By Erica C. Barnett

Mayor Bruce Harrell issued an executive order Monday expanding Health One to include a new overdose response unit aimed at getting people into treatment, directing the Seattle Police Department to “prioritize enforcing [illegal drug] sales and distribution related crimes to the fullest extent permissible,” and committing the city to “site, explore funding for, and work with the University of Washington Addictions, Drug and Alcohol Institute (UW ADAI), and County partners to establish a post overdose diversion facility where EMS can bring people after non-fatal overdoses to recover, get stabilized on medications, and access resources.”

Currently, when medics revive someone who has overdosed, the person can either agree to go to the hospital, where they’ll get information about treatment, or decline; a post-overdose facility would provide another route for people who would ordinarily decline additional care.

“What’s going to happen now is that [in addition to Fire Department medics], Health One is also going to respond” to overdoses, Seattle Fire Chief Harold Scoggins said at an event announcing the order in Pioneer Square Monday afternoon. “Health One comes with case managers and firefighters who are trained [to] talk to folks and really explain the resources that are available to them. After the fire units leave, the police units leave, Health One will still be on the scene.”

Harrell didn’t have many details about the plan to open a post-overdose response site, such as how it would be funded, who would staff it, or—importantly—why people who overdosed and refused to go to Harborview would be willing to go to a different facility. “Full disclosure: How it’s staffed, how we fund it—that’s the work we’re trying to do now, because in looking at the numbers of fatalities and overdoses, we realize that’s sort of a gap in our treatment scenario,” Harrell said.

The order also endorses an evidence-based harm reduction strategy called contingency management, which involves providing incentives, such as low-dollar gift certificates, to drug or alcohol users who enroll in treatment and stay clean. Contingency management has been especially effective at reducing stimulant use, for which—unlike opiates—there is no drug-based treatment. “We will do what makes sense to get people in treatment,” Harrell said.

City Councilmember Sara Nelson, who is in recovery and has previously expressed opposition to harm reduction approaches like medication-assisted treatment, called  contingency management a “proven method…  that rewards people who want to stay sober, and get on the path to long term recovery, no matter what their addiction.” After the press conference, she told PubliCola the program already has a funding source: Seattle’s share of a statewide fund that resulted from a settlement in the state’s lawsuit against the three largest opiate distributors.

The executive order also commits the city to “convene a workgroup to map out the various local, county and state programs and services available to treat and respond to the opioid and synthetic drug crisis.”

“This time-limited workgroup will be tasked with identifying gaps in our current systems and making recommendations on how to better coordinate a treatment-first approach to reducing substance abuse disorders and overdose rates. The workgroup will also assess ongoing investments and programs to determine what is working well and how existing investments could be expanded to serve more people.”

As a separate part of the downtown plan, the head of the city’s Office of Economic Development, Markham McIntyre, announced that the city will reopen City Hall Park next to the downtown King County Courthouse, which has been closed and fenced off since 2021 (more “jumbo chess boards”); open up streets to pedestrians  more often for special events, including, “perhaps, on-street pickleball tournaments”; and ask the Washington Liquor and Cannabis Board for “sip and stroll” liquor permits that would allow people to walk around with drinks during events like First Thursday art walks.