Recently the Pierce County Council passed legislation that called for the Pierce County Planning Commission to make a recommendation back to the Council on prohibiting the zoning of safe injections sites (SIS). SIS are legally sanctioned facilities where people who use intravenous drugs can inject pre-obtained drugs under medical supervision. These sites are designed to reduce the health and societal problems associated with injection drug use. The ban passed on a vote of 5-2. I was one of the two.
I have gone back and forth on this issue, it’s not plain and simple. I would like to take you through my thought process.
I believe that substance use disorders (SUD) should be approached through a public health model and not the criminal justice system. Many people believe that people choose to use drugs. True…up to a point. Most choose to use drugs that first time and maybe the second or third. Depending on the drug and the person, addiction can either happen quickly or after a number of uses. But it always happens after continued use. Why? Briefly, it is because it changes the brain. Addiction affects neurotransmission and interactions within reward structures of the brain that then requires that drug in order to function. Then addictive behaviors supplant healthy, self-care related behaviors (American Society of Medicine). Therefore, treatment, such as medical assisted treatment and/or cognitive behavior treatment, are key to changing addictive behaviors.
But safe injection sites are not treatment. It is based on a philosophy of harm reduction. In recent years, all communities throughout the United States have seen large increases in opioid use that often escalates into heroin use. This recent crises has arisen primarily through opioid medication prescribed by doctors to treat injuries or pain from surgeries and even dental work. It is highly addictive. We know that most of those addicted are white middle class, your brother or sister, your son or daughter. We also have seen high incidences of overdose deaths here in Pierce County as well as the rest of the country.
It is those deaths that safe injection sites are trying to confront. Harm reduction minimizes a drug’s harmful effects rather than simply ignore or condemn them. By providing a safe, supervised place to use their drugs, it will prevent overdoses. Plus the added benefit of safe disposal of syringes. These sites also help to create relationships between addicts and medical professionals who can offer reliable treatment information and referrals.
So, the back and forth…I believe in treatment but I also believe in keeping people who use drugs alive and preventing irreparable damage.
It is important to note that there has not been any proposal to start one of these facilities in unincorporated Pierce County. I believe that this resolution came before us out of a sense of panic, a lack of knowledge, and a rush to ban these facilities. There was no research on effectiveness, safety for the user or impacts on the community. I do not believe that this mindset leads to good policy. Harm reduction principles as well as treatment protocols encourage open dialogue, consultation and debate. A wide range of stakeholders must be meaningfully involved in policy development and program implementation, delivery and evaluation.
I would have preferred to put on the brakes, researched and actually acted on facts.
Connie Ladenburg is a member of the Pierce County Council. See more of her blogs at https://blog.co.pierce.wa.us/connieladenburg.