Washington Law Review Online

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The United States is experiencing a drug overdose epidemic of historic proportions. As fatal overdose rates continue to increase, some jurisdictions have sought evidence-based solutions to this public health issue. This Comment concerns one proposed remedy in particular: supervised consumption sites. In a supervised consumption site, drug users are encouraged to consume their own drugs at the facility. Facility staff give drug users clean equipment, teach safe injection techniques, and, most importantly, monitor drug users for symptoms of overdose. If a staff member witnesses an overdose, they act to prevent the overdose from becoming fatal. Research conducted on supervised consumption sites outside the United States has generally concluded that the sites are effective at saving lives, preventing the spread of disease, and eventually leading drug users towards treatment. As of this writing, no supervised consumption sites operate legally in the United States. U.S. jurisdictions that have considered establishing supervised consumption sites face a number of legal hurdles, including the threat of federal prosecution. However, these jurisdictions can take steps to put their proposed supervised consumption sites, and those who will utilize and staff them, in the best possible legal position under their own laws. This Comment focuses on the emerging issue of supervised consumption sites by examining research on supervised consumption sites and its implications for the sites as a public health measure. Specifically, this Comment looks at King County, Washington, which, jointly with the City of Seattle and other entities and organizations, created a detailed plan to establish supervised consumption sites that has faced legal and political challenges. This Comment contrasts King County’s legal hurdles with those faced by San Francisco, California, which also seeks to implement the sites. This Comment makes three recommendations to any jurisdiction seeking to implement the sites: (1) empower public health boards to make decisions in the public interest that are protected from direct referendum, (2) allow public health boards to make decisions in the name of public health unconstrained by criminal law, and (3) if necessary, enact legislation at the state level to exempt supervised consumption sites from state drug laws. Finally, this Comment calls for a change in federal law to allow jurisdictions to legally establish supervised consumption sites.