I support the King County Heroin and Prescription Opiate Addiction Task Force’s recommendation of CHEL or safe consumption sites. Here’s why:
Community Health Engagement Locations (CHEL) are a place where people suffering from addiction can get health care, social services, and inject under the supervision of a health care worker.
First, I agree that prevention activities and expansion of treatment are key priority steps that need to be taken. Yet, even with those steps, many people facing addiction are not ready to enter treatment on any given day. Users are all different, often with their own set of complex challenges and struggles to deal with before they are ready to enter treatment. For this reason, the goal must be to find additional ways to save people’s lives and reduce the health care burden on individuals until they are ready and able to start treatment, so that eventually they can return to health. An additional goal must be to ensure public safety.
We know that people inject every day in unsafe public spaces, outdoors, on our streets. The Task Force strongly believes that no one should have their family member or loved one harmed while vulnerable, or overdose and die where there is no help available when there could have been, cutting off any future chance for treatment and return to health. I believe that it’s in everyone’s best interest to allow people who are suffering from opiate use disorder to have a safe place to inject under the supervision of a health care worker who can save their lives if they overdose and connect them to needed services.
CHEL sites are not party rooms but an extension of the type of harm reduction strategy used at the County’s needle exchange sites. They will not provide drugs to individuals or in any way encourage drug use. The sites will provide health services, support, and compassion to users. These types of sites have been operating successfully in other countries: reversing overdoses, preventing deaths, decreasing injecting in public spaces, and connecting users to treatment. They have not been shown to cause an increase in injecting frequency or to encourage people to use drugs. In fact, after over 30 years of operation, tens of millions of drug consumptions have occurred in facilities around the world, but no overdose-related deaths have occurred. In addition, data show a long-term reduction of drug-related deaths in proximity to the facilities. In Europe, more people using these injection facilities ultimately seek out treatment resources to address their use disorders and are less likely to participate in risky behavior like sharing syringes, reusing syringes, rushing injections, and injecting in public spaces. Multiple European studies have found a reduction in syringes and injection-related litter as a result of drug consumption rooms.
Another important thing to note is the relationship between drug use and homelessness. About 13% of people who are homeless in Seattle list alcohol and drug use as the primary cause of their homelessness. Most of the people who are homeless in Seattle lived here for significant lengths of time prior to becoming homeless. The City of Seattle’s 2016 Homeless Needs Assessment demonstrates that Seattle’s population experiencing homelessness are generally “homegrown” with around 70% having said they lived in Seattle or King County when they were last stably housed. Another common misperception is that this population are recent arrivals to the city and county who have been attracted to the homeless service network and local resources. The data suggests that the length of time of local residence is probably not too different from the general population and people who come to the area to access their personal safety nets, job opportunities, and for other common reasons. The data show that people on the streets generally have lived here for some time and that City and County services are not attracting large numbers of persons experiencing homelessness to the area.
I know that upon first look CHEL sites might seem antithetical to helping people with opiate use disorder, but these sites are one of several ways needed to ensure we are doing everything we can to respond to the heroin and opioid drug crisis, helping connect people to treatment, where and when they are ready for it. Medical providers onsite will be able to offer or refer people to medication to treat opioid addiction as well as connect people to inpatient or outpatient treatment, and link them to other important health and social services, such as housing assistance. And finally, CHEL sites will be carefully evaluated to be sure they are working as desired, and make any needed changes if necessary.
Lastly, this is not just an idea that Seattle and King County had. In addition to 90 sites worldwide, a number of jurisdictions are looking at this intervention throughout the United States. Locally, creation of a pilot project of two sites was overwhelmingly recommended by the Heroin and Opiate Addiction Task Force. The Board of Health voted to support these sites unanimously and they have also been supported by the King County Prosecutor and Sheriff, the Deans of the University of Washington Schools of Public Health and Nursing, the Seattle Human Rights Commission and the Washington Academy of Family Physicians in addition to over 40 other health care providers.
Find more information on CHEL sites here: http://bit.ly/2mKHOxa
(Image credit: seattle.gov)