Wait, voters can’t say whether drug injection sites are OK?

A judge ruled Monday that an initiative to ban drug injection sites in King County cannot go on the February ballot as planned. The Seattle Times reports:

“Letting voters decide whether to ban safe-injection sites would infringe on the power of the King County Board of Health, King County Superior Court Judge Veronica Alicea-Galván ruled Monday.”

The voters, if the ruling stands, will not have their say – but it isn’t the final word. Organizers for I-27 immediately announced they will appeal. While courts have generally been reluctant to rule on initiatives before they go for a vote, the judge in this case was not.

The Times notes, “Alicea-Galván’s ruling cites a 1992 Washington Supreme Court case that kept controversial needle-exchange clinics open.” This area of the law is hardly settled, however, and further appeal is appropriate. The 1992 case involved a direct challenge to a needle exchange program set up by the Spokane County Health District. There was no initiative to ban the program, as there is in the I-27 case.

The court ruled then that the needle exchange was legal because state law says local health boards “shall have supervision over all matters pertaining to the preservation of the life and health of the people within its jurisdiction” and that this means those boards have “extraordinary power which might be unreasonable in another context.”

This case is different. It is not, like the 1992 case, a dispute between government officials about who has the power to do what. It’s about whether a local health board’s power under the law is so total that the people, in whom “all political power is inherent,” cannot themselves overturn a determination by the King County Board of Health.

What’s in a name?
Those backing drug injection sites don’t believe the public should have any say on whether our local government establishes and operates these sites.

Even the name they’ve chosen for them – “community health engagement locations” – seems designed to deflect attention from their actual purpose. It’s an Orwellian use of language, a name chosen intentionally to obscure the issue. I’ll use the term “supervised injection sites” because that is at least descriptive.

Seattle Times columnist Danny Westneat is already convinced supervised injection sites are a good idea. But he rightly calls out Seattle’s mayoral candidates for their reluctance to say where the sites should be located. He writes of “an awkward truth about our progressive town: Everybody expresses support for social experiments like this, but that doesn’t mean people want it on their block.”

We need to be clear-eyed about these sites, and part of that is knowing which areas will bear the brunt. The board of health might not be accountable to the people on this issue, but that’s all the more reason other local government powers, including Seattle’s next mayor, should be forthright about the siting options.

Vancouver’s example not a slam-dunk case either way
We also need to be clear-eyed about the limits of “harm reduction” strategies. The Canadian newsmagazine Macleans recently revisited Vancouver’s Insite, a supervised injection site in the troubled Downtown Eastside neighborhood.

Insite has been operating for 14 years now, and gives us a pretty good baseline of what to expect from similar sites here. It does succeed at reducing overdose deaths – but it’s no panacea. Macleans describes the immediate area’s reality:

“It sits smack in the middle of an eye-popping outdoor drug market and shooting gallery. Here’s a snapshot: a urine-soaked alley, directly behind Insite. A man squats on the broken pavement, poking a needle into an open, bleeding wound in one arm. Another man stands nearby, moaning, eyes glazed, a sharp protruding from his wrist. Next to him, a woman holds a small cosmetics mirror in front of her face. She’s not applying makeup; she’s pushing a needle into her neck.

“Back on Hastings, right next to Insite, a thin man in a dirty orange t-shirt and ragged blue jeans sits on the sidewalk, cross-legged, pulling small folds of heroin from a plastic bag. He’s handing the drugs to a steady stream of customers. No one bothers to disguise or conceal their transactions.”

You can see why Westneat thinks local officials need to be honest about where similar sites should go in Seattle. Which neighborhoods are we going to write off?

“Gateway to services” is open, few walking through
While many were hopeful that Insite would be a gateway to treatment, that hasn’t happened. Macleans notes, “Addiction treatment and primary care services are also offered to anyone interested. But a large percentage of DTES drug users will rarely, if ever, use the facilities and services.” A British Medical Journal study that looked at treatment rates before and after Insite’s opening concluded there was “no substantial decrease in the rate of stopping injected drug use.”

Nor has Insite resulted in reduced property crimes. This should be no surprise, given that the massive open-air drug market around the site requires a constant stream of cash. Tristin Hopper wrote in the National Post last year:

“There’s also a city hall-funded ‘street market’ that — despite organizers’ fervent claims to the contrary — is well-known by locals to be a brazen hotspot for stolen goods. There are now more than 170 non-profits clustered in an area of only a few blocks, all devoted towards supporting an increasingly dense community of addicts. In a 2015 interview, longtime Downtown Eastside organizer Scott Clark referred to the growth of ‘a pipeline for vulnerable populations’ that has become a ‘magnet over the years.’

“’These service providers, and the government managers that keep funding these agencies, they refuse to look at the evidence that says putting these many vulnerable people in one building, in one community, is simply not healthy for anyone,’ said Clark, executive director of the Aboriginal Live in Vancouver Enhancement Society.”

Advocates for supervised injection sites are confident in the programs, but the tradeoffs are hefty. Maybe that’s why so many city councils around King County are voting against allowing the sites. Do voters have the right to weigh in? For those same advocates, the answer is a pretty steely “no.”
-Rob McKenna

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Rob McKenna
Rob served two terms as Washington’s Attorney General, from 2005 to 2013. He successfully argued three cases before the U.S. Supreme Court and negotiated three of the largest consumer financial protection settlements in national history, all involving mortgage lending and servicing. He is a recognized leader in the development of consumer protections on the internet, in data protection and privacy regulation.