King County has been providing alcohol, tobacco, and, until two weeks ago, cannabis products to some patients with diagnosed or potential COVID-19 infections who are staying at the county’s isolation/quarantine and assessment/recovery sites, The C is for Crank has learned. These sites serve people who are homeless or who cannot isolate safely at home.

The program, which is not funded through public dollars, is similar to efforts in other cities, including San Francisco, to enable patients who have tested positive for COVID-19 or have been exposed to the virus to remain isolated safely while mitigating or preventing withdrawal symptoms.

“Limited and controlled quantities of alcohol and nicotine have been provided by the health and behavioral health clinicians on site as part of clinical management of withdrawal symptoms and harm reduction practices to support patients to safely stay in isolation,” Department of Human and Community Services spokeswoman Sherry Hamilton says. “In all cases, this clinical review and approval for a requested item is required.”

While programs like King County’s have been controversial in other cities, they are based in the principles of harm reduction, a set of strategies at reducing the negative consequences of drug and alcohol use. Other examples of harm reduction include methadone clinics, needle exchanges, and the Downtown Emergency Service Center’s 1811 Eastlake project—not to mention things like nicotine gum and marijuana as an alternative to heroin.

Hamilton did not say how many people had received alcohol, nicotine, and cannabis products, but said that the department’s director, Leo Flor, has been paying for these items out of his own pocket while the county secures “private foundation funding as a more sustainable approach to funding moving forward.” It’s illegal to spend public funds on alcohol, tobacco, or marijuana. Hamilton was not able to immediately provide details about how much these “initial harm reduction supplies” had cost.

Providing people with substances they would otherwise seek out makes it easier to keep people from spreading COVID-19 in the community surrounding the county’s quarantine and isolation sites, and makes it more likely that people will stay at those sites for their entire isolation period instead of leaving against medical advice. In the case of alcohol, it also may be saving lives—for heavy, daily drinkers, withdrawing from alcohol without specialized medical intervention can cause seizures, heart failure, and death.

“For those who cannot do so, or who do not have a home, the County has created isolation and recovery sites,” Hamilton said. “We try to keep guests safe, stable and comfortable so they will stay the entire time, and harm reduction is one strategy that helps to achieve that goal for some of our guests.”

I have asked for more details about funding for this program, including how much DCHS director Flor has spent out of his own pocket, and will update this post when I learn more.