A proposed supervised drug consumption site, first recommended by a county task force and opiate addiction almost three years ago, could be downgraded to what county and city officials euphemistically refer to as a “fixed mobile” site—essentially, a large van where drug users could inject heroin and other drugs under medical supervision. The recommendation, which city and county officials discussed during a meeting of the city council’s housing committee yesterday, comes at a time when drug overdoses, particularly those involving drugs that are frequently smoked or inhaled, like meth and other stimulants, are on the rise.
Jeff Sakuma, an advisor to Mayor Jenny Durkan, told committee yesterday that the city and county have failed so far to find an appropriate site for a permanent safe consumption facility in Seattle, and suggested that buying a large medical van—similar to those used for breast cancer screenings and blood drives—would be a more viable, and affordable, alternative. Sakuma estimated that a van would cost the city around $350,000.
The van proposal would likely preclude safe consumption of drugs by means other than injection—a key recommendation of the county’s opiate addiction task force.
Three years ago, the opiate addiction task force made eight recommendations for addressing the heroin and prescription opiate epidemic in King County. Of those, only one—the opening of two safe consumption sites—has failed for three years to get off the ground, thanks largely to community opposition to (and misconceptions about) the idea of safe injection. Several cities around King County, including Bellevue, have preemptively banned the sites, and as city council member Debora Juarez noted yesterday, Seattle still “can’t find a neighborhood or a district that has their arms and hearts open to some degree” to a safe consumption site. “Are we looking for, like, a unicorn here?” Juarez wondered aloud.
Because it could be easily moved from a neighborhood if problems arose, a van would theoretically address some of the public-safety concerns surrounding drug consumption sites. Users would inject drugs inside the van and access more mainstream services, such as medically assisted treatment, addiction counseling, and wound care, in a fixed location next door.
Patricia Sully, a staff attorney for the Public Defender Association and an advocate with the harm reduction group VOCAL-WA, compares the “fixed mobile” model to portable classrooms outside a brick-and-mortar school—the curriculum may be the same, but it’s hard to get the same quality of education in a rickety, temporary building. “A fixed mobile model is predictable, serving one community. People know where to access it and when. [But] it has inherent space limitations. You can’t just have the same service flow that you can in a brick and mortar site,” Sully says. There’s also something inherently sketchy about a van, which inspires images of quick getaways and dodging the law. A permanent location says: We welcome this solution in our neighborhoods. A mobile van, even one parked next to a community clinic, says: We can move this somewhere else at any moment.
“A concern with mobile units is whether they can offer the same level of therapeutic benefit and privacy and integrated services as a fixed site model. When you go to the doctor’s office, it’s a dignified experience,” Sully says. “Hopefully you go into a building, there’s a waiting room, you go back to see your service provider. That’s the kind of experience that all of us are hoping to provide to those who use safe consumption sites—giving people access to hope and dignity, where they’re being with respect and being able to build those relationships that can be transformational.”
One of the longstanding issues with siting a safe consumption site—as opposed to a site strictly for safe injection—is that few elected officials seem to understand the difference. “Safe injection” and “safe consumption” are often used interchangeably, but they are different concepts—compared to safe injection sites, safe consumption sites are considered a harm reduction approach, because they give drug users the opportunity to consume drugs by less risky methods than injecting, such as inhalation. By quietly precluding the concept of safe consumption, at least for the first “fixed mobile” safe injection site, the city would be forgoing the opportunity to do something truly groundbreaking—acknowledging the existence of addiction, and the need to help addicts who may not be ready for treatment, by encouraging drug users to adopt less risky consumption methods. A safe injection site, particularly one located in a van, is a start—as Sully notes, “if it’s in an area where most of the public drug use is injection, then maybe for that first pilot site, [allowing] consumption isn’t as vital of an issue”— but a permanent safe consumption site, like the ones the opiate task force unanimously recommended three years ago, would be potentially revolutionary.