it known earlier this year that he opposes such facilities.
"We have a vigorous disagreement over allowing people to inject heroin and meth, to literally destroy their bodies and their minds, in a city-funded shelter, as some have proposed," he told the city's board of supervisors at the time.
Others, too, have stepped into the debate, including John P. Walters, chief operating officer of the Hudson Institute and director of drug control policy under former President George W. Bush, writing in an op-ed for USA Today that "the only 'safe' approach to heroin is not to take it."
Walters argued that, by embracing such clinics, the government is essentially putting users at increased risk, as he said some people simply stay on drugs, with these facilities becoming yet another place where they use.
"Supporting addicts' heroin use maintains their disease, administering the poison that causes their illness and diminishes their lives," he wrote. "A government-approved place for unlimited heroin injection creates the conditions for never-ending addiction and gives government a drug dealer’s power over the addicted."
Calling injection centers "shameful," Walters said that embracing them runs afoul of common sense and is a form of "heartless indifference" to the addicted.
"We do not protect addicts by reviving them from overdose death only to return them to death’s front door, perpetuating the self-destructive cycle of addiction," he wrote.
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