06/10/18 Seattle Safe Consumption

Century of Lies
Doug McVay
Drug War Facts

This week we hear an update on efforts by King County/Seattle, Washington, to establish a safe consumption space in response to the opioid overdose crisis.

Audio file



JUNE 10, 2018

DEAN BECKER: The failure of drug war is glaringly obvious to judges, cops, wardens, prosecutors, and millions more now calling for decriminalization, legalization, the end of prohibition. Let us investigate the Century Of Lies.

DOUG MCVAY: Welcome to Century Of Lies. I'm your host Doug McVay, editor of DrugWarFacts.org.

On June Seventh, the Seattle City Council's Housing, Health, Energy and Workers' Rights Committee got an update on the Heroin and Prescription Opiate Addiction Task Force recommendations. Loyal listeners may recall that way back in September of 2016, that task force recommended that Seattle and King County set up community health engagement locations, a fine euphemism for a safe consumption space or supervised injection facility.

The person testifying is Jeff Sakuma from the mayor's office, he's a member of that task force. Nearly two years later and they are still talking about it. You know, rather than me rant, let's just get straight to it.

JEFF SAKUMA: As has been mentioned, overdose deaths continue to rise, that the recommendations, and I think that this is a really important piece from the task force are being implemented, and that we are expanding our prevention work and our treatment work. And something that I would point out is, even though those -- the recommendations did come out twenty months ago, part of that was that we really needed, in order to move the CHEL work forward if you will, that we really needed to be very, sort of, clear about our commitment to expanding treatment.

So, that is part of the timeline in this, is to really make sure that people understand that there are treatment options open, so that when we do open a CHEL, that people who choose to move into treatment, we can get them into that treatment rapidly.

SALLY BAGSHAW: Jeff, thank you so much, and I'm, again, thankful to you and Brad Finegood and the others that were on the opioid task force. Now, when you were here last time, I think Brad mentioned that there are over 40 treatment facilities available where people can go and get access to buprenorphine. Can you talk about, as you're going through this, how those differ from what you're talking about?

JEFF SAKUMA: Sure. I think -- yeah. So, we've got, obviously, Brad isn't here today, and he's the one that has the expertise on the very specifics, and he did sort of talk about them last time that he was here, but I will kind of just review sort of the numbers again, if you will.

And also, just as a reminder, I know that every time we -- that we speak to this issue, that there are new people who are sort of watching and listening, and so to also remind everyone that the task force made eight different recommendations in the prevention, treatment, and user health areas, and that a Community Health Engagement Location was one of those recommendations, and this is all part of a really important package.

So this gets to what you were just talking about, Councilmember Bagshaw, and that is what's been happening in terms of treatment and user health expansion in King County.

And again, I think that Brad and Doctor Duchin sort of did talk about this last time that they were here, and that in 2017, that there was the new detox facility that was opened up on Beacon Hill, a very important piece of the treatment system, that there are 40 new access points for buprenorphine, that there are ten new outpatient treatment on demand agencies providing services to people in our county, and this is county data, we don't break it down sort of by -- we can get the city-specific, but this is county data.

And then really importantly that we have put out, you know, 8700 naloxone kits in the community, which also help to prevent overdoses in our community.

So, I kind of want to kind of get to the headline here around Community Health Engagement Locations. As you know, the last time we had a discussion, we did -- part of it was the presentation of the SLI [Statement of Legislative Intent], where we did outline sort of what we had looked at it in terms of options for a Community Health Engagement Location, and along with that we sort of outlined the potential costs for those, each of those options.

So, the work that we have been doing really has been looking at a couple of those options that had us looking internally, if you will, to city and county owned properties, that when we began to look at all the various options that we realized that the city doesn't own a lot of buildings, if you will, and the buildings that we do own oftentimes are community centers or park-related centers, and obviously those would not be appropriate types of building sites.

So we have kind of exhausted what we have looked at, and determined that there wasn't anything truly viable to move forward if we wanted to move forward sort of quickly, if you will.

TERESA MOSQUEDA: And, Jeff, on this issue of location, when you say none available or appropriate, I think the appropriate piece is really important to emphasize. You know, we just talked about some of the community conversations that we have across the city, but really when we think about appropriate locations, it's not going to be somewhere in district five, perhaps, it's going to be in an area where we're already seeing high rates of overdose and death.

And so when you looked at locations, I assume you were really looking at locations that were accessible directly in areas where people are frankly already using, and we're trying to prevent deaths and use outside. Is that correct?

JEFF SAKUMA: That's correct. So we were really focusing on the overdose and overdose response data that we have, both from, obviously from the county, and as to location of a death outside, as well as the SFT [Secure File Transfer] data around sort of response to overdoses outside. And then again, the outside piece is really important just because we understand that a Community Health Engagement Location would be there mostly for individuals, not entirely, but mostly for individuals who are currently using in public settings, outside, bathrooms, other types of settings.

And it's really that group of folks that we want to bring inside, and ensure that they're safe, because oftentimes when they're doing -- doing -- engaging in -- injecting drugs, or using drugs, in the bathrooms and, you know, other types of areas, and that they're doing so alone, as well, and so it's really those individuals that we'd like to continue to focus.

So that's correct. So we -- we know, sort of generally, where the majority of that activity happens. We know that the majority of that activity happens sort of in the downtown corridor, down to the SoDo district. We know that there is -- that activity occurs up on the west Capitol Hill area. So we understand sort of generally where the areas that we really do want to focus on, and that's what we've done.

TERESA MOSQUEDA: Councilmember Bagshaw.

SALLY BAGSHAW: Yeah, Jeff, just following up on that really quickly. Do we actually have the data, and maybe a map, heat map, that could say, you know, 23 here, 64 here, that kind of thing? Because I think as we're talking with the community, to be able to say, hey, look, the problem's already here, we're not bringing people to you, the problem is here, let's get them inside.


SALLY BAGSHAW: So if you could do that for us, then we've got that data to go back and --

JEFF SAKUMA: Absolutely, yeah, there is a heat map, I know that Caleb has presented that heat map in different settings, but there are -- there is in fact a --

SALLY BAGSHAW: I'm sure we've seen it, but it would just be helpful to have it in our hands.

JEFF SAKUMA: Absolutely.

TERESA MOSQUEDA: I think that that, just to sort of bring back the conversation we were having before about the community, I think that will be a helpful tool as we talk about where this is going to possibly be a benefit to the community, where we can prevent deaths and overdose, are places that might be very welcoming of a site like this.

We just heard testimony that the Capitol Hill Friends have asked us to consider how we might provide assistance up there. I'm looking forward to touching base with them and getting some contacts so that we can do some outreach, because again I think this is, according to your slide here, this is going to require us to reach out and have partnerships with either nonprofits or the religious community, or the business community, to help us identify a location.

JEFF SAKUMA: Absolutely. This, as you will see, this is definitely having us work with another entity.

So, and obviously, the cost of purchasing a property, as you will imagine, is -- can be quite prohibitive, and, you know, I think that if we want to move forward sooner than later, as obviously has been discussed, that that -- that we also, sort of, we're not sort of pursuing that area.

Let's see. So, I think that what we have really -- so the other piece that's really important for the background of this is, is that understanding that if we are, potentially are not putting this into an owned city-county property, that we obviously are at risk of having somebody else's property seized, just because of our federal government not necessarily seeing this as something that's legal or appropriate.

So, therefore, what we are, that has really moved us towards, this -- what I'm, this is my term, a -- a fixed mobile option. And, what I mean by a fixed mobile option is, is that, that it is an option, where we would actually lease, or go into an agreement regarding a fixed site, and then with that, that we would have a mobile van, a van is a little bit of a misnomer as you all know, these are potentially a very large vehicle, that we would then house the actual consumption activities in.

And that -- that mobile van, and that fixed site, would be, I mean, that -- the van would literally be parked right up against a site, I mean, that would be the preference, is something that is really sort of almost adjoined, but obviously two different settings, and therefore, in such a -- in that situation, what we'd do is in the fixed site part is, is that we'd have the reception and waiting area, so that people who are wanting to use, we're not queuing people outside or anything, that we are bringing people inside, if you will.

That we are, in that indoor setting, providing people with other types of services and resources, so that we -- that if people, including low barrier buprenorphine, so that if any of those individuals say today I choose not to inject, or use in the van, but instead I really want to consider treatment, that we can -- that would be an immediate hand-off for any of those individuals.

The mobile piece of this would be the place where that people can -- would be using, or consuming, drugs, in that setting, and then also, hope -- you know, a space that, there for that they don't have to leave until they've been sort of observed for a period of time. So that would include both sort of the drug injection process as well as the recovery space, if you will.

And then lastly, just is that this has become such a super important piece of this, is that, any of that, any of this that we would also be having security and neighborhood mitigation services, that regardless of how much we bring services indoors for the individuals themselves, obviously there will continue to be concerns about the neighborhood, as, the security of the neighborhood, about other activities happening in the neighborhood, and so we would definitely want to make sure that we provide a safe area, if you will, not only for obviously the neighbors but also the individuals who are using as well.

TERESA MOSQUEDA: Thank you, Jeff. Do we have a few questions? Councilmember Juarez? No. Okeh. So, fixed mobile site is I think a new term that we should all familiarize ourselves with. And I understand the complexity given our federal government, the rationale behind why you have coined that term.

I know that San Francisco and Philadelphia have also announced plans to move forward with similar concepts around how they can try to find a location for individuals to safely consume substances under the supervision of trained healthcare providers, and more importantly make sure that they have immediate access to other health services as well, so it's truly wraparound.

And I appreciate the courage that I think Seattle, San Francisco, and Philadelphia are showing here, and I know that we -- we have many potential new challenges now that were not maybe anticipated two years ago, when this report was originally drafted. But I think that this being one tool among the eight that were recommended back then, in addition to the concept of a fixed mobile site, provide at least us with a better vision of how this may work, only in, it sounds like, those certain neighborhoods you're talking about.

And when you say, same location every day, it also sounds like the concept here would be to almost have potentially a pilot, right? A pilot location instead of an actual roaming --

JEFF SAKUMA: Absolutely, and thank you for pointing that out. I sort of skipped over that point, but I did sort of put it up on the slide here, and that is the concept of the same location every day. In other words, that the mobile piece of this is only mobile from point -- place of parking overnight from place of where it would be located on a daily basis. So that would be the only mobility that it would have, if you will, that it would go from parking to that same site every day.

SALLY BAGSHAW: It would leave at night and go to a secured, locked location like what the methadone clinic has down on Airport Way, as an example.

JEFF SAKUMA: Right. Or, like what our the -- our mobile medical van has, as well. Obviously, they're -- these are pretty expensive pieces of equipment, and we want to make sure that they are secure.

SALLY BAGSHAW: And the supplies inside, that I assume you don't want to leave overnight in the --

JEFF SAKUMA: Yeah. Though, you know, with a safe injection site, there probably wouldn't -- you know, obviously people are bringing in their own -- what they're, ever they're using, they're bringing in their own.

But, again, but, for the security of the whole vehicle, absolutely.

DOUG MCVAY: You're listening to Century of Lies. We're a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.net. I'm your host Doug McVay, editor of DrugWarFacts.org.

We are listening to audio from a Housing, Health, Energy and Workers' Rights Committee of the city of Seattle's City Council. They are getting an update on Heroin and Prescription Opiate Task Force recommendations that were made almost two years ago. The person testifying is Jeff Sakuma, from the mayor's office. He's a member of that task force. The chair of the committee that we're hearing is Teresa Mosqueda, and one of the other city councilmembers who we're hearing a bit from is Debora Juarez. Now let's get back to that hearing.

DEBORA JUAREZ: Jeff, I know we talked about the CHEL siting factors, and, you know, thank you, executive, for the memo that outlined the four, and I know that we looked at the study, so, let me just be candid. Is this, I mean, are we -- are we looking for like a unicorn here? I mean, at some point, I mean -- I've seen the areas where there have been siting factors that were much more intense and egregious than these four, that we were able to find land.

Granted, it was a different issue, but, when I look at the map of the city, it looks like a CHEL site, looks like it probably would end up south of the ship canal, and again going back to what Councilmember Bagshaw said, you're going to want to put it in that service area to capture where people are, and, quite frankly, when I look at the -- the factors or limitations, as you called them, what is our -- what is the executive's position, or what is the strategic thinking, how to, if you will, overcome, whether you call them factors or limitations.

I guess I'm frustrated that it's like, well, there are four factors here, I'm sorry, five, and we just can't find it. We just can't find a perfect spot that meets all these, so we're just going to kind of throw up our hands and say, well, we can't, we can't find anything. We can't use existing city property, we can't use existing county property, we can't lease, we can't buy. I mean, what's the bottom line? It's, I mean, I know we wouldn't ask Seattle Public School to lease some of their property, whether or not we could explore with the Port, their property. What is going to be the executive's response to this?

SALLY BAGSHAW: A parking lot?

DEBORA JUAREZ: I mean, at this point, it's like, and I apologize, I'm not trying to take it out on you because I know you've -- we've been looking at each other for two years now. So, I just want you to be --

SALLY BAGSHAW: Like, every day.

DEBORA JUAREZ: Yeah. Yeah, and Doctor, all the doctors, too, the two Jeffs. What is, just be straight with me, what is, what is -- what are we going to do about this?

JEFF SAKUMA: Yeah. You know, I -- you're right. I mean, it does narrow, sort of, our options, greatly, but, and I do think that the most important piece going forward is going to be finding a willing partner, and that partner is a partner who owns a piece of property that is willing to work with us.

So I think that that will be sort of the key to this. But, potential -- but, possibly, it may be due to my over optimism in -- on this subject, and in life, but, I, you know, I just think that we just need to be, you know, as we begin to move forward in figuring out sort of the next slide around how we're going to continue to pay for this, is, is that is something that, you know, that we just need to go out there and do our -- our best work in trying to find that, that partner.

DEBORA JUAREZ: Okeh. Let me follow up.

JEFF SAKUMA: I think that's not a great answer.

DEBORA JUAREZ: No, it's not. But that's okeh, I understand.

JEFF SAKUMA: My optimism isn't a guarantee, I understand.

DEBORA JUAREZ: Let me just be, again, straight with you and candid.


DEBORA JUAREZ: It's -- we have like five hundred thousand dollars, is that correct? How much money do we have?

JEFF SAKUMA: Well, so, that gets to this next slide.

DEBORA JUAREZ: Yeah, I know, but just -- just so I can finish this question with you, and we can go to the next slide.


DEBORA JUAREZ: So, what is -- I know what the county, what does the city have to site this?

JEFF SAKUMA: Yeah, so, we have, right now, we have the funding to potentially buy the van, which will cost between, you know, somewhere between three fifty and four hundred thousand dollars. We have the $1.3 million that the council has put in proviso.

DEBORA JUAREZ: Right, that's what Councilmember Johnson and I did.

JEFF SAKUMA: Yes. Absolutely.

DEBORA JUAREZ: So, now you're looking at, what?

JEFF SAKUMA: Yeah. So we're looking at, again, up here, it says about $1.8 million that we are currently working, that we have to work with. That's one time funding to try to put something into place.

DEBORA JUAREZ: That's a -- does that include operating costs? That's --



JEFF SAKUMA: It would only include operating costs if we don't exhaust all -- I mean, all of that money, and the operating, obviously, is an ongoing. These are one-time funds, though, so it would only move towards whatever we could --

DEBORA JUAREZ: I don't want you to go in the weeds, I know you've got a whole chart, and I know we're going to go into that. I'm just -- we'll get there. Just, I just want a straight answer: Can we not just buy a piece of property or build, brick and mortar, and do this? Because what we're finding in the last two years, we have seven districts, and not everyone is a willing district or neighborhood, with open arms. Whatever we think about that, the point is, we don't have that.

And the one that we do have, which maybe is district two, there are all these limitations because of space and schools that don't line up with the five limitations, or whatever we want to call them.

So, it seems to me, then, if I were in charge, I would just say, I need more money, we need to either just buy our own dang building, or build one. Is that ever going to be a conversation we have? I'm not trying to put you on the spot. I read the one time costs, operating costs, capital costs, but this conversation's been going on for two years.

So, I just -- help me out here.


ALAN LEE: Oh, no, I was just going to point out that Jeff did outline what leasing a space would look like, what the challenges are, and we know that there are potential legal challenges, and when we exhaust that process, that I think Jeff will describe more in detail later in his presentation, then we can explore these other -- that the council could explore these other options, such as purchasing a site outright.

Of course, one of the big challenges there is, if we're -- if we're considering the three areas that were recommended by the task force, Capitol Hill, Belltown, the Pioneer Square area, that we're talking about, are some fairly expensive pieces of real estate.

DEBORA JUAREZ: Okeh. Thank you.

TERESA MOSQUEDA: I really appreciate your sense of urgency, and I also share your frustration. I also think that if we have a known amount for the purchase of a van, potentially being $350,000, that we should move forward with the purchase of that van as we engage with the community about the possible location, and with a reminder that it would be a fixed location.

If those dollars are in hand right now, and if I'm reading the information correctly, if that is the most cost-effective and most expedient way for us to create a potential site, I would like to register in addition to wanting to have the dollars to move forward so that we could either purchase our own property and build brick and mortar, if that's not an option right now, then I would like us to get this van in hand.

So I think you hear a sense of urgency for one or the other, so we can move forward. I know that the -- you can stay, you're good? Okeh, I just want to do a quick time check, I thought we had a time limitation. We are on the second to last slide, and you've been incredibly helpful in giving us some additional data this time around. I do have some questions about the community engagement section on the one time cost there. Have you already gone through this slide, or do you have more to say on it?

JEFF SAKUMA: Oh, no, I think that the one really important piece on this slide is that we do not have ongoing operating costs being -- budget for the ongoing operation cost of a Community Health Engagement Location. So I just wanted to be very clear in pointing out this slide, that the ongoing costs, and this is us really working hard with folks at public health, to really ask the question, what is it that we absolutely need on this site, and how do we do so in a way that doesn't have such a large dollar attached to it that it -- that will be come our barrier.

So we worked really hard to sort of really bring this down to between $1.5 and $2.5 million dollars, an on annual operating basis. The difference there would be the number of days and hours per day of operations.

But that is where we are, but that, those dollars, for ongoing operation costs, have not been identified at this point in time. So, I just want to be very clear that that is the -- that, what we are looking at is really trying to secure that, those ongoing dollars in order for us to move forward. And that is securing both, that is securing, with our partners, at the county, sort of sharing in those operating costs, moving forward.

DOUG MCVAY: We've just heard a portion of a hearing before a Seattle City Council committee on the Heroin and Prescription Opiate Addiction Task Force recommendations about establishing a supervised consumption facility, a safe injection space, which in Seattle is referred to as a Community Health Engagement Location.

It appears that nearly two years on, the city of Seattle still has no idea what they are going to do. There are people dying in the streets, in the alleyways, in doorways, in bathrooms, in public libraries, in parks, there are people dying because elected officials cannot pull their thumbs out, and they cannot figure out how to save lives.

There's an easy solution. Vancouver, at the Insite facility, in places around the world, in Australia, in Germany, in the Netherlands, there are dozens of supervised consumption facilities in nations around the world. And they work. They save people's lives. They engage people with the healthcare system, people who may not have contact with the healthcare system.

It's being stymied in the city of Seattle because of what's called NIMBYism, not in my back yard. We only became concerned, as a society, about this opiate overdose crisis because middle class, middle aged white people and middle class young people were dying of opiate overdoses. We only became concerned about this because those very same middle class people who are raising objections about having a supervised consumption facility are the people whose family members are dropping dead.

Now, what are we to make of it, when those people don't want to see a harm reduction intervention that could have saved those lives? My god, what has our society become? What is a human life worth? There are other cities around the country that are moving forward with this, hopefully Seattle will figure itself out, and start trying to save the lives of people who live there.

Meanwhile, New York City and San Francisco are both moving forward. I will be hopefully bringing you news about those supervised injection facilities, those harm reduction interventions, very soon.

Meantime, that's all the time we have this week. I want to thank you for joining us. You have been listening to Century of Lies. We're a production of the Drug Truth Network for the Pacifica Foundation Radio Network, on the web at DrugTruth.net. I’m your host Doug McVay, editor of DrugWarFacts.org.

The executive producer of the Drug Truth Network is Dean Becker. Drug Truth Network programs are available via podcast, the URLs to subscribe are on the network home page at DrugTruth.net.

The Drug Truth Network is on Facebook, please give its page a like. Drug War Facts is on Facebook too, give its page a like and share it with friends. Remember: Knowledge is power. Follow me on Twitter, I'm @DougMcVay and of course also @DrugPolicyFacts.

We'll be back next week with thirty more minutes of news and information about drug policy reform and the drug war. For now, for the Drug Truth Network, this is Doug McVay saying so long. So long!

DOUG MCVAY: For the Drug Truth Network, this is Doug McVay asking you to examine our policy of drug prohibition: the century of lies. Drug Truth Network programs archived at the James A. Baker III Institute for Public Policy.