Thank you, Madam Chair, members of the Committee.
My name is Barbara Brohl and I am here to testify in support of Senate Bill 18-040. I’ve often said that the measure of a government is how it treats its most vulnerable. That group includes those who are addicted to drugs or alcohol. If you’ve worked, lived, or played downtown, you’ve seen them – those nameless, sometimes faceless individuals who at times blend into the background.
Some of them became addicted as a result of opioid use, mental illness, or they began using drugs in other ways. How they became addicted is not an issue for my testimony. Suffice it to say this is not only their reality but ours as well.
They are addicted, and the issue is what can be done about it.
As the ED for the DOR from 2011 to August of 2017, I was the State Licensing Authority for tax, liquor, tobacco, and marijuana.
I regulated marijuana for six years, working very hard to get our arms around the medical side and then was responsible for rolling out Amendment 64’s mandate of adult-use marijuana.
Throughout that time, I took my responsibility to protect the public safety while balancing burden on the industry very seriously.
What I began to understand and learn more about was the concept of “harm reduction”.
Effective drug treatment strategies utilize four pillars—biomedical strategies, psychological strategies, social approaches, and harm reduction. These are explained in detail in the November 1, 2017 letter to President Trump by group of addiction treatment, education and research professionals.
- Biomedical strategies are fairly new and include treatments that prevent overdose such as Naloxone or Narcan, and those that are effective in preventing relapse such as methadone, Naltrexone or Vivitrol, and Antabuse.
- Psychological strategies address the underlying emotional issues that can drive addiction to begin with.
- Social approaches address how socio-economic circumstances play a role in addiction.
- Harm Reduction strategies recognize that although drugs and alcohol can have destructive impacts on the lives of the people who use them, it is also extremely difficult for many to become abstinent. Thus, many are not ready or able to stop. Harm reduction strategies “meet people where they are”.
I had the opportunity to see these strategies in action while speaking at a Harm Reduction Conference in Switzerland and then touring a Supervised Injection Facility in Frankfurt, Germany. The most progressive part is the Harm Reduction pillar and is the pillar I will discuss today.
When I first heard about Harm Reduction, I was fascinated and did not understand what it meant, how it came about, and how it could work. I was very fortunate that I was able to talk with former Swiss President Ruth Dreifuss, who is now a Commissioner on the Global Commission on Drug Policy. She explained how supervised injection facilities had come about in Switzerland.
As I learned more about Harm Reduction, I learned how supervised injection facilities play an essential role in Harm Reduction and Public Safety. Because frankly, Public Safety and Harm Reduction are two halves of the same coin. Implementing Harm Reduction concepts for persons who use drugs generally means that they will not inject on the street, the alley, or in a public restroom. By definition, that increases public safety.
Harm Reduction Encompasses Many Things.
First – Needle exchanges – that is a good start. It has been shown to lower the risk of HIV transmission and in many areas in the world, including here in Colorado, the rate of new HIV infections among people who inject drugs has dropped significantly. I applaud the Harm Reduction Action Center for the work it has done.
Second – Supervised injection facilities – I am one of the few Coloradoans who has seen one and toured one. I have seen how they work. I still maintain a relationship with the director in Frankfurt, Germany.
What I saw when we arrived at the facility was not what I expected. I expected to see a lot of people milling around, asking for money, maybe even dealing drugs. That was not the case. What struck me at first was the line to come into the building – it was short – and the people who were waiting were quiet, patient, and well-behaved. There weren’t conflicts in line and I didn’t see them create problems for the public that was passing by.
When we entered, I discovered why. These individuals must schedule a time to enter and use the Supervised Injection Facility. The supervised injection room has two parts that are divided by a glass wall. There are medical professionals on one side of the wall and study carrels on the other side of the wall where people who inject drugs can consume with some modicum of privacy. The medical professionals are there in the event one of the patrons overdoses or needs medical care. They can either administer medication to counter the overdose such as Narcan or call for an ambulance.
The Eastside Facility in Frankfurt, Which is the One That I Toured, Offers the Following Services
- Social Services – counseling and assistance with physical, psychological, and social problems
- Craft Shops – assistance with job placement
- Living Quarters – the residential area provides for 73 sleeping facilities in dorm-like rooms; 24-hour staff; which helps to ensure their survival and provide daily structure.
- Café – provides for meals and other basic necessities
- Supervised Injection Room – provides hygienic conditions for drug consumption, needle and syringe exchanges, advice and information about the risks and prevention of blood-borne infections. In emergency cases, the staff provides first-aid and – if necessary – calls an ambulance.
During counselling and interventions with the clients, the staff address the issue of problematic drug use and counsel drug users to seek support in behavior change.
So, these individuals come to “feed their immediate needs” with an injection and as they build trust, many of the individuals decide to “feed their long-term needs” with treatment, health care, a place to sleep, shower, do laundry, and ultimately work
Some Statistics About the Supervised Injection Facility in Germany:
- The non-profit facility was founded in 1989.
- The first Supervised Injunction Room opened in 1991.
- 25 Supervised Injunction Rooms are operating throughout Germany (4 are in Frankfurt).
- HIV prevalence in persons who use drugs decreased from 20% to 4-6% today.
- The facility I toured serves approximately 1,500 clients annually, and 1,200 are referred for other social services and help.
Benefits as a result of Supervised Injection Facilities:
- To the general public: the people who use drugs consume mainly in those facilities instead of public places.
- This reduces the tension in public places, which lessens the need for police action and increases the feeling of security among the public.
I urge the Committee to vote yes on this bill. I recognize that this is a difficult subject, but things worth doing are rarely easy.
Colorado voters have a history of taking care of its most vulnerable from being the first state to grant women the right to vote by popular referendum, to Referendum C passed in 2005, restoring some of the funding for mental health services that had been cut previously.
We take risks. For example, we provided a global model on the implementation of adult-use marijuana statutes and regulations, and we continue to make improvements to this day.
I’ve worked with this Legislature for six years, I know it is a body of people who take their commitment to the service of the people of Colorado seriously – and this legislation will not only continue Colorado’s legacy of caring for the vulnerable, and for leading the nation in tackling complex issues, but it will further cement this Legislature’s place in history as one which serves the needs of all Coloradoans.
This concludes my testimony and I can answer any questions you may have.