Bill floats novel approach to opioid crisis
Measure would make state the first in U.S. with injection centers
OAKLAND » A woman walks into a clinic where a nurse offers her a choice of sterilized needles of different sizes. She picks one, pulls a packet of heroin out of her purse and injects herself. The health staff stands by, ready to give her the overdose reversal drug naloxone if she shows signs of potentially fatal distress.
There are government-approved drug injection centers like this in Europe, Canada and Australia, but none in the United States. Cities from Boston to Seattle have attempted to start safe consumption programs in response to the national opioid plague, but have run into a wall of public opposition.
Now a bill working its way through the Legislature would make California the first state in the country to open centers where intravenous drug users could shoot
up without fear of being arrested, and receive referrals to drug-treatment services. AB 186 has passed the state Assembly, cleared two Senate committees and now awaits a vote on the Senate floor.
It would create a pilot program giving eight California counties the option of setting up safe-injection centers between now and 2022: Alameda, San Francisco, San Joaquin, Santa Cruz, Mendocino, Fresno, Humboldt and Los Angeles. The local city council or board of supervisors (if the proposed site is in an incorporated area) would have to sign off. The idea is to collect data to determine whether the controversial programs do in fact prevent overdoses and check the spread of HIV and hepatitis C — as the scant re- search outside the United States has suggested.
Assemblywoman Susan Eggman, D-Stockton, a former social worker in addiction services, authored the bill and a similar measure last year.
“Three thousand six hundred more Californians have (died) from overdoses since the last time we tried to pass this,” Eggman said. “I am convinced by the evidence I have seen from programs all over the world that these facilities save lives and have been used to help get people into treatment.”
Last year, according to the Centers for Disease Control and Prevention, drug overdoses killed 64,070 people in the United Sates, a 21 percent increase from 2015. AB 186 advocates said it’s high time for drastic, unconventional measures to save lives.
The Drug Policy Alliance is sponsoring the bill, and it has broad support among addiction and HIV-preven- tion organizations. In June, the safe-injection movement got a big boost from the American Medical Association, which voted to support the development of medically supervised pilot programs.
But a broad coalition of law enforcement including police, sheriffs and district attorneys has come out against the bill, which some said promoted “government sanctioned shooting galleries.”
“AB 186 … raises tremendous liability issues for local governments when participants inevitably overdose, or injure or kill someone after leaving a program site while still under the influence of whatever substances they consumed on the premises,” Alameda County District Attorney Nancy O’Malley wrote in a June 19 letter to Sen. Ed Hernandez, D-West Covina, chairman of the Senate Health Committee. “The bill also provides immunity against drug-re- lated offenses for individuals who are participating in one of these programs, but it does not specify how far this immunity would extend. If a person has drugs five miles away, could they avoid arrest by saying they were going to use them in one of these programs?”
Some Republican lawmakers noted the law would put California in the cross hairs of the federal government. U. S. Attorney General Jeff Sessions, who has been vocal in his opposition to marijuana legalization, would likely not approve of state-sanctioned heroin injection centers.
Bishop Ron Allen, who heads the International Faith Based Coalition in Sacramento, testified against the bill during a Senate Health Committee hearing in July, saying already fragile communities would become magnets for crime.
“No addict when they get high is trying to find a program to get into. That’s all they want to do all day,” said Allen, who called himself a former crack addict. “And I’m talking from experience, not something I heard from someone.”
Yet AB 186 supporters said crime near existing safe injection centers did not increase. Furthermore, the sites would be located in areas where people are already using drugs in public, in parks, alleys and on the beach.
“The only increase that happens are the number of people who don’t die on the streets and the decrease in the number of needles seen in the community,” said Loris Mattox, executive director of the HIV Education and Prevention Project of Alameda County (HEPPAC).
She said safe injection centers are an evolution of harm reduction — strategies that seek to keep people who are engaging in risky behavior as healthy as possible. That includes distributing condoms, mobile hep- atitis C testing, syringe exchanges and distribution of naloxone kits, she said.
“I see it as moving up the thermometer,” Mattox said. “Now, we can give them a safe place to use, because right now we’re just giving them the tools and saying, ‘Here, use in the Burger King bathroom or in the alley.’”
“We know that when people first hear about safer drug-consumption services, it takes awhile for them to really digest the idea,” said Taeko Frost, western regional director for the Harm Reduction Coalition, a cosponsor of AB 186. “If you want people to get better, why would you give them a place to use drugs? But people had the same concerns with needle- exchange programs, and they have become the gold-standard for reducing HIV.”