The King County Heroin and Prescription Opiate Addiction Task Force recently released recommendations about how to confront the region’s opiate epidemic. They include both short-and long-term strategies to prevent opioid use disorder, prevent overdose, and improve access to treatment and other services for individuals experiencing opioid use disorder.
The task force is continuing King County’s work as a national pioneer in treating drug abuse as a public health issue, rather than as a criminal matter. The ACLU of Washington participated on the task force and will be advocating for implementation of its cutting-edge, public health-based approach.
At least two of the recommendations could have impacts that go far beyond this region. One calls for establishment of a pilot program with at least two sites where supervised consumption of opiates can occur for adults with substance use disorders. Known as Supervised Consumption Spaces (or as Community Health Engagement Locations in the recommendations), they have been proven to be a safe and effective public health intervention at sites across Australia, Canada, and Europe. The evidence is clear that they can get a hard-to-reach population into treatment.
No jurisdiction in the U.S. has yet authorized facilities where illicit drugs can be consumed onsite in a public health environment. The ACLU-WA strongly supports this approach and is a member of the coalition that is working to make it a reality locally.
Another recommendation is to offer buprenorphine treatment “on demand” for opioid use disorder. Despite clear evidence of this treatment’s effectiveness, several barriers exist to getting it into the hands of people who need it. Opposition comes in part because it cuts against the orthodoxy of abstinence-based treatment, which still dominates nationally.
The task force, however, recognizes that giving people the help they need can mean not insisting that they immediately abstain from using drugs. The task force recommendation helps to get around some of the barriers and also includes a new definition for what “treatment on demand” actually means – “the individual meeting with a prescriber immediately, or on day one or day two, to initiate treatment.” This is important because all too often, a person with a substance use disorder wants to get treatment, can’t get in to see anyone for days or weeks, and then changes their mind about getting help.
By ensuring that evidence-based treatment is available on demand, King County can show the rest of the country how a 21st-century drug policy can work.
A summary of the task force’s recommendations is available online