By Erica C. Barnett

The Downtown Emergency Service Center will open Seattle’s first post-overdose recovery center at its headquarters at the historica Morrison Hotel building in Pioneer Square next year. The Overdose Response and Care Access (ORCA) Center, part of a larger new behavioral health clinic, will be a dedicated space for drug users to stabilize, rest, and access voluntary treatment, including long-acting medication, after experiencing a nonfatal overdose.

Currently, when emergency workers revive someone experiencing an overdose in downtown Seattle, their options are basically: Transport the person to Harborview Medical Center or let them go. Those who walk away from an overdose typically seek out more drugs to counteract the effect of overdose reversal drugs like Narcan, which can send users into a state of painful, intense withdrawal.

The ORCA Center offers a third option for emergency workers to take people immediately after an overdose—”breaking the cycle of repeated overdoses” as Mayor Bruce Harrell put it Thursday, “by stopping painful withdrawal symptoms [so] people [can] find a pathway to recovery and support.” Admission to the ORCA Center will be voluntary, as going to the hospital after an overdose is today.

Thursday’s announcement took place in the second-floor area that will house the recovery center, which looks out on Third Avenue through large, semicircular windows. For decades, this floor housed a large, crowded shelter, along with day rooms and a clinic (and, at one time, an enclosed indoor smoking area). Today, the space is a hollowed-out construction zone, with two rows of metal lockers the only visual reminder of the building’s former purpose. Rooms that once held dozens of metal bunk beds are stripped to the studs, with cords hanging from the ceiling, and the floors have been stripped to their bare plywood bases.

PubliCola first reported on DESC’s plans last summer, after Harrell announced he would use $7 million in unspent federal funds to “provide care and treatment services for substance use disorders” in Seattle. DESC will receive $5.65 million of that total to help build out the new $12 million facility, which will also be funded through state and county grants and private donations. The remaining $1.35 million will go to Evergreen Treatment Services, which is building out a new campus on Airport Way.

Recent floods forced ETS to reimagine the facility, which will now include a “fire station-style” building to house its mobile units, which provide methadone treatment to hundreds of clients in downtown Seattle. ETS will also receive another $1 million from the city to add another unit to its mobile-clinic fleet, which ETS director Steve Woolworth described as another important part of the continuum of care for people with opioid use disorder.

Methadone is a highly effective treatment, but federal law requires patients to travel to a physical clinic to get doses until they “earn” take-home doses—a hurdle to recovery that’s even more daunting for people who lack a stable place to live. “Expecting folks who are living unsheltered… to come to a fixed location can’t be the only strategy we’re investing in to address community health,” Woolworth said. “And so what you’ll see from us will be a much more adaptive, flexible and mobile approach to taking medication out to where people are.”

The new recovery center won’t be a shelter, although it will have places for people to sleep. Legislation that established new licenses for 23-hour crisis clinics in 2023 stipulated that these clinics are supposed to offer “recliner chairs,” rather than beds, which is one way these clinics are distinct from hospitals or shelters. But, Malone noted, “true stability” will require places for people to live on a more permanent basis.

PubliCola is supported entirely by readers like you.
CLICK BELOW to become a one-time or monthly contributor.

Support PubliCola

“It’s very important to me that as we’re going through the process of getting the construction done here and opening this place, that we’re also working on finding more places where people are going to be able to stay after they leave here if they don’t have their own place” to live.

DESC will stand up the new overdose response center at a time when Mayor Harrell and the City Council are proposing new crackdowns on drug users downtown, including a public safety plan that will reported emphasize arrests for drug use and possession and discussions about moving some of the city’s contracted jail beds to SCORE, a quasi-private jail in South King County, so that people arrested under the new drug law can be booked and jailed instead of arrested and released. (The King County Jail has not been booking people for most low-level misdemeanors since the pandemic because of staffing shortages).

There’s an inherent tension between arresting people for using drugs in public—a policy that encourages drug users to hide and avoid city officials—and telling those same drug users to trust uniformed city employees to take them to a place where they can rest and recovery. Harrell doesn’t see this as a contradiction.

“We have to recognize that in addition to helping people as aggressively as we can, there’s still a need to use police to create safety,” Harrell said. “We are very cognizant that when we use terms like ’emphasis patrols’ or when we’re looking at some of the unlawful activity that occurs, alarms go up. I’ve made it clear that we don’t criminalize poverty, and we’re not fighting war on drugs—we have to help. But we also have gunfire in the streets. People are committing acts of violence. So our approach is holistic by design.”

Speaking to PubliCola after Thursday’s announcement, CARE Department Chief Amy Smith said her goal was to have emergency service providers like the CARE Team, not police, responding to all drug-related crisis calls. “We don’t want law enforcement to have to be involved at all,” Smith said.