Prescription opioid deaths in King County are on the decline from 2008, but heroin-related overdose deaths continue to rise.
Prescription opioid deaths in King County are on the decline from 2008, but heroin-related overdose deaths continue to rise.
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The complete slideshow presentation on King County drug and alcohol-related deaths can be found at the bottom of this article.

With city staff citing a lack of viable options for a brick-and-mortar supervised drug consumption site, Seattle is moving toward a fixed-mobile model.

The City of Seattle has been planning for a community health engagement location (CHEL) since it was recommended in a 101-page report by King County’s Heroin and Prescription Opiate Task Force released in September 2016.

CHELs are facilities where people can use drugs safely under medical supervision and receive health and social services, as well as access to treatment services when they’re ready. They’re also known as safe consumption spaces and safe injection sites.

While the Capitol Hill Community Council has welcomed the idea, other neighborhoods have opposed having a CHEL sited near them.

The task force recommended Capitol Hill, Belltown and Pioneer Square as viable sites, but Alan Lee with Central Staff said real estate in those neighborhoods is prohibitively expensive.

Former Seattle Human Services Department health integration strategist Jeff Sakuma led a CHEL status update during the June 7 Housing, Health, Energy and Worker’s Rights Committee. Sakuma now has the same job in Mayor Jenny Durkan’s office.

He told the committee there are no viable city-owned properties where a CHEL could be sited, some because the location would not be appropriate. Community centers and park facilities fit that category.

“We have kind of exhausted what we have looked at, and determined that there wasn’t anything truly viable to move forward,” he said, “if we wanted to move forward quickly, if you will.”

Councilmembers on the health committee said they did, and more quickly than the schedule provided to them.

“This conversation’s been going on for two years,” said District 5 Councilmember Debora Juarez.

There is only $1.8 million in one-time funding budgeted for a CHEL currently. Ongoing operational and administrative costs still need to be approved.

The quickest and most cost-effective solution Sakuma offered was the fixed-mobile option.

This would require purchasing a large mobile unit where people in addiction can consume drugs, which Sakuma estimated would cost $350,000-$400,000.

Sakuma clarified during the discussion that the mobile unit wouldn’t actually be deployed around the city.

The fixed-mobile unit would be parked next to an actual building, where people would access all other services, as well as wait for access to the mobile unit.

That would cost $1.5 million to operate for eight hours per day, five days a week. To operate a CHEL 10 hours per day, seven days a week, it would be $2.5 million.

Juarez wanted to know why the city couldn’t buy a suitable building or construct one. She acknowledged not every neighborhood is on board with a CHEL site, and that some requirements make certain areas prohibitive, but felt the conversation still needed to be had.

“Are we looking for, like, a unicorn here?” she said.

A CHEL site should be where people are known to already be using drugs, Juarez said.

“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,” Sakuma said. “We know that that activity happens up on the West Capitol Hill area. So, we understand generally where are the areas that we want to focus on.”

VOCAL-WA, a project of the Public Defenders Association, has been a longtime advocate of safe consumption spaces, and has been working with the Capitol Hill Community Council to educate and gather support for siting an SCS in the neighborhood. Capitol Hill advocates again pushed for greater urgency in establishing a safe consumption space on June 7.

Councilmember Teresa Mosqueda said she looked forward to reaching out to learn more about that effort.

Wherever the mobile unit ends up being sited, it would not remain there overnight, Sakuma said; it would be stored in a secure site.

“Obviously, these are very expensive pieces of equipment, and we want to make sure they’re secure, ” he said.

The neighborhood that is selected will need to be provided with security and other mitigation measures, Sakuma said, making sure the area is safe for neighbors and those at the CHEL.

Cost aside, Sakuma said there is also concern about putting a CHEL in a building due to the current federal administration. There is the risk that the federal government could seize a property if it were deemed to be doing something illegal, he said.

But an important piece to establishing a CHEL remains finding a partner with a piece of property that’s willing to work with the city. Juarez said the private sector needs to help.

“I don’t want to call out any particular company,” she said, “but if people want to change their image in the city, it’d be nice if they stepped up.”

Mosqueda said she shares Juarez’s frustration about how long it’s taking to establish a CHEL. If the amount needed for a mobile unit is known and the funding is available, Mosqueda said, she encouraged staff to move forward with a purchase.

Councilmember Sally Bagshaw asked Sakuma to settle misinformation she’s heard from constituents worried that the city will be providing drugs to people.

“We are not recommending any program where we would actually be supplying drugs to any individual,” Sakuma said.

Even if everything were secured today, he said, the timeline for opening a CHEL would still likely be a nine-month process, making it unlikely people in addiction will have a safe place to consume drugs before 2019.

Public Health-Seattle & King County health officer Dr. Jeff Duchin provided the committee with the latest county data on overdose deaths, which are up from 273 in 2008 to 379 in 2017 — that includes drugs and alcohol.

Prescription opioid deaths have been decreasing since 2008, down about 50 percent, Duchin said, while heroin deaths have doubled. The 2017 Overdose Death Report shows an increase from 23 percent of heroin-related opioid deaths in 2008 to 56 percent in 2017. Many overdose deaths involve a combination of drugs, he added.

Methamphetamine-related overdose deaths have increased “sixfold,” he said.

Men are twice as likely to overdose, Duchin said, and black and Native American populations are at the highest levels despite representing a small percentage of the county’s overall population.

The Native American/Alaskan Native population in King County is 0.6 percent, but accounts for 5 percent of the drug and alcohol-caused deaths, Duchin said.

King County’s homeless population is less than 1 percent of the total population, he said, but accounts for 14 percent of drug and alcohol-related deaths.

Mosqueda asked that a map of overdose hot spots in the county be scaled to better show impacts in Seattle neighborhoods, with a particular interest in the downtown core and Capitol Hill.

 

Drug Overdose Deaths in King County Presentation by branax2000 on Scribd