I’ve written before about the critical need for, and lack of, drug and alcohol detoxification services in King County, particularly for people without private insurance coverage. Detox from drugs and alcohol, experts across the spectrum of treatment philosophies acknowledge, is a critical first step toward getting well; without medically assisted, professionally monitored detoxification, people who are addicted to opiates or, especially, alcohol can become sick or even die. They’re also much less likely to enter long-term treatment.

Until last year, low-income addicts and alcoholics who needed detox in Seattle were usually directed to Recovery Centers of King County, a facility on First Hill that included 27 detox beds as well as long-term inpatient treatment. But RCKC closed abruptly last August, under the shadow of a federal investigation and allegations of unpaid wages. Eventually, King County replaced some of those beds by contracting with private agencies like Fairfax, a mental health hospital in Kirkland, and Seadrunar, a long-term treatment center in Georgetown.

Now, nearly a year later, an agency called Valley Cities Behavioral Health Care plans to reopen an old RCKC building on Beacon Hill as a detox and treatment center that will also include “medication management”–long-term opiate replacement with drugs like suboxone–for people addicted to heroin and other opiates.

Milena Stott, chief of inpatient services at Valley Cities, says the detox center, which will initially have 16 detox beds, is part of a larger push by her agency to “get in the business of doing inpatient treatment,” including treatment of patients committed involuntarily under a law passed this session known as Ricky’s Law, which allows involuntary commitment of people with substance abuse disorders. “Detox is a point of contact for treatment,” Stott says. “Our position is to engage patients into long-term care after detox … focusing on motivational interviewing and really being welcoming to individuals so they are willing to focus on the next step.”

That focus on being “welcoming” highlights one area where the new facility could differ from RCKC, which is somewhat notorious among people in the recovery community as a place where staff could be gruff, rude, and impatient in their interactions with patients under their care. Mary Guiberson, a case manager with REACH, a group that does street outreach, says that when she went to visit the facility last year, after hearing that the agency’s services were not “up to date,” “the staff was yelling ‘What drugs are you on?’ and all these personal questions–the situation was completely inappropriate.”

For people dealing with trauma, particularly women, Guiberson says being barraged with suspicious questions in a public place can “retraumatize people. … Traditional treatment services are not very trauma-informed.” RCKC also had no group activities or counseling sessions for people hoping to get clean, and was reportedly filthy and poorly maintained inside.

Stott says Valley Cities plans to remodel the inside of the building so that people “feel good when they walk inside. … We strongly believe that patients need to feel good about their healing space in order to engage in recovery. We want it to be a nice facility, and currently it is not. It’s not clean. We want to have a workout space, and beef of the community space so people will come out of their rooms and engage in activities,” Stott says.

Valley Cities will not be providing methadone treatment, which requires clients to show up at a clinic every day, but they are seeking a license from the state pharmacy board to prescribe suboxone, an opioid antagonist that interferes with the patient’s ability to get high from opiates and is an opiate itself, making it somewhat controversial in the recovery community. Suboxone is a highly controlled substance, and is itself addictive.

The facility itself could also be controversial in the surrounding neighborhood, which is just starting to get wind of Valley Cities’ plans. Stott says she hasn’t heard anything negative so far, except from a neighbor who was worried that patients at the facility would leave cigarette butts on his lawn. She hopes to have city approval for building permits by the end of the year; approval from the Board of Pharmacy, which meets just once a month and is backed up with licensing requests, could take longer.

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