Seattle is on the verge of becoming the first American city to host a supervised consumption site—a clinic where illicit drug users can get high with clean equipment under medical supervision, with counselors ready to enroll them in drug treatment or other programs if and when they’re ready. But one Republican state senator says he’s drafting a bill to ban them statewide.
In September, in response to the current heroin epidemic, local leaders promised they would create such two safe drug sites on a pilot basis, as recommended by a local drug policy task force. A detailed plan is due in January. The sites are part of a larger “harm reduction” approach to addiction, which aims to immediately help drug users reduce harms like overdose and disease transmission and eventually help them stabilize their lives. “Without a pulse, no change is possible,” as one harm reduction advocate put it. There’s been an injection-only safe drug site called InSite operating in Vancouver, B.C. since 2003. So far, it’s had 3.4 million visits, 4,922 overdoses and zero deaths. Three different studies concluded it saves taxpayers money by reducing downstream health costs like HIV treatment. Drug users who come to the site are more likely to enter detox, and the site has not caused an increase in drug crime or public disorder.
However, the impending shift toward public health-oriented drug policy has elicited critics, including state Sen. Mark Miloscia, R-Federal Way. He says he’s working on a bill to ensure “proper enforcement or consequences for local governments that nullify or disregard current laws on heroin, meth [and] crack.”
We asked Miloscia, who has visited InSite, why he opposes the sites, which have been empirically shown to save lives and money. He says that while harm reduction isn’t all bad, “harm reduction as a pinnacle value is completely wrong” and “a pathway to nowhere.” He even opposes clean/dirty needle exchanges, except in short term cases. Instead, he says, we should enforce drug abstinence.
“The human motivation is carrots and sticks,” says Miloscia. “That’s how the law and society works. You have to motivate people, get people to live a certain way. And the law and government and relationships through family and community is all designed to make people live a certain way. What we’ve allowed, especially in Seattle, is the effective decriminalization of drugs…So the stick has been taken away from that equation. And whether it’s managing employees or children or drug dealers on the street, if you stop arresting people and you stop the negative sticks, you’ll have more of it.
“It comes back to my faith,” he says. “You hate the sin, you love the sinner. Our goal is to take that human being, our brother or sister…who’s hooked on drugs, and get them into treatment, whether they want to or not. It’s not about waiting for them to be ready.”
Miloscia believes that safe drug sites are part of a slippery slope that will inevitably lead to full drug legalization and government-sponsored heroin. “Once you start that, you’re going the pathway Canada’s going toward, where you have to stop arresting people who taking or selling drugs, you give them a pass, then all the sudden you find out it doesn’t work,” Miloscia says. “And the next step is instead of one site, we’re going to need fifty of them. And it doesn’t stop the crime. All these heroin addicts stay on there longer and longer, and they need money, so that means you’ve got to give it away for free. So all the sudden you’re giving out free heroin.
“Are we going to have [safe drug sites] in high schools an college dorms next?” he says. The sites are “just trying to save lives,” he says. “But at the end of the day, it’s not just about saving lives. My goal is saving lives and reducing heroin use.”
Miloscia acknowledges that there is some unknown number of drug users who will live, at least for a while, if Seattle establishes safe drug sites and who will die if we do not. But he denies that his position amounts to sanctioning the deaths of those drug users.
“I can play that game also,” he replies. “I can say let’s go out there and hire 1,000 police and literally arrest every drug addict and and throw them in solitary confinement for a year and let them go cold turkey. That’ll work, too, and probably be more successful” at keeping them alive. He allowed, however, that there may be some room for supervised drug consumption as a short-term first step in the road toward recovery and abstinence. But people can’t keep coming and using “until they die or get enlightenment,” he says. “It can’t be permanent.”
“I’m trying not to go down this false path of ‘This is about saving lives,’” he said later. “It’s best to save lives by eliminating drug use.”
Miloscia says he’s working on the bill to ban safe drug sites with staff, and hopes to have it finished by the end of the year. “We will have a statewide conversation on this,” he says. “For the record, I think it is already illegal [under] state/federal law.” But just because something’s against the law doesn’t mean that law gets enforced. Miloscia’s goal to create mechanisms for disciplining local governments who stray too far from the War on Drugs. He says he won’t start looking for cosponsors until the draft bill is complete. “Other than me, there’s not very many legislators who’ve publicly taken a stand on this,” he says.
Of course, this local debate about whether to reduce harm to drug users could be obviated by federal changes. President-elect Donald Trump has nominated as Attorney General Jeff Sessions, an Alabama senator who according to testimony in a 1986 Senate hearing once said he thought the Ku Klux Klan were “OK, until I learned that they smoked marijuana.” If and when Sessions re-escalates the War on Drugs, safe drug sites and harm reduction policies generally will become much more difficult. “I think there’s a high likelihood of that” happening, says Miloscia. “I’ll be lobbying for that…with our local congressional delegation.”
