Drafter

Clerk 01/12/2017

Title

A RESOLUTION endorsing the Heroin and Prescription Opiate Addiction Task Force Final Report and Recommendations and calling on local and state actors to implement the public health policies outlined in the report, including the establishment of at least two pilot community health engagement location sites.

Body

                     WHEREAS, heroin and prescription opioid use constitute a public health crisis in King County, resulting in a growing number of deaths, and

                     WHEREAS, heroin overtook prescription opioids in 2013 as the primary cause of opioid overdose deaths, and

                     WHEREAS, two hundred twenty-nine individuals died from heroin and prescription overdose in King County in 2015, and

                     WHEREAS, heroin is the most common drug for which individuals seek treatment for substance use disorder in King County, and

                     WHEREAS, there is a high, unmet demand for opioid treatment in King County and treatment providers dispensing methadone and buprenorphine are working to expand their capacity, and

                     WHEREAS, treatment with methadone or buprenorphine for substance use disorders improves survival rates, increases retention in treatment, decreases illicit opioid use and other criminal activity, increases patients' ability to gain and maintain employment, improves birth outcomes among women who are pregnant and contributes to lowering a person's risk of contracting HIV or hepatitis C by reducing the potential for relapse, and

                     WHEREAS, the majority of young adults who use heroin report being hooked on prescription-type opioids prior to using heroin, and

                     WHEREAS, the King County Board of Health in 2013 enacted secure medicine return regulations to combat the abuse of prescription-type opioids and other medications, and created a product stewardship program to dispose of unused medicines, becoming the second jurisdiction in the nation to do so, and

                     WHEREAS, the United States Surgeon General declared the heroin opioid drug epidemic a national crisis in a report titled Facing Addiction in America, and

                     WHEREAS, the King County Board of Health provides for and promotes the health, safety and welfare of the general public, and

                     WHEREAS, Washington state law grants local boards of health authority over the supervision of matters pertaining to the preservation of the life and health of the people within its jurisdiction, and

                     WHEREAS, the King County Board of Health held ten public briefings, from 2012 to 2016, related to the epidemic of opioid misuse and abuse:

                     1.  May 17, 2012, BOH Briefing 12-B06:  Safe Disposal of Unused Medications;

                     2.  September 20, 2012, Resolution 12-11:  Calling on the Drug Enforcement Administration to expedite its efforts to provide our communities with additional options for operation of secure, accessible, convenient medicine take back programs that can safely dispose of all household medications, including controlled substances;

                     3.  June 21, 2013, R&R BOH13-03:  Relating to providing safe collection and disposal of unwanted drugs from residential sources through producer provided and funded product stewardship plans, for which there was a unanimous vote to establish a secure medicine return program;

                     4.  March 20, 2014, BOH Briefing 14-B07:  Secure Medicine Return Fees, for which there was an initial briefing;

                     5.  April 17, 2014, R&R BOH 14-02:  A Rule and Regulation relating to fees for the secure medicine return regulations, for which there was further discussion and the matter was deferred to the May 15, 2014 meeting;

6.  May 15, 2014 R&R BOH 14-02:  A Rule and Regulation relating to fees for the secure medicine return regulations, for which where was a unanimous vote to adopt the fees;

                     7.  December 18, 2014, BOH Briefing 14-B28:  Secure Medicine Return Program, Annual Report;

                     8.  March 19, 2015, BOH Briefing 15-B05:  Strategies for Responding to the Opioid Overdose Problem in King County;

                     9.  March 19, 2015, Resolution 15-05:  Calling on the Washington state Legislature to pass Engrossed Substitute House Bill 1671 to expand access to opioid antagonists such as naloxone for opioid overdose;

                     10.  March 17, 2016, BOH Briefing 16-B06:  Secure Medicine Return Program - Annual Report for 2015; and

                     11.  October 20, 2016, BOH Briefing 16-B17:  Heroin/Opioid Taskforce Recommendations, and

                     WHEREAS, the King County Board of Health has called on the Washington state Legislature to expand access to opioid antagonists such as naloxone for opioid overdose reversals, and

                     WHEREAS, King County Executive Dow Constantine, Seattle Mayor Ed Murray, Auburn Mayor Nancy Backus and Renton Mayor Denis Law in 2016 formed the Heroin and Prescription Opiate Addiction Task Force made up of over thirty experts and stakeholders to confront the epidemic of heroin and prescription opioid use disorder and overdose in King County, and

                     WHEREAS, the task force met over a six-month period from March to September 2016 to review:

                     1.  Current local, state and federal initiatives and activities related to prevention, treatment and health services for individuals experiencing opioid use disorder;

                     2.  Promising strategies being developed and implemented in other communities; and

                     3.  Evidence-based practice in the areas of prevention, treatment and health services, and

                     WHEREAS, the task force applied an equity and social justice lens to the work to ensure that recommendations do not exacerbate, but rather lessen, inequities experienced by communities of color as a direct result of the war on drugs, and

                     WHEREAS, the task force made extensive recommendations to prevent substance use disorder and overdoses and improve access to treatment for opioid use disorder in its ninety-nine-page Heroin and Prescription Opiate Addiction Task Force Final Report and Recommendations, and

                     WHEREAS, the King County Board of Health has evaluated and was fully briefed on the task force report by Public Health - Seattle & King County Health Officer Dr. Jeff Duchin and King County Department of Community and Human Services Behavioral Health and Recovery Division Assistant Director Brad Finegood in October 2016, and

                     WHEREAS, the task force recommended these specific prevention responses:

                     1.  Raise awareness of the possible adverse effects of opioid use;

                     2.  Promote safe storage and disposal of medications; and

                     3.  Leverage and adapt existing screening practices to prevent and identify persons with opioid use disorder, and

                     WHEREAS, the task force recommended treatment expansion and improvement responses, specifically to:

                     1.  Create access to buprenorphine in low-barrier models close to where individuals live for all people in need of services;

                     2.  Develop treatment on demand for substance abuse treatment services; and

                     3.  Alleviate barriers placed on opioid treatment programs, including the number of clients served, and

                     WHEREAS, the task force also recommended these specific evidence-based user health and overdose prevention responses:

                     1.  Expand distribution of naloxone in King County; and

                     2.  Establish, on a pilot program basis, at least two community health engagement locations where supervised drug consumption occurs and where medical care, behavioral health and social services and access to substance use disorder treatment are provided for adults with substance use disorders, in the Seattle and King County region, and

                     WHEREAS, supervised consumption sites have been in operation abroad since 1988, and have successfully reduced overdose deaths and behaviors that cause HIV and hepatitis C infection, reduced unsafe injection practices, increased use of detox and treatment services, reduced public drug use and publicly discarded injection equipment and have not increased drug use, crime or other negative impacts in their areas, and

                     WHEREAS, the King County Board of Health previously adopted a resolution supporting a strategic and operational plan for HIV prevention in King County that included community health engagement location sites, in September 2007;

                     NOW, THEREFORE, BE IT RESOLVED by the Board of Health of King County:

                     A.  The Board of Health endorses the Heroin and Prescription Opiate Addiction Task Force Final Report and Recommendations and recognizes that implementation of the recommendations will protect and preserve the health of King County residents by reducing overdose deaths, limiting the transmission of infectious disease and increasing public safety.

                     B.  The Board of Health calls upon state, county and city actors, as well Public Health - Seattle & King County, to implement the public health policies outlined in the Heroin and Prescription Opiate Addiction Task Force Final Report and Recommendations, including establishing, on a pilot program basis, at least two community health engagement location sites.