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Some of the ideas were standard: “Promote safe storage and disposal of medications.” Some were more contemporary: “Expand distribution of naloxone in King County.” But only one sparked months of litigation and acrimony: “Establish, on a pilot-program basis, at least two Community Health Engagement Locations where supervised consumption occurs for adults with substance-use disorders in the Seattle and King County region.” Clif Curry, the King County Council’s chief legislative analyst, compared the sites to a controversial housing facility that opened in Seattle 10 years ago to deal with a population of street drunks, many of whom had cycled in and out of rehabs for decades. These chronic alcoholics had become a public nuisance—urinating and vomiting on the sidewalks—and they were costing millions in emergency-room bills and jail stays. The county placed 75 of them in a government-subsidized apartment building where they could drink as much as they wanted. They didn’t even have to promise to quit. “Services were available to them there, but they didn’t have to make use of them,” Curry explained. Critics at the time included a local conservative radio host who derided the arrangement as “bunks for drunks” and “aiding and abetting someone’s self-destruction.” But, Curry said, “the research showed ... that one out of five sought treatment on their own, even though they were allowed to continue to drink themselves to death.” And even among those who didn’t seek help, “they weren’t dying anymore,” he said. Plus, “there are no chronic inebriates on the street anymore.” Seattle’s safe-injection facility for opioid users would be the first such site in the United States. Other American cities are considering similar programs, and an unsanctioned, invitation-only site has been operating at an undisclosed location in the United States for several years.
For the original version including any supplementary images or video, visit https://www.theatlantic.com/health/archive/2017/11/why-cant-addicts-just-quit/545552/