Seattle and King County, Washington will be the first places in
the US to build so-called safe injection facilities for heroin
users, Seattle mayor Ed Murray announced Friday, an effort to
reduce an epidemic of deadly drug overdoses.
Long controversial, the facilities provide anyone who walks in
with access to clean needles and space to inject drugs. Nurses
are on hand monitoring the users, and, if an overdose occurs,
can administer the reviving medication naloxone. The facilities
also provide testing for HIV and hepatitis, as well as medical
“Like many places across our nation, Seattle and King County
are experiencing an epidemic of heroin and prescription opiate
use unlike any we’ve seen before,” Murray said in a statement.
“Keeping people alive gives them the opportunity to get
treatment and begin their path to recovery.”
Fears that the facilities, long established in Europe and
Canada, amount to condoning illegal drug use have until now
stymied their use in the US. Vancouver’s Insite facility, the
first safe injection space in North America, has been visited
nearly 3.5 million times since it opened in 2003. Nurses have
intervened in nearly 5,000 overdoses, and no one has died.
“The goal is to prevent overdose deaths,” Jay Unick, medical
epidemiologist at the University of Maryland, told BuzzFeed
News. “There is overwhelming evidence that safe injection
facilities do that.”
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On Friday, the King County Executive, Dow Constantine, and
Murray announced that they were directing Seattle/King County
Public Health to set up two sites, though they have yet to
announce specific locations or funding sources.
The announcement comes as many US cities grapple with how to
fight the a crippling heroin overdose epidemic raging across
the country. More than 33,000
people died in 2015 due to misuse of opioids, the highest
number ever recorded. Heroin use has more than
quadrupled since 2010.
spiked by 58% in Seattle in 2014.
“The reality is people are using drugs, and it should be our
mandate to keep people alive and make sure that they can reduce
the harms associated with drug use as much as possible,” Alyssa
Aguilera, executive director of advocacy group VOCAL NY.
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The political resistance to opening up safe injection sites are
similar to fights against setting up needle exchanges in the
1980’s, Unick said.
“There were no needle exchanges until HIV came around,” Unick
said. “And then HIV presented a public health emergency that
needed to be addressed, and clean needles were the solution.”
As governor of Indiana in 2015, Vice president Mike Pence
drew sharp criticism from public health experts after
refusing to set up a needle exchange, even as an outbreak of
HIV due to injection drug use spread rapidly in his state.
Eventually, he put it an order allowing it to be used for harm
reduction during a public health emergency.
New York City, which currently has 14 needle exchanges
scattered across the city, is also considering building a
supervised injection facility, although right now the
Department of Health and Mental Hygiene is just at the very
beginning stages studying “the clinical, legal, and safety
issues associated with SIFs,” spokesman Christopher Miller told
In March of last year, the mayor of Ithaca, Svante Myrick,
also announced his support for a safe injection space in the
city, though no concrete plans are yet underway.
After the mayor’s announcement, a Cornell University law
professor, William A. Jacobson, said a safe injection space in
the city would be tantamount to “government-run heroin shooting
For Gwen Wilkerson, who prosecuted cases in the war on drugs as
Ithaca’s district attorney for 25 years, the topic is personal:
her son is in recovery from a serious heroin addiction.
“When I first heard about SIFs, I said you’re out of your
goddamned mind,” Wilkerson told BuzzFeed News. “But the more I
read the more I am convinced that the SIF is the best avenue to
reaching those people whose disease is so intractable that they
have not been able to get help any other way.”