Naloxone is often used on people overdosing on heroin and other opiates, though people will still need medical attention after.
Naloxone is often used on people overdosing on heroin and other opiates, though people will still need medical attention after.
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Early last Wednesday morning behind Dick’s Drive-In, Gehbre Teheshosm has been pressure-washing the parking lot since 3 a.m.

He says, “I see needles back here every morning. I never see people, but I see heroin needles.”

Across the street, at the main entrance of Capitol Hill Station, volunteer health care workers equipped with overdose-delay drug Naloxone and donuts are beginning the next phase of their advocacy campaign for safe consumption spaces in Seattle. The official recommendation of an SCS pilot program in Seattle by a King County task force, spurred more than 100 health care professionals to mobilize as the Health Care Workers for Safe Consumption Space Coalition. Their objective is to address the growing concerns about the opioid addiction crisis by drawing attention to the SCS model.

The SCS model includes supervision and harm reduction for intravenous drug users in a safe space. The expectation is that the facilities will decrease the likelihood of a fatal overdose, while increasing the potential for a user to seek treatment.

Capitol Hill commuters encountering the street team on Feb. 7 were invited to express their concerns about having an SCS pilot facility in their neighborhood.

“Some people say this will encourage drug activity and selling,” said Mandy Sladky, founding member of the coalition and registered nurse. “We counter that with evidence. From the spaces that exist, evidence is coming out that says drug-use in the site area and crime do not increase.” 

The volunteers moved between a sidewalk booth and light rail foot traffic, offering information, literature, stickers and pins. Yes to SCS focuses outreach to morning and evening rush hour in Capitol Hill and the University District. Messaging is coordinated between the Yes to SCS multi-partner campaign, Health Care Workers for SCS and Voices of Community Activists and Leaders (VOCAL-WA). The Public Defenders Association, a nonprofit organization for justice system reform, provides legal, organizational and public relations guidance for the cooperative mission.

The move toward major community engagement began last November, after the Seattle City Council unanimously approved the 2018 budget, which includes funding for the SCS pilot.

“It was me who found the $1.3 million to do the site work construction and operation,” says District 4 City Councilmember Rob Johnson, who believes Capitol Hill is among the top-contender neighborhoods for an SCS.

Though the decision is made to implement an SCS in Seattle, the efficacy of the program and approach to the problem are still debated.

Washington 30th District Sen. Mark Miloscia stridently disagrees with the ideology of an SCS-based approach to the state’s opioid crisis. Miloscia cites a lack of adequate research to support SCSs.

Everyone is in their own silo, and refuses to talk to each other,” he said. “No one is measuring the system. I’m disappointed that the people pushing this are not having a broader discussion.”

The Yes to SCS campaign is run by a coalition of like-minded integrated groups, working together to promote SCSs and adjacent programs. The SCS campaign has drawn support and participation from numerous community organizations, such as the Capitol Hill Community Council, which is pushing for a safe consumption site in the neighborhood.

Among the health care workers at the Yes to SCS morning session was registered nurse Jennifer Fritschy. She focuses on educating passersby about Naloxone. Fritschy explains how Naloxone can prevent overdose deaths.

“When administered through the nose, the inhalant sends Naloxone HCI directly to neural pathways, blocking the opioid drug from attaching to receptors in the brain,” she said, “effectively bringing an unresponsive person to a waking state. Some people might want to keep it on hand, so they can intervein should they witness an overdose.”

Fritschy said one caveat to using Naloxone is “it’s only effective for a short time, so if the person does not contact emergency services right away, they risk going back into overdose.”

The process of discerning which neighborhood will host the first Safe Consumption Space and choosing a building is underway. Seattle City Council will address the implementation phase at the end of February.

“I would be very surprised if on the 28th we will be announcing the opening of a facility,” Johnson said. “I’m expecting an outline and hoping for an operating plan, and the cost and agreement between multiple jurisdictions, and the criteria between them.”

The cost assessment and cost tenability of the planned SCS will be extrapolated from other programs like it, such as the Downtown Eastside Insite in Vancouver, B.C.

District 1 City Councilmember Lisa Herbold notes that “we are using peer review studies of other jurisdictions, so it’s hard to extrapolate exactly what our saving would be.” She added, “they increase access to services, reduce disorder and are actually cost-saving.”

If the installation of a safe consumption space comes to fruition in Seattle, it will be the first one of its kind in the United States.

Learn more about Yes to SCS and safe consumption spaces at YesToSCS.org