Do you support Seattle Mayor Harrell's new overdose recovery facility plan?

[00:00:00] Hello and welcome to the latest edition of Seattle Nice. Special Emergency Podcast Edition,

[00:00:16] Seattle Mayor Bruce Harrell held a press conference. Not only was Erica C Barnett a public hola

[00:00:20] there but political consultant Sandeep Kaushik was also there in I think a Seattle Nice first.

[00:00:26] Mayor Harrell announcing plans to create a recovery center for people who survive an overdose. We're

[00:00:32] going to be getting into that. But first, I just want to bring up the fact that somebody recently

[00:00:36] asked me if the name of the show Seattle Nice is meant to be ironic since the phrase Seattle

[00:00:41] Nice kind of refers to superficial. It's like Seattle people are skin deep in terms of, you

[00:00:47] know, they won't invite you to their home but they'll act super polite and public whereas

[00:00:50] these two old friends are not superficially nice to run another on the show, although they

[00:00:55] might be today. So then I was going to say yes, but then I remembered irony was dead supposedly

[00:01:01] like dating back to September 11th and so I was like what so maybe the answer has to be no because

[00:01:06] irony is actually dead. We don't know what irony is. We have no idea what that's the problem.

[00:01:10] I have no idea what that person was talking about. Just tell that person we're Mexico's

[00:01:14] 110th most popular political podcast show. Shut the fuck up. For a reason. For a reason. That's

[00:01:20] right. Yeah. For a reason. Topping the charts in, yeah, Halesco. I'm trying to think.

[00:01:29] Yeah. This is part of Mexico because I'm ignorant.

[00:01:31] Oaxaca. All right. So Erica C Barnett, we have a fental crisis. We've got an overdose crisis,

[00:01:37] but this center is for helping folks who have already overdosed. So help us understand

[00:01:44] that the situation currently somebody overdoses and survives what happens to them. Why is the

[00:01:48] center needed? Yeah. I mean, well currently if somebody has an overdose and survives,

[00:01:52] it is often because they've been administered Narcan on the streets and in a lot of cases,

[00:01:58] if it's paramedics, they may end up going to Harborview. They may end up just walking off,

[00:02:03] neither of which are great options obviously. And so this new center, which was announced

[00:02:09] last year, but the location and the details were unveiled today. And it's at the DEC's

[00:02:15] Downtown Emergency Service Center's Old Morrison Hotel Building where there used to be a big shelter.

[00:02:20] We were there today and it's been totally hollowed out, the places where you used to see bunk beds,

[00:02:26] big metal rows of bunk beds, they're all gone. And so it's going to be a place where people

[00:02:30] can come for up to 23 hours after they overdose. They'll be brought there by, I mean,

[00:02:36] they can walk in, but the city's Health99 program, which is run by the fire department,

[00:02:41] will go around and collect people or reverse overdoses and bring them, obviously,

[00:02:49] if they are willing to do so to this place. And they will then be able to sort of rest and recover

[00:02:56] and also to get started on medications like Sublacate, which is an injectable form of

[00:03:01] Uprenorphine, and Suboxone and potentially Methadone. And then from there the ideas that

[00:03:07] hopefully they would begin some sort of treatment. Evergreen Treatment Services is a partner and

[00:03:13] they're going to be opening a big campus near downtown starting, I think, next year to sort of

[00:03:18] accept some people into a longer term program. So it's all part of this kind of continuum of care

[00:03:24] that we haven't really had in the city of Seattle. So it's a small facility,

[00:03:29] relatively speaking, but they can potentially accept 20 people a day. So it's not nothing.

[00:03:35] It's a significant announcement, I should say. It's not just not nothing. It's a big step for the city.

[00:03:42] And Sandeep, your full disclosure on the board of the Downtown Emergency Services Center that's

[00:03:48] getting millions of dollars to help administer this new program, right? But you're also a political

[00:03:54] person. Why is the center such a big priority for the mayor?

[00:03:57] Yeah, the center really has two purposes. The first and kind of most immediate one is to save lives.

[00:04:06] We're experiencing an overdose crisis in the region, and particularly in the city of Seattle

[00:04:13] and particularly downtown within the city of Seattle. John Skolls, the head of the

[00:04:18] Downtown Seattle Association, spoke at the press conference today and laid out a litany of

[00:04:23] grim stats about how many people are dying on the streets of Seattle. So the fact that this could

[00:04:29] get people connected to medications that will save their lives and greatly reduce

[00:04:35] the likelihood of future overdoses by those people is the first purpose. The second purpose,

[00:04:39] though, as Erica alluded to, is to start creating a continuum of care where we're

[00:04:45] actually creating a pipeline where we're proactively interacting with people suffering

[00:04:50] from addiction on our streets to get them start, bring them here, get them started on what would

[00:04:56] be a medically assisted treatment program and then hopefully to hand them off to kind of continue

[00:05:01] that work so that they can kind of move on to get a kind of stable long-term treatment program

[00:05:07] right that helps them actually address their underlying issues. And given the severity of

[00:05:12] the fentanyl crisis that we're facing on our streets, I think the mayor and others

[00:05:17] are really pinning a lot of hopes on this sort of process, the creation of this what's called

[00:05:23] the Orca Center to really start helping address and ameliorate that very, very visible and

[00:05:30] destructive problem. So a lot of agreement between the two of you, which I just want

[00:05:34] to point out we got some feedback from our last live show on Aurora with somebody

[00:05:39] criticizing me and saying, I should have started with where the two of you

[00:05:43] agree and then gotten to where the disagreement is, which I surre completely disagree with. That is

[00:05:48] not how I'm ever going to do this, but I appreciate the feedback so keep it coming. We may get to

[00:05:53] disagreement. Just tell them David that where Mexico is 110th most popular political

[00:05:57] population, shut the fuck up. I'm going to just say comedy is hard, comedy is hard. Okay,

[00:06:03] so Erica, how does that help us understand how this connects up with

[00:06:07] what everybody was talking about ad nauseam from your perspective to some extent last year,

[00:06:12] the effort to crack down on public drug use? Yeah, I mean and I asked the mayor about this at

[00:06:17] the press conference too because I think there is a real tension if not a contradiction in

[00:06:22] the idea or the policy of cracking down on public drug use by arresting people for using drugs

[00:06:30] in public or possessing drugs in public and the policy of creating a new city run system

[00:06:37] led by fire department officials in uniforms going around saying, hey get in this truck and come with

[00:06:43] us. I think that just from the perspective of potential clients of this new overdose recovery

[00:06:52] center, it's a little problematic because you're on the one hand sort of getting the message that

[00:06:58] you need to hide in the shadows as much as possible and don't use drugs in public because

[00:07:02] you'll get caught and potentially taken to jail and the city is talking about doing a new contract

[00:07:08] with the South Regional Entity Score and taking folks down to South King County who are committing

[00:07:15] minor crimes like violating this drug law and at the same time standing up this center and

[00:07:20] saying that we want to help you. So I think there's a contradiction there. I mean, I think

[00:07:24] that there's a punitive approach happening in the exact same physical space as an approach

[00:07:30] that is a little more clinically supported and a medical approach. And I think there's going

[00:07:36] to be attention. And I think we actually know which approach works and it's not the punitive

[00:07:41] approach, it's the medical approach. But the city, I think sort of, I won't even say they feel

[00:07:47] like they have to do the punitive approach. I think the city is very invested in the punitive

[00:07:52] approach. So I think there's going to be some tension there.

[00:07:56] Sadeep Kashik, do you agree or disagree? I disagree.

[00:08:01] Thank God.

[00:08:01] It's a surprise. Yeah, yeah. I do disagree. Look, first of all, it's worth noting that the,

[00:08:06] you know, Erica, you did ask that question of the mayor and I thought he gave a pretty firm

[00:08:13] response that he sees that role for police and that there is a public safety set of issues

[00:08:20] that are involved in these questions as well. He didn't back down from that. That's worth

[00:08:24] noting for our audience. I don't think there's necessarily an inherent tension. I think these are

[00:08:32] two sides of the same coin. We do need to stand up a real system to get people help and who are

[00:08:40] suffering from addiction on our streets and to get to addressing their underlying conditions.

[00:08:44] I actually think the drug law could very much be part of that by creating proactive

[00:08:50] opportunities for intervention. Right now, the protocol primarily with the drug law is that

[00:08:54] people get handed off to lead. Right? There isn't right now a protocol where they would

[00:09:00] potentially be brought here to the Orca Center, but there's no inherent reason why that couldn't

[00:09:05] potentially become part of how SPD too, along with the fire department, is responding to

[00:09:13] the encounters they're having on our streets.

[00:09:15] So wait, so to be clear, are you saying like they would, the cops would pick somebody up

[00:09:19] and say it's jail or DESC? Well, if somebody is smoking fentanyl in a bus shelter,

[00:09:25] I think the drug law creates the opportunity for a cop to come up and say you're not allowed to do

[00:09:29] that here. Right? That is illegal. And by the way, do you need help? Do you want to stop? Do you

[00:09:35] need help? But to be clear, this is an overdose center. It's not a do you need help center.

[00:09:42] So it's not all-purpose treatment. To be clear because I've been very involved in the

[00:09:46] conversations leading up to this, obviously I'm DESC board chair as David mentioned. And I've talked

[00:09:50] to the medical staff there a number of times about this. And so the sort of primary or stated

[00:09:56] purpose is an opioid overdose recovery center. So it, but overdose is really just the trigger,

[00:10:03] if you will, to create an opportunity to talk to someone and ask them to come over here.

[00:10:06] They do expect there to be significant walk-in traffic of people who just come in either on

[00:10:11] their own because they're looking for help. That's going to be part of this. And it's

[00:10:14] certainly not limited to overdose. And so I think the question here is going to be,

[00:10:19] how do we integrate something like this, which we both agree is important,

[00:10:22] into our existing systems, whether they're therapeutic or potentially on the public safety

[00:10:29] side, a potential on the punitive side, to kind of maximize the advantage of actually

[00:10:33] getting people the help they need. I don't think that necessarily these things are mutually

[00:10:38] opposed and contradictory. I don't think we should be ideally making drug treatment,

[00:10:44] the kind of thing that we say you're either forced to go to treatment or jail. So if

[00:10:50] you're presented with those as two options because you got caught exhibiting the signs

[00:10:54] of your addiction, which is using the drug that you're addicted to, I don't think that it is

[00:10:58] productive particularly when you don't have to. I mean, this is not an infinite capacity

[00:11:03] center to say your two options are you have to go to jail or you have to go to this facility.

[00:11:09] I just don't think that's necessary. And I also don't think it's conducive to trust and care.

[00:11:17] I just, I don't see why we would want to introduce that. And that's why I do think

[00:11:21] that the two are in conflict. I don't foresee that happening. There was no

[00:11:26] SPD presence there today. The fire department was there in force saying,

[00:11:30] we're going to be the ones doing this. And so the scenario you're talking about,

[00:11:34] I mean, I think I haven't heard anybody even saying that that would be part of this, including

[00:11:39] and you're mischaracterizing what I'm saying. I'm not saying that SPD should use this as a kind

[00:11:44] of forced choice. I'm going to march your sorry ass off to jail unless you go over here. Right?

[00:11:50] I don't think anybody is suggesting that. But I do think a lot of what's happening on the

[00:11:56] streets of Seattle when SPD is encountering people who are using say fentanyl on the streets of Seattle,

[00:12:04] as we know they're not actually arresting all that many people. Right? And if they're and when

[00:12:08] they're arresting them, essentially none of them are going to jail, right? The King County jail

[00:12:13] isn't accepting. But I think that the city is very much in the mindset right now of changing

[00:12:18] that. Right. And I think, yeah, I think where the question arises is what happens

[00:12:23] when you're arresting or encountering the same person for the fourth or fifth time. And

[00:12:30] you've tried to divert them to lead or do other things to kind of send them on an alternative

[00:12:35] pathway to get help and it's not working. And yet they're still over and over getting there.

[00:12:41] I think that's where I think you're hearing some frustration from some folks at the city where

[00:12:45] maybe as a last resort, somebody might actually go to the pokey for a while.

[00:12:50] I want to really push back on that extremely hard. The idea that

[00:12:57] so if you're a fentanyl user, you're using pretty constantly all day. So to say, oh my God, we caught

[00:13:03] him on the fourth time. It's his absolute last chance resort. We have to take him to jail. That

[00:13:08] could be in one day. I mean, you're not you're not that does not show an understanding. And

[00:13:12] Sunday, but I think you're being glib and I think you do have an understanding of how this

[00:13:16] stuff works that you're pretending you don't have for political reasons. But but but let me finish.

[00:13:22] But to say like that the fourth or fifth time of someone using fentanyl in public who is homeless

[00:13:27] and cannot use it anywhere other than in public, it is addicted to it is, you know, is your last

[00:13:33] chance. I mean, that's absurd. That is an absurd way of thinking that shows a profound lack of

[00:13:38] understanding on the part I think of the city. That is, you know, sort of their attitude,

[00:13:43] you know, about how drug addiction works. Yeah. And and yeah, I mean, just glibly saying like,

[00:13:48] oh, I'm four times throw him in the pokey. That's I mean, that's that's stupid, Sunday. Sorry.

[00:13:54] No, I don't agree with you. In fact, I strongly disagree with you. I actually do think you

[00:14:00] end up in this weird place of misunderstanding. I know exactly what opioid addiction was like.

[00:14:06] I was addicted to heroin for that's why I said that Sunday. Right. And which is why

[00:14:11] I do think at some point there needs to be some friction in the system somewhere that does create

[00:14:16] a push because the psychology of addiction, I think I've said this maybe on the podcast before

[00:14:22] when you're in the throes of it, when I was in the worst, the final three years where I was

[00:14:26] hitting bottom, every junkie simultaneously both really, really wants to stop and really,

[00:14:33] really doesn't want to stop. And with every other like study just to why you're

[00:14:37] this is exactly why measure 110 in Portland in Oregon flop so badly. The idea that we give somebody

[00:14:45] a card to call an 800 number and some fentanyl, you know, person on the throes of fentanyl addiction

[00:14:50] on the street is going to walk over and make that phone call and, you know, set up an appointment

[00:14:56] for a you know, the idea that somebody's going to get clean and jail and stay clean while they

[00:15:00] when they're released to homelessness is equally absurd and more absurd. I would say I actually

[00:15:05] think we're not doing in the jail what we should be doing which is setting up actually robust

[00:15:10] programs to try to address people's conditions and work on their reentry into society. I think

[00:15:15] right now we do use the jail to just warehouse people and it's an incredible missed opportunity

[00:15:20] that pisses me off. I think it's kind of a scandal. Well, I want to talk about something that

[00:15:24] Daniel Malone the head of DEC said at this event at the Morrison today, you know, he said

[00:15:30] the real issue, you know, beyond addiction, you know, once you get somebody stabilized on

[00:15:36] addiction medication because they don't have shelter, they don't have a place to live. And I

[00:15:39] think that, you know, if you're just saying like let's treat quote unquote treat people in jail,

[00:15:44] which I don't think there is a very successful model of that, you know, in this country,

[00:15:49] because once you release people back into homelessness, they're going to use again.

[00:15:54] And it's just magical thinking to think otherwise it's also a way of wasting money

[00:15:57] because you're investing in, you know, programs that you know from evidence will not work.

[00:16:02] Yeah. And this is where we're 100% of agreement and I can elaborate on what Daniel was talking about

[00:16:08] at that moment. And so this is a really important step, right? We need something like

[00:16:13] this. I think this is going to be helpful. I do think how we integrate this into a larger,

[00:16:18] you know, our systems and a larger continuum care is still going to getting worked out.

[00:16:22] And as it's getting worked out, it's very clear what Daniel was saying is there's a gap

[00:16:26] in this system. So you get somebody to come down to the Orca center, you get them a shot of

[00:16:32] sublocade, which is a 30 day long acting opioid treatment. Right? Yeah. Yeah. It's the first step

[00:16:40] on medically assisted treatment. It will now A prevent them very likely prevent them from

[00:16:45] overdosing again the next 30 days. But it's also the first step in a kind of the process

[00:16:51] of medically assisted treatment for opioid addiction. Now, if you have that person for

[00:16:55] a couple hours at the Orca center and you just let them out back out on the street,

[00:16:59] the idea that they're going to stop is really far fetched. I think you're absolutely right about

[00:17:04] that. And so what Daniel's saying is what is the handoff? Right? Especially for somebody who's

[00:17:11] homeless. And what we, I think Daniel didn't say this and I don't want to be careful about

[00:17:17] going too far. But I think the idea here is it would be great if we had a place where

[00:17:23] someone takes that first step and say, Hey, rather than putting you back on the street,

[00:17:27] we will house you for 21 or 30 days. We will get you stabilized in a treatment program will work

[00:17:33] out your longer term kind of housing issues do an assessment, figure that out. That could really

[00:17:38] make a difference in terms of then the kind of longer term benefits of this sticking for people.

[00:17:44] Right? We don't have that right now. And the model for this is right now,

[00:17:48] DSC does have a program where when people are in mental health crisis on the streets and they're

[00:17:54] taken to a hospital like Harborview, they're stabilized in like 48 hours or 72. You know,

[00:17:59] they hold them for a very short term stay. They're really not even particularly, I mean,

[00:18:03] maybe they're not in immediate crisis, but they're obviously in, you know, still in

[00:18:09] significant impairment. And the hospitals of course don't want to just put those people

[00:18:13] back out on the street. So DSC has a program where the hospital calls we will DSC houses

[00:18:17] those people for 30 days. And again, does an assessment figures out their kind of longer term

[00:18:23] needs? How do we get them the kind of mental health therapies and medications that they need?

[00:18:30] How do we get the house run? We need something like that for fentanyl to go along with this

[00:18:34] thing, right? That's a big missing gap in our system, a glaring gap in our system that

[00:18:40] I think that's what Daniel is alluding to there. Other people brought it up too.

[00:18:43] The head of Evergreen treatment services was also there. Dr. Woolworth saying the same thing.

[00:18:48] All right, Erica, what are the next steps? How much is this going to cost? Where's the money

[00:18:51] going to come from? Like, you know, what's the next step in the process here?

[00:18:56] So the city has $7 million that is left over from unspent funds in past years. So that's

[00:19:02] where some of the funding is going to come from it. There's a private donor.

[00:19:05] Sunday, if you probably know more about Peter Shapiro who donated and then I'm sure there

[00:19:10] are other funds that I'm not aware of that maybe Sadeep can talk about.

[00:19:13] In terms of how it's funding, the primary funding is coming from the city in terms of

[00:19:20] a kind of clunky mechanism of these sort of, I think they're community development block

[00:19:23] grants. It's federal money that the city has but that is going to be purpose to this and

[00:19:28] there are some hurdles that have to be jumped over to get that money flowing, but that

[00:19:32] work is happening and it's going to flow. There is some county money here. There's also,

[00:19:36] yes, there's a major private donation from actually a very new DSE board member Peter Shapiro,

[00:19:42] but he's a longtime donor and supporter of DSE as well as the low income housing institute and

[00:19:48] other housing programs successful retired attorney in Seattle who's been a big funder and donor

[00:19:54] of these sorts of things who's put some money in. The original idea for this actually came from

[00:19:58] Kayla Banta Green who's a University of Washington Addiction Researcher and very prominent

[00:20:04] in the conversations of public policy conversations around addiction and treatment and those sorts

[00:20:09] of things. And Kayla actually was the one who originated this idea. It's based on something

[00:20:14] that was originally pioneered in Boston a few years ago and has had some success

[00:20:19] and Kayla actually got some grant funding, I think federal grant money that was sort of

[00:20:24] the seed money that then the city has come in on top of that as well as some county money

[00:20:28] as well as private donation to kind of make this happen. The timeline is, of course,

[00:20:33] getting all those pots of money coalesced, getting the actual construction and all that work to

[00:20:38] commence in the planning and the organization of how it's going to be structured,

[00:20:42] take some time. And so we're looking at probably not till next March at the earliest that we'll

[00:20:46] see this open. So one other next steps thing that I thought was really interesting that

[00:20:51] Evergreen Treatment Center's CEO Steve Woolworth brought up is that this sort of brick and

[00:20:56] mortar approach is important, but the city and the county also need to have mobile approaches

[00:21:02] and that's something that ETS is doing, I think very much in collaboration with this

[00:21:06] brick and mortar approach to overdoses. And so they have, they're standing up a whole new campus,

[00:21:12] as I mentioned earlier, near downtown and that's going to be more in the kind of 2025 range,

[00:21:17] but they're going to be able to send out and are actually now sending out essentially

[00:21:23] methadone vans to get people doses of methadone, get them on methadone. And that is not directly

[00:21:29] related to this overdose recovery center, but it's also an important part because a lot of times

[00:21:34] people are not necessarily going to want to travel any distance really to get to a specific center.

[00:21:40] So if you're in Belltown, you might not want to come all the way to Pioneer Square or if

[00:21:46] you're another part of the central Seattle area. So they've got vans that go out and

[00:21:52] they're going to be expanding that program too. So that's part of that continuum of care that we

[00:21:55] were talking about that I think is also going to be really important. So I'm excited about this.

[00:21:59] I know I always come off as very cynical, but I actually think, I mean, I am hopeful about

[00:22:04] this. I hope that it works and is effective and saves some lives.

[00:22:09] We've been critical of the mayor for, and said there's been some smoke and mirror stuff

[00:22:14] happening around fentanyl last year and the drug law and stuff. But again, this is real.

[00:22:18] I'm with Erica. I think it's an important step. I agree with her too that the mobile

[00:22:22] methadone vans that Evergreen is doing is also important. And so there's a glimmer of hope here

[00:22:29] that we're actually starting to get some pieces in place that might make a difference

[00:22:34] in terms of the terrible toll that fentanyl is taking on our streets right now. So

[00:22:38] that's a good thing. We should encourage that.

[00:22:40] All right, complaining listener, you got your wish. We started and ended with agreement

[00:22:45] between Son Deep and Erica. I don't like it, but you probably do. So

[00:22:49] We fought a lot in the middle though.

[00:22:50] There was some of that. I think he was supportive of that. All right, that's

[00:22:54] it for another edition of Seattle Nice. He's Son Deep Kaushik. She's Erica C Barnett.

[00:22:59] I'm David Hyde. Our editor is Quinn Waller. You, the listener are also our supporters.

[00:23:04] Thanks everybody who's been stepping up and supporting us this year. We've seen,

[00:23:08] I would say overwhelming support, but not quite enough to really get this podcast

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[00:23:23] And thanks everybody so much for listening.