Category: Addiction

Addiction, Drugs, Police

Seattle’s CARE Department Chief Amy Barden and Her Husband, Former Deputy Police Chief Eric Barden, Have a Podcast

By Erica C. Barnett

Amy Barden, the chief of the Community Assisted Response and Engagement (CARE) program, has started a podcast called BomBardened along with her husband, recently retired deputy police chief Eric Barden. The first episode of the show features a conversation with Ginny Burton, founder of a prison-based program called Overhaul—Unrelenting Transformation—and a vocal critic of evidence-based approaches to addiction and homelessness, including Housing First, harm reduction, and medication-assisted treatment.

Barden said the show gives her and her husband an opportunity to highlight, though not necessarily endorse, the perspectives of guests with various views and backgrounds; upcoming guests will include actor Billy Baldwin; Pallet Shelter and Weld founder Amy King; and peer counselor and drug court housing case manager Joe Barsana.

“The basic idea behind it was to be able to debate things respectfully,” Barden said. “[Eric and I] have really different lenses on most of the issues, but happily, most of the time we have reach similar conclusions about what would be most helpful.”

The podcast’s kickoff interview was the second Amy Barden has done with Burton, who interviewed Barden on her own Modern America podcast earlier this year. On that show, Barden appeared to agree with Burton’s criticism of low-barrier supportive housing providers like the Downtown Emergency Service Center—whose buildings get a high number of 911 calls because they house people with challenging mental health conditions who would otherwise be on the street—and praised Union Gospel Mission’s high-barrier shelter, which has a different population and purpose, for having fewer emergency calls.

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

Support PubliCola

 

“The spirit of the place is different. There are more activities, there’s more pro-social behaviors,” Barden said. Asked about those comments, Barden said that “from a 911 lens, [UGM] is a more peaceful environment, but you’re 100 percent right that DESC is doing its best to get the very most vulnerable people inside.”

As the first guest on BomBardened, Burton laid out her views as an advocate for abstinence and incarceration, and mentioned that she personally hosts people who want to “kick” fentanyl at her house. In Burton’s view, using medication, such as buprenorphine or methadone, to treat addiction is just embracing addiction to a different drug—an opinion that was once common at treatment centers and in 12-step recovery groups, but has become less prevalent as attitudes toward medication-assisted treatment have evolved.

“When you’re dopesick, that’s when the clarity starts to occur,” Burton said, adding that harm reduction is a “distorted concept” pushed by pharmaceutical companies to keep people addicted to drugs that that “get you loaded.” (The general medical consensus is that in prescribed doses, opiate replacement drugs make it possible for people to function, and don’t get them high.). Instead of pushing back, Barden agreed that reducing harm or keeping people stable is not enough. “Somebody should be better off in six months and much better off in a year,” Barden said.

Barden said she didn’t push back on Burton’s views, which contradict the approach adopted by the CARE dual-dispatch team, because she isn’t an expert on addiction. “When I watched it back, I though there were a couple of things I wish I had interrogated,” she said, adding, “I’m a harm reductionist—but I’m a directional harm reductionist.”

Eric Barden, who left SPD in December, said first responders should have more power to force people into treatment after they reverse an overdose, comparing that near-death experience to someone who tries to jump off the bridge. In the former case, he said, first responders have to let the person walk away.

“That’s not what we do with somebody who’s going to jump off the bridge. We try to save them, and then we take them and we involuntarily commit them to treatment, because we know that they’re in a place that’s going to ultimately lead to their death. And there is absolutely no intellectual difference between the addict who is overdosing and is going to kill themselves than the person that’s about to jump off the bridge, and yet we treat them very, very differently.”

(Not to belabor this too much, but “treatment” is not one thing and it is incredibly difficult to access if you’re poor. Also, the state’s involuntary treatment act has strict standards for commitment, and even those who meet the standards can only be detained for a maximum of 14 days.)

Barden said she and her husband have different perspectives on addiction because “he’s generally informed by the worst-case scenario.” But, she added, fentanyl is different than other drugs, in that it’s deadly and can cause cumulative brain damage. (Again, not to belabor, but: Same goes for alcohol.) “If it’s predictable that you’re not going to be here in a couple years, I do think we should be thoughtful about that,” Barden said. “We can’t just keep Narcaning the same kid without [us] taking some kind of accountability.”

Editor’s note: This post initially misstated Eric Barden’s former position; he was deputy chief of SPD, not assistant chief. Amy Barden also reached out after publication to clarify that in her final quote, she meant that “we in public safety should assume accountability, not the person being revived again and again.” We have updated the post to reflect these changes.

Addiction, City Council, Mayor Harrell

CARE Crisis Response Team Moves into South Seattle As Council Complains It’s Ineffective

 

CARE Team director Amy Barden (l) along with two members of the crisis-response team.

By Erica C. Barnett

The city’s CARE Team, a group of 24 civilian first responders who respond to 911 calls that don’t require a police presence, announced Wednesday that they’ll soon be expanding into Southwest and Southeast Seattle. The team is part of the city’s 911 department, now called the CARE (Community Assisted Response and Engagement) Department.

In a news conference outside the Delridge Community Center Wednesday morning, CARE Department chief Amy Barden compared the pilot program to the construction of the waterfront tunnel that replaced the Alaskan Way Viaduct, making the new Overlook Walk park at Pike Place Market possible.

“The vision was to recapture and acknowledge the spirit of our ancestry, the essence of our shared values, to reaffirm our connection to nature and to each other,” Barden said. “And so then my thoughts naturally turn to the past two years, to my adventures and the questions and comments and skepticism and incredulity I’ve encountered.”

The viaduct replacement may not be the most auspicious metaphor (just south of the Market, the waterfront street widens into a vast, ugly highway), but the skepticism about the CARE team’s progress is just as real as criticism of the tunnel project was a decade ago.

That skepticism, Barden noted, has sometimes come from people who think it’s unsafe to send social workers to respond to 911 calls, or asking why the city is spending money on the CARE pilot instead of police. More recently, though, it came from members of the City Council, who interrogated Barden last week about why CARE hasn’t shown more progress at improving conditions on Seattle streets.

The pilot program, which began with six staffers in 2023, is now a 24-person team (plus three staff who don’t respond directly to calls) for which the city spends a little more than $2 million a year.

In a meeting of the council’s public safety committee last week, council members interrogated Barden about what they described as a lack of results from that spending. Cathy Moore (whose district was not served by the pilot program until very recently) said she was dismayed to hear that her constituents were calling 911 for people in crisis and CARE wasn’t being dispatched.

“We have enough money in the city. We have enough services in the city to make it work. You’ve been in place now for a while. Why are we not doing a better job with the resources that we have?” she asked.

Other council members piled on, saying the city already had “an abundance of services” to help people in crisis (Rob Saka), that CARE was failing to call designated crisis responders to force people into treatment (Moore), and that the project, in general, “isn’t working” and shouldn’t be expanded until it is (Maritza Rivera).

“It’s a very broken system, and we have to fix it,” Moore said. “And just creating one more … agency, and [spending] another $100 million, is not going to fix it if we don’t come together holistically and talk about how it’s broken, be honest about where it’s not working, and the fact that we have different ideological positions about what should be happening. And we need to be evidence-based and be prepared to say sometimes, ‘Your civil liberties do you no good if you’re dead.'”

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

Support PubliCola

 

Barden noted that the CARE team has just 24 members, spread across the city, which means that in Moore’s council district, there probably won’t be more than two to four people available to respond to calls at any time. “North is absolutely a priority for me,” she said. “We are studying those crisis hot spots, but I want to manage your expectations.”

One thing Barden didn’t bring up explicitly is that the CARE Team can only refer to services that are available, and that those services—including long-term treatment, case management, housing, and even basic detox—are not as ample and widely available as council members repeatedly suggested. Nor is it a great use of resources to send people through inadequate light-touch services again and again, Barden noted.

After Barden said 14 days in a facility isn’t long enough for someone to make major, necessarily life changes before sending them back out onto the street, Moore objected, citing the common refrain that relapse is a part of recovery and it often takes “many rounds” of treatment for people to get sober.

The other solution Moore suggested, involuntary commitment, is not a simple matter of pulling people off the street and taking them to treatment; even those who meet the standards in state law can only be confined for five days against their will, plus a potential 14 more with a judge’s order.

Speaking with PubliCola a few days after the council meeting, Barden expressed frustration at council members who say “‘Hey, Amy, can’t we round everybody up and detox them?’ … I don’t know why it’s so difficult to grasp that different levels of support work for different people. A lot of people [on the street] are demonstrably getting worse, but we’re like, ‘Sentence fulfilled, return to community!'”

In its first 18 months, the CARE team has responded to just under 1,800 calls. While council members like Saka expressed skepticism about expanding the pilot “unless and until” the pilot “is starting to achieve better results,” the primary constraint on the CARE Team’s size is a memorandum of understanding between the CARE department and the Seattle Police Officers Guild limiting the total number of CARE responders to 24. Any future expansion—Barden has suggested 96 responders as a near-term goal—will have to be bargained with SPOG, which has historically resisted reducing the police department’s authority in any way, including for jobs such as directing traffic at special events.

On Wednesday, PubliCola asked Harrell whether he shared the council’s concerns about CARE’s effectiveness. “I think that there was somewhat of a misunderstanding of the role and scope of these fine people,” Harrell said. “So we will take the feedback. … And hopefully, a year from now, we’ll have even more success stories on the lives we save.”

 

Addiction, City Council, Drugs, King County

County Says They Have “No Intention” of Turning Sobering Center into a Secure Facility for Drug Law Violators
The Yesler Building, site of the county’s sobering center since 2019 (photo via King County)

By Erica C. Barnett

Earlier this month, City Councilmember Maritza Rivera proposed a budget amendment directing the city’s Human Services Department to analyze “the appropriateness and feasibility” of using King County’s sobering center, which provides people a place to recover from the acute impacts of alcohol and drug intoxication, “to address individuals arrested under Seattle’s drug possession laws, including an evaluation of the need and feasibility for such a facility to be secure.” The amendment is now in the council’s “consent package” of amendments slated to pass without further discussion.

But King County says it has no interest in converting the sobering center into a secure facility for people arrested for public drug use and possession, and says neither Rivera nor Council President Sara Nelson, who supports Rivera’s amendment, has reached out to the county to discuss their idea.

“The City of Seattle has not spoken to us about these budget requests, and the County has no intention of changing the model to what the Councilmembers describe,” King County Department of Community and Human Services director Kelly Rider told PubliCola. “The intended purpose of this facility is to serve people living unsheltered to sleep off acute alcohol or drug intoxication or opiate overdose and connect them to treatment, housing assistance, and other supports.” 

During a recent council discussion, Rivera said the sobering center was a facility the county “had [operated] pre-COVID, actually, and had not reopened. I know that they’re looking to r- establish and reopen it.” In fact, the county’s sobering center has been open continually in various locations, mostly the Yesler Building in Pioneer Square, since before the pandemic, and has been operating out of the Yesler Building since 2022.

However (as a more recent staff description of Rivera’s amendment acknowledged) it has faced challenges finding a permanent location. In 2022, a plan to move the sobering center to an existing Salvation Army shelter in SoDo was thwarted by anti-shelter efforts led by, among others, Chinatown/International District activist Tanya Woo—who subsequently ran for city council, lost, got appointed, and then lost again.

Rivera said the sobering center could be a place where people who use drugs in public “can sober up, and then we can offer services and they can consent and then go get the treatment that they that they really need.”

The sobering center, which is operated by Pioneer Human Services, currently offers case management and can direct people to treatment and other services, but it does not compel people to “go get treatment” and most people who leave the facility do so by walking out the door. Its primary purpose is to relieve downtown emergency service providers by giving people under the influence of substances a safe, dry place to go that isn’t the hospital or jail. Sobering centers have been around, and serving this specific, limited purpose since the 1970s.

The county is still looking for a building to permanently house the sobering center, allowing the county to double its current capacity from 30 to 60 people a night.

Addiction, City Council, Drugs, housing, human services

Auditor: City Needs to Implement Smarter Strategies to Reduce Overdoses and Drug-Related Crime

By Erica C. Barnett

The City Auditor’s Office released a report on Tuesday calling for an “place-based problem-solving approach” to addressing overdoses and drug-related crime, basing its recommendations on local and national research as well as a case study focused on two blocks of Third Avenue between Blanchard and Virginia Streets, where there were 11 fatal overdoses, ten of them in or outside of the three permanent supportive housing buildings in the area.

This section of Third, according to the audit report, had the fourth-highest concentration of overdoses and “crime incidents” in the city; the top ten spots on this list are all in or around downtown, encompassing much of Third Avenue along with hot spots just outside downtown, including 12th and Jackson in the International District, around Harborview hospital on First Hill, and in the area around Pike and Broadway on Capitol Hill.

A “place-based” approach to overdoses and street crimes, according to the report, would include making the areas where drug use and illegal street vendors concentrate more appealing to people using the streets for other purposes— essentially dispersing drug activity and improving overall street safety by activating the sidewalks. For instance, the report identifies opening up sight lines in areas that are currently blocked by construction scaffolding and low-growing shrubs, opening up storefronts that are currently vacant to increase “natural guardianship,” and making other changes that are specific to conditions at specific locations, such as eliminating back-in angled parking on Blanchard Street.

City Council Public Safety Committee chair Bob Kettle put out a statement in response to the audit, saying it showed the need for “additional meaningful action that includes a coordinated effort to address permissive factors at the intersection of public safety and public health.” However, few of the recommendations explicitly involve police or a crackdown on the “permissive environment” Kettle often cites as a reason for crime. (The report does recommend that that Seattle police start investigating fatal overdoses, and says King County transit police should “increase patrol checks of bus stops and shelters” and enforce the Metro code of conduct.)

Instead, the audit points to the community-based project Rainier Beach: A Beautiful Safe Place for Youth, which used a framework developed by the Substance Abuse and Mental Health Services Administration’s (SAMHSA) to identify non-arrest interventions to address youth crime and victimization in Rainier Beach. Although the project wasn’t connected to an immediate reduction in crime, a followup report found that it “significantly improved community members’ perceptions of serious crime and the police in the short and medium term” and suggested that “even communities with entrenched crime problems can leverage this capacity to reduce crime in the longer term.”

The report also emphasized the need for “evidence-based” approaches to drug use, including medications like naltrexone and methadone that help people reduce or eliminate their opiate use, “wraparound human services,” recovery housing, and harm reduction for people who continue using drugs.

Although Councilmember Sara Nelson, in a letter responding to the audit, wrote that the rise in fatal overdoses “reveal[s] the limitations of relying on our current harm reduction approach to address a drug that is so cheap, ubiquitous, and deadly,” the report actually endorses harm reduction strategies like needle exchanges and naloxone distribution, and calls harm reduction “an essential component of overdose prevention framework.”

The report does note that housing is not a panacea for preventing overdoses, which happen indoors as well as on the street. In 2023, 279 people in subsidized, permanent supportive, or abstinence-based recovery housing died from overdoses in Seattle. “Although housing is essential for addressing homelessness, new research suggests that housing alone does not sufficiently address overdose risk,” the report notes

Nelson, a proponent of abstinence-only treatment, said this finding shows that the city should consider “modifying our current low-barrier, housing first model for city-funded affordable housing projects.”

However, the research the auditor’s report cites did not call for erecting barriers to housing or adopting a “treatment first” model that requires people to get sober before they “qualify” for housing and stay sober if they want to keep it—quite the opposite.

In fact, the author of the forthcoming study has written that existing research suggests the need for both low-barrier housing and “co-location of safe consumption sites, on-site provision of harm-reduction supplies, and expansion of peer workers” at permanent supportive housing sites. The study itself aims to confirm that it’s possible to implement “gold-standard” strategies like harm reduction in permanent supportive housing, not test whether these strategies are worth pursuing.

The study involves implementing three evidence-based strategies—overdose response, harm reduction, and support for substance use disorder treatment—in 20 existing permanent supportive housing buildings in New York.

Addiction, City Council, Equity, homelessness, Police, Transportation

Afternoon Fizz: Encampment Removal Recommendations, Transportation Equity, and Police Testing

Council members say no to homelessness recommendations; equitable transportation advocates decry proposals to cut community-based programs; and police recruits won’t get a chance to take an easier hiring test any time soon.

1. Seattle City Councilmembers Joy Hollingsworth, Bob Kettle, and Sara Nelson declined to sign off on a set of recommendations for responding to encampments at a King County Board of Health meeting yesterday; the recommendations, created by the Board of Health’s homelessness and health work group, include limits on encampment removals, adopting harm-reduction policies such as a “housing first” approach to people with addiction, and increasing access to mental health and substance disorder treatment.

“If we do not remove [encampments], resolve, whatever it is, we are complicit in allowing a situation where more and more people fall into or [fall] deeper into addiction and chronic homelessness because their lives are further disrupted,” Nelson said. “I think that it’s also an issue of nomenclature— ‘forced removal’ versus ‘resolution’… so much depends on the words in the statement, and so therefore, for these reasons, I will not be signing on.”

Kettle, who represents downtown, Queen Anne, and Magnolia, said, “I’ve often said that we need to lead with compassion, we need to start with the empathy, but then we also have to have the wisdom to understand that we have the broader community to also look after.” Kettle praised the work of Mayor Bruce Harrell’s encampment removal team, the Unified Care Team, and said he liked the model at the Salmon Bay tiny house village and RV safe lot in Interbay, which “gives people the ability to basically graduate from the RV to a tiny home.”

King County Councilmembers Teresa Mosqueda and Jorge Baron, who are both on the Board of Health, signed on to the “call to action.”

2. In response to proposals to cut funding for community-initiated transportation safety projects from the 2024 transportation levy, the Seattle Department of Transportation’s Transportation Equity Workgroup wrote a letter to the council saying the proposed cuts “will exclude your marginalized constituents who rely on a safe and accessible transportation system for their everyday needs.”

PubliCola reported this week on amendments by Councilmembers Rob Saka, Cathy Moore, and Sara Nelson to scale back or (in the case of Moore’s amendment) eliminate a proposed new participatory budgeting program aimed at building 16 projects identified and “co-created” by historically marginalized communities. Moore and Saka proposed moving funds from the proposed new program, known as the Neighborhood-Initiated Safety Partnership Program, into a separate fund for projects council members themselves would select.

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

Support PubliCola

“After expressing our concerns at the previous two council meetings through public comments and letters, we are disappointed in your lack of commitments to the City of Seattle’s Race and Social Justice Initiative (RSJI) through cuts to equitable investments that center low-income, BIPOC, immigrant, refugee, disabled, and aging communities,” the workgroup wrote.

“Community-driven projects take time in order to engage those who have been historically disengaged from city planning processes due to barriers such as: language access, lack of trust, and capacity. Relying on district-level decision-making only, as outlined in councilmember amendments, does not adequately address these barriers to full participation, and risks neglecting community-identified safety concerns in underserved areas.”

3. The president of the company that created Seattle’s police officer exams, which some City Council members have suggested replacing with a test that has a higher passing rate, appeared at a meeting of the independent Public Safety Civil Service Commission on Thursday to explain how the test is designed to predict future job performance. The Seattle Police Department began using the test, created by the National Testing Network in collaboration with SPD, in the wake of a consent decree by the US Department of Justice in 2012.

To “validate” that the test predicts job performance, NTN president Carl Swander told the commission, the company compares police officers’ test scores, which are ranked, with their subsequent on-the-job performance evaluations. Swander said by demonstrating that “at [a higher score level], people are more likely to do better than at [a lower] score level,” NTN can create a “cut score”—the maximum passing score—that weeds out people who are obviously unqualified to be police officers.

Other tests, like the Public Safety Testing exam that City Council President Sara Nelson has suggested as an alternative to the NTN test, don’t “actually substantiate… that you’re that what you’re doing is predictive of job performance,” Swander said. Ninety percent of applicants who take the PST test pass it, compared to a 73 pass rate for the NTN exam.

PSCSC director Andrea Scheele also confirmed that if Seattle did contract with PST in the future, it would have to create a custom exam for Seattle, which “eliminates or reduces, at least, the benefit of working with that company.” Nelson and other proponents of changing the hiring test have suggested that switching to PST would allow applicants to submit their test results to multiple agencies at the same time.

A report the commission issued earlier this week notes that the PST test “is not an option” because the company “does not want to provide police testing services for the City of Seattle right now.”

 

Addiction, Drugs, homelessness, Mayor Harrell

Downtown Recovery Center Will Give Drug Users New Options After an Overdose

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. Continue reading “Downtown Recovery Center Will Give Drug Users New Options After an Overdose” →