By Erica C. Barnett

The Downtown Emergency Service Center, which operates shelters, housing, and mobile crisis response teams, will operate a new opiate overdose response center, serving up to 20 people a day, inside its Morrison Hotel building on Third Avenue in downtown Seattle. DESC director Daniel Malone says the new facility will share the second floor of the Morrison, which housed the agency’s congregate shelter prior to COVID, with an expansion of DESC’s existing outpatient behavioral health clinic and serve people looking for services and a place to physically recover immediately after an overdose.

Currently, if someone overdoses in Seattle and emergency medical services (EMS) responds, they generally face two options: Go to the hospital in an ambulance, or walk away. A post-overdose stabilization site would create a third option where people could rest, receive IV fluids or medication to get them through the early stages of withdrawal, and initiate treatment for opioid use disorder. Patients could also access DESC’s outpatient behavioral health clinic, which connects patients with psychiatric care, counseling, and case management.

Methadone—an opiate that effectively replaces more harmful drugs like heroin and fentanyl, allowing people to resume normal lives—remains one of the most highly regulated drugs in the nation; patients typically have to show up in a physical location to take a single dose at a specific time every day, although lawmakers temporarily loosened those restrictions during COVID. Buprenorphine, which works by partially occupying the brain’s opiate receptors, is more widely accessible, and a new injectable form of the drug, trademarked Sublocade, lasts a month.

“Methadone introduces a set of additional regulatory complications that the other medicines don’t have, but methadone would be an important tool in the toolbox,” Malone said.

Between January and July of this year, according to data from the King County Department of Public Health, emergency medical services responded to 2,546 nonfatal overdoses in Seattle, out of 4,918 countywide. Both fatal and nonfatal overdoses have increased steadily over the past five years, as fentanyl—a powerful opioid first developed as a pain medication in the 1960s—has worked its way into the street drug supply.

Funding for the new facility would come from the city of Seattle, King County, private grants, and the University of Washington’s Addictions, Drug & Alcohol Institute (ADAI). In July, the King County Council approved spending $2 million in unspent CLFR (federal COVID) funds to help renovate the second floor of the Morrison to accommodate the expanded outpatient center and the opiate recovery site.

The city of Seattle is expected to provide another $2 million for construction, out of $7 million in unspent federal funding that Mayor Bruce Harrell announced as part of his plan to “invest $27 million toward facilities, treatments, and services to address the opioid crisis.” As we’ve reported, the $27 million is actually $7 million in unspent federal grants for capital projects, plus a little over $1 million a year from state settlements with opiate manufacturers and distributors. That million dollars could could help fund the day-to-day operations of the new overdose recovery site over the next two decades, but it won’t be enough to keep the new site open full-time, Malone said.

“If there’s not enough money to [operate] 24/7, then some version where it’s only open certain hours may have to be implemented,” Malone said. Overdoses happen at all hours, so having only a part-time facility “would seriously limit the ability of this facility to meet all the community’s needs over the course of the day.”

Harrell expressed support for a post-overdose recovery center back in April, when he signed an executive order expressing the city’s commitment to site and “explore funding for” a new facility “where EMS can bring people after non-fatal overdoses to recover, get stabilized on medications, and access resources.” However, his office would not comment on the plan to open the site on Third Avenue, and would not confirm that DESC was the intended recipient of the funds Harrell announced last month. “There is [a request for proposals], and no decisions have been made,” Harrell spokesman Jamie Housen said. “It is a competitive process, and we expect DESC will apply.”

King County just approved spending $2.2 million in unspent federal COVID relief dollars to help renovate the site, which used to house DESC’s congregate shelter, last month.

The Morrison Hotel, which also includes 190 permanent supportive housing units, is located directly across from the King County Courthouse. The sidewalk around the building’s Third Avenue entrance is often occupied by people who are unhoused, have untreated behavioral health conditions, or are actively using and selling drugs, making the building a target of frequent complaints and a perennial subject for conservative local media such as KOMO News, which infamously blamed DESC for crime on Third Ave. in its followup to the agitprop film “Seattle Is Dying.”

In addition to funds for the overdose site itself, King County approved $200,000 for a “client engagement team” that will “manage client presence and prevent conflicts on Third Avenue in front of DESC’s renovated facility,” according to a King County Council memo.

“It’s extremely important to us to make sure that we won’t have that kind of chaotic and disruptive activity happening on the sidewalk in front of the building, and part of our plan is to really enhance our capacity to have a much stronger presence to help ensure that the environment is calm and conducive to people coming and going safely,” Malone said. The new staff will “be present not just inside, but in the immediate external sidewalk area… to connect with people who are out there and deal with anything that may be happening that is contributing to an undesirable environment.”

Judges and other courthouse officials have complained for years about safety issues around the courthouse, which also borders City Hall Park—a compact greenspace that recently reopened after a lengthy closure. King County Superior Court Judge Patrick Oishi, who has repeatedly raised alarms about the safety of jurors and courthouse staff, told PubliCola he hopes the opioid recovery center will have a positive impact on the street scene around the courthouse.

“Although it is difficult to predict what impact an opioid recovery center will have on the courthouse area, the Court commends Mayor Harrell, the City of Seattle, and King County for taking critical steps to address this significant public health crisis,” Oishi said. “It is our hope that responding to the opioid crisis will enhance public safety in the courthouse area.”