A proposed initiative that sought to ban safe drug consumption sites within King County was struck down by the Washington State Supreme Court late last week following nearly two years of opposition to the county’s plan to begin a pilot program.

The court ruled on Dec. 6 that Initiative 27 could not appear before King County voters on a ballot because it infringed on the county’s right to set its own budget. The initiative would have prevented the county from spending money on funding safe consumption sites — and create civil penalties for people who run them, essentially banning the sites in King County. The Supreme Court ruled that by barring the county from using its budgetary powers on only one aspect of a robust plan to curb opioid overdoses, the initiative could be kept from voters.

“Because this indicates how and where money is to be spent, I-27’s aim is directly at the budget appropriation. Viewed in context, the ultimate goal of I-27 is to eliminate the funding for (safe consumption) sites,” the decision read.

It was a narrow decision in a years-long struggle between those in favor of the sites and those opposed.

The road to last week’s decision began in late 2016 when a county task force created by Executive Dow Constantine made a list of recommendations on ways to deal with the opioid epidemic. One of these recommendations was that the county should create a pilot program for safe consumption sites where people could use drugs while supervised by medical professionals. These sites would ideally also help connect people to services and help move them away from using opioids. It recommended one site be created in Seattle and another somewhere else in King County.

King County Councilmember Jeanne Kohl-Welles has been heavily involved in pushing for the safe consumption sites and said the court’s decision will let them proceed.

“The county is able now to go ahead and site safe consumption sites at one or two, to go forward as a pilot project. This is what the Board of Health approved unanimously two years ago,” she told Seattle Weekly on Thursday.

Seattle’s Capitol Hill Community Council has already requested a safe consumption site or mobile van-based site to be placed in the Capitol Hill neighborhood. The county council passed a resolution last year stating it would not force sites in cities or neighborhoods that did not want them. Several cities in the county passed resolutions barring the sites within their borders. Many of these were suburban cities and places where Kohl-Welles said the safe consumption sites would not be as heavily needed.

“They would be designed to be located where there is a very high usage of heroin or other opiate drugs,” she said.

On the Eastside, many cities have already approved legislation to ban sites. Councilmember Kathy Lambert said most Eastside cities already have banned sites because the sites don’t match their community norms.

“There’s not enough density of users outside of Seattle. They are mostly in Seattle,” Councilmember Lambert said. “It has to be a city that wants this kind of help or a place that wants this kind of help… I don’t know if it would be worth county dollars to be opening a facility like that outside of Seattle.”

In May 2017, an opposition group known as Safe King County was created and headed by former Bothell mayor and then city councilmember Joshua Freed. It began gathering signatures for I-27 and ended up gathering more than 69,000 signatures, qualifying it for placement on a countywide ballot. Seattle Weekly has attempted to reach Freed for additional comment on Thursday’s ruling.

However, the Safe King County Facebook page posted about the decision.

“These justices join a majority of the King County Council in an undisguised contempt for the voters who elected them and, if allowed to vote, would prevent illegal heroin injection sites from coming to our state,” the statement read.

The post mentioned that Rod Rosenstein, deputy U.S. attorney general, wrote a New York Times opinion saying cities that create safe consumption sites will face “swift and aggressive action.”

“It is revealing (sic) moment in our state’s history that we must rely solely on the federal law enforcement for protection from a tiny elite that seeks to impose a dangerous social experiment on vulnerable communities,” the Safe King County statement continued.

Following I-27’s creation, supporters of the sites filed a lawsuit to block the initiative from reaching the ballot. It argued that the initiative violated the county’s authority to address public health issues, and in October 2017 a King County Superior Court judge ruled against I-27, keeping it from reaching a February ballot. This was appealed by supporters of the initiative.

The court ruled only on the budget implications of I-27 instead of whether the initiative had the power to affect public health policy, which was an argument that supporters of the consumption sites have made in the past.

Mark Cooke of the ACLU and Protect Public Health, an organization in support of the safe consumption sites, said the court did not need to address every argument to make its decision.

“The court doesn’t have to reach all the different legal issues that are raised,” he said.

Thursday’s ruling opens the doors for the county to begin setting up consumption sites as part of its pilot program. It is unknown what Safe King County or other organizations may do next, but Kohl-Welles said she has heard the group may file a statewide citizens initiative or push lawmakers in Olympia to introduce legislation prohibiting the consumption sites.

Advocates of such sites point to the safe consumption facility Insite in the Downtown Eastside neighborhood of Vancouver, British Columbia, which has run similar programs for years. Health care providers and researchers previously contacted by the Redmond Reporter, a sister publication of the Seattle Weekly, were adamant that such sites provided a public health benefit to drug users.

“There may be arguments against Insite, however, these arguments are not based in medical evidence because, indeed, the scientific evidence is clear,” Dr. M-J Milloy, a research scientist for the B.C. Center on Substance Use, told the Reporter in 2017.

Advocates of safe consumption sites in King County say they could help reduce the rate of deadly overdoses and new HIV cases and other diseases that can be easily transmitted through the use of needles.

On top of this, a report released Dec. 5 by the Washington State Department of Health showed the powerful opioid fentanyl has been causing more deaths in the state. In the first half of 2018, there were 81 deaths linked to fentanyl, up from 48 during the same period during 2017. Fentanyl can be up to 50 times stronger than heroin and many users may not know they’re using the drug if it is mixed or substituted for heroin. This should prompt public officials to explore new ways to combat the opioid epidemic, Kohl-Welles said.

“Clearly what is happening now is not working, our epidemic is being exasperated,” she said. “We need to get people who have drug issues and abuses and addicted into treatment programs. We can’t just wish that to happen, we have to meet people where they are at.”