Tag: heroin addiction

After Two-Year Gap, Detox Center Will Open on Beacon Hill

King County Executive Dow Constantine stands next to a detox bed at the soon-to-open Recovery Place.

The new detox and inpatient treatment center that will open later this year on Beacon Hill doesn’t look like much from the outside. A low-slung institutional building surrounded by a black iron fence and fronted by a small parking lot, it looks somewhat out of place in a residential neighborhood where brightly colored townhouses have sprouted like dandelions in recent years.

Even from the inside, you have to squint to imagine the transformation—from what Valley Cities Behavioral Health Care CEO Ken Taylor called a “ghastly” institution, run by Recovery Centers of King County, into a modern, brightly lit facility with fitness rooms, two large kitchens, and rooms for group meetings and private counseling.

The opening of the new facility, called Recovery Place, marks a significant milestone for detox and treatment in King County—the restoration of 32 beds for people needing medical detoxification from alcohol, heroin, and other drugs, and the first residential detox center in King County where people can access treatment for addiction and mental health issues simultaneously. (Most treatment centers do not deal with dual diagnoses).

The city’s Navigation Center, a new low-barrier shelter less than a mile away, will direct clients to Recovery Place, which will also take patients directly from emergency rooms and (eventually) on a walk-in basis. In addition to detox and a traditional two-to-four-week inpatient treatment program, the center will offer medication-assisted treatment with drugs like buprenorphine to heroin and opiate addicts. “We’re embracing a harm-reduction approach as much as an abstinence-based approach,” Milena Stott, Valley Cities’ director of inpatient services, said.

Valley Cities CEO Ken Taylor in the detox wing of Recovery Place

The last tenant to occupy the building, Recovery Centers of King County, went bankrupt and shut down abruptly in 2015, and since then, the 27 detox beds they provided have been distributed all over King County through contracts with institutions like Fairfax Hospital in Kirkland and the Seadrunar long-term treatment center in Georgetown.  Before RCKC closed down, Taylor said, the building “was dark and damp, and all throughout the central corridors there was plumbing and electrical running literally right down the middle of the corridor.” Outreach workers told me last year that RCKC was known for treating clients rudely and asking “inappropriate” personal questions in earshot of other patients; the new facility, in contrast, will have private consultation rooms. After RCKC closed, the building itself was taken over by squatters and stripped bare, with everything from the toilets to the copper wiring stolen and carted away.  Morgan Irwin, a Republican state representative (R-31) and Seattle Police Department officer who was on hand for yesterday’s tour, said that the last time he was inside the building, which is on his beat, “It was literally flashlight and gun out.”

The building cost $4 million to buy, plus $9 million to renovate. A million dollars of the budget to buy and fix up the building came from King County; the rest came from a combination of state and grant money and a $4.5 million loan that Valley Cities took out from Bank of America to cover the remaining costs. The state’s capital budget, which remains in limbo, is supposed to provide about $2 million toward the cost of repaying the loan, but Taylor said Valley Cities “is going to be able to repay the loan” ion its own if state funding doesn’t come through. “We’re very fortunate. Not every agency can do that.” Ongoing operations will cost about $5 million a year; that funding will come from the state and federal governments as well as from patients’ insurance payments. RCKC went bankrupt, King County Human Services Department director Adrienne Quinn told me, in part because of unfavorable state reimbursement rates, which she was quick to add have been addressed.

Contrary to common belief, not every person with addiction needs detox, although medication can ease the suffering and make it less likely that people withdrawing from opiates, for example, abandon treatment. (Severe alcoholism does require detox because going cold turkey can cause seizures, DTs, and fatal heart conditions.) Buprenorphine, and other opiate substitution medications, can help short-circuit the withdrawal process and get opiate addicts on a path to stability. “I hope that everyone for whom buprenorphine is appropriate will elect to do that,” Taylor said, “but sometimes it takes them time to get to that point.”

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County Presses Pause on Safe Consumption Sites

Two weeks ago, rejecting the unanimous recommendation of the King County Heroin and Prescription Opiate Addiction Task Force, the King County Council voted to prohibit funding for supervised drug consumption sites except in cities that explicitly approve them—a sop to suburban cities and rural areas where residents are vehemently opposed to the sites and a slap in the face for the task force, which recommended a pilot project that would include one supervised consumption site in Seattle and one somewhere else in the county. (The county refers to supervised consumption sites by the clunky acronym CHELs, for Community Health Engagement Locations).

The council also voted to prohibit the county from funding safe consumption sites anywhere outside Seattle, and barred spending any of the county’s general fund on a Seattle site. As a result of those restrictions, any money for the pilot project would have to come from the county’s Mental Illness and Drug Dependency levy—a tax that generates about $66 million a year but is already largely spoken for. The supervised consumption pilot was never supposed to be funded entirely through the MIDD, and supporters say that as the cost estimate for the pilot has ballooned to more than $1 million, the likelihood that it can be funded MIDD dollars alone is virtually zero.

“EFFECT: Restricts the General Fund Transfers to DCHS and Public Health such that 86 no General Funds can be used to establish CHEL sites. Restricts the MIDD  appropriation such that no MIDD funds can be used to establish CHEL sites outside 88 the city of Seattle.” – King County budget amendment barring county spending on safe consumption sites outside Seattle

Kris Nyrop, who wrote an op/ed for the Stranger comparing the council’s move to the “state’s rights” politics of the 1980s, says the vote “effectively kills” safe consumption sites, at least for the next two years, because “The MIDD dollars are all already accounted for until the fall of 2018” and because “the [King County] health department has dithered so long on this that they have given the opposition time to really organize” against it.

Supervised consumption sites, where addicts can use illegal drugs under medical supervision in a location that also offers medical care, detox, and referrals to treatment, are common in Europe but almost unheard-of in North America, where more puritanical attitudes toward addiction have made them controversial. The idea behind supervised consumption is that it keeps people from dying of overdoses and treatable conditions (like wound infections), prevents disease transmission via dirty needles, and gets people who may not have seen a doctor in years into the health care and social service system, providing a lifeline toward housing, treatment, and recovery.

“We haven’t yet done the work that we need to do at the council to understand the proposal, the benefits, or the criteria for when and where these [safe consumption sites] make sense.” – King County Council Democrat Claudia Balducci

The sites are controversial for obvious reasons: Intuitively, giving drug addicts a safe place to consume dangerous, illegal drugs seems like condoning their behavior. (This view assumes that addiction is a choice and ignores the fact that forcing people into treatment, an alternative that safe consumption opponents frequently suggest, is cost-prohibitive and doesn’t work, but it’s ultimately an emotional argument, not a rational one.)

“Trust me, you don’t treat alcoholism by inviting alcoholics to the bar,” Republican county council member Reagan Dunn, who has been public about his own struggles with addiction, said before the vote. “Fifty-six percent of my constituents said they are extremely against these sites. Only 20 percent of people indicated they were open to considering these sites.” Dunn said he was concerned about the county’s liability if users OD and die inside the facility (in almost 15 years, not one person has died at Insite in Vancouver) and worried that the sites would become magnets for heroin dealers. He suggested that Seattle should be a test case for the site, “before we take the show on the road” to suburban areas that don’t have the same capacity to provide treatment and emergency services.

Republicans weren’t the only ones arguing that safe consumption sites should be limited to the state’s largest city. Suburban Democrats like Claudia Balducci (a former Bellevue City Council member) and Dave Upthegrove, who represents South King County, argued that the county would be overstepping its authority if it opened a safe consumption site where residents opposed the idea. “One of the things that always drove us crazy at the city level was when higher levels of government told us what to do at our city,” Balducci said. “I come from a city that has decided this is not what they want in their city. It doesn’t fit the needs or the desires of their community…. [Safe consumption sites] work best in locations where there’s a lot of street drug use,” she added.

Public Defender Association director Lisa Daugaard, who sat on the heroin task force, argues that “it sets a dangerous precedent to withhold funding for health services from residents of towns whose elected officials have ideological problems with those medical strategies. … The health and well-being of people who live in Kirkland and Kent affect that of people in Seattle, and vice versa.”

Larry Gossett, a Seattle Democrat, scoffed at the implication that drug addiction—particularly heroin addiction—is a problem restricted to big cities like Seattle. Noting that, nationally, heroin and opioid addiction is largely a rural and suburban problem, Gossett said, “I do not understand this concept that people who live outside of Seattle and in suburban and rural areas are different than people who live inside of cities.” Council member Rod Dembowski, whose district includes Shoreline, Kirkland, and Woodinville, added, “There is a serious rural crisis going on, with people dying every day, and I don’t think it’s fair to the citizens of my district to say, ‘No, you don’t get to have return on your investment’ if such a facility would serve their needs. … I don’t think the public health of the 2.1 million residents of this county should be decided based on fear.”

On the  phone last week, Balducci defended her vote, arguing that the budget amendment is a temporary pause, not a permanent spending prohibition. “We haven’t yet done the work that we need to do at the council to understand the proposal, the benefits, or the criteria for when and where these [safe consumption sites] make sense,” she said. “We have to do a little more background work and figure out, what are these [safe consumption] sites and who do they serve.” Balducci also suggested that a huge debate about safe consumption sites could blow up her ongoing efforts to establish the first permanent men’s shelter on the Eastside in Bellevue. “We are facing a really tremendous backlash about that, and one aspect of the opponents’ position is that this is just the camel’s nose under the tent and they’re going to legalize heroin next and [addicts] are going to be out in all the neighborhoods.”

Of course, they’re already there.

Daugaard, who still holds out hope that the council could reverse its decision during the ongoing budget process, says that if they don’t, “it will be very difficult to keep the promise that the heroin task force made to neighborhood leaders in Seattle: that Seattle would not be left alone to respond to this need, which is fundamentally unfair given the widespread use of heroin and opiates throughout the county.  Waiting until 2019 to move forward inevitably will mean avoidable overdose deaths, and no solution to drug use in unsupervised public sites like bathrooms and parks.  Hopefully we all can agree that the status quo is unacceptable. Waiting is not a plan.”

If you enjoy the work I do here at The C Is for Crank, please considerbecoming a sustaining supporter of the site! For just $5, $10, or $20 a month (or whatever you can give), you can help keep this site going, and help me continue to dedicate the many hours it takes to bring you stories like this one every week. This site is funded entirely by contributions from readers, which pay for the substantial time I put into reporting and writing for this blog and on social media, as well as costs like transportation, phone bills, electronics, website maintenance, and other expenses associated with my reporting. Thank you for reading, and I’m truly grateful for your support.