The Washington Supreme Court on Thursday unanimously upheld a lower court's decision to keep a measure banning safe injection sites in King County off the ballot.
The measure was beyond the scope of local initiative power and would interfere with King County's budgeting authority, the justices said.
A Seattle-King County task force studying ways to combat the opioid epidemic in 2016 recommended a supervised injection site pilot program that called for one site in the city and one in the county. The county council approved the recommendation and agreed to spend $2.1 million, while allowing cities to bar them from their incorporated areas.
Opponents, led by former Bothell Mayor Joshua Freed, proposed Initiative 27, which would have prevented public money from being used for safe injection sites and banned them in the county.
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A King County Superior Court judge blocked it from appearing on the ballot next February, and the Supreme Court upheld that decision Thursday.
Several other U.S. cities, including San Francisco, New York and Philadelphia, have expressed interest in opening supervised injection sites. Denver's City Council voted 12-1 last month to approve a measure that would allow one site to open for at least two years under a pilot program, though state approval is still required.
The efforts come as federal officials have vowed to crack down on injection sites. U.S. law makes it a felony to maintain a place for using a controlled substance.
In an op-ed in The New York Times in August, U.S. Deputy Attorney General Rod Rosenstein warned that cities and counties allowing such sites should expect "swift and aggressive action" from the Justice Department.
Seattle Mayor Jenny Durkan said in a written statement that while the city has committed $1.4 million in one-time funding to develop a safe-injection site, any such site should be accompanied by other services, including medication-assisted treatment, to help address opioid-use disorder — and that will cost at least $2.5 million annually.
"That need is one reason why securing additional state resources for mental health treatment and chemical dependency remains a top priority," she said.
Dr. Jeff Duchin, the county's public health officer, noted in a written statement Thursday that the county has money available to support a site in the city, his department's priority remains increasing access to other forms of treatment for opioid use disorder, such as buprenorphine.
"Treatment access will continue to expand over the next year, including through our Public Health Downtown Needle Exchange and King County jail," he said. "We're also preventing fatal overdoses by making life-saving naloxone kits available throughout the county."
King County Councilwoman Jeanne Kohl-Welles welcomed the ruling.
"Safe injection sites have the potential to change the trajectory of a person's life," she said in a written statement. "I only wish my young nephew had access to one before he died."