Getting to the point where someone struggling with addiction is ready to seek treatment can be difficult. It can be even harder if withdrawal or detox treatment isn't available to them once they're ready to get sober.
For those who need a bed while they're assisted with withdrawal from substances, and who receive insurance through Medicaid (for those with low income), as many unhoused people do, Spokane currently has fewer bed options than it once had.
Spokane Treatment and Recovery Services (STARS) had long operated 16 "sobering" beds where people could be brought in downtown while in crisis or in any state of inebriation, be given the chance to sober up, and then have a conversation with staff there about possible treatment options such as inpatient withdrawal management, says Ryan Kent, now the operations manager for STARS, and who worked with the sobering unit for at least 10 years.
But insufficient funding from insurance companies made those beds financially unfeasible to keep staffed, Kent says. The 16 sobering beds at STARS' downtown location at 105 W. Third Ave. were closed around September 2021.
Compounding issues further, by May, STARS' more intensive and financially feasible withdrawal management beds for detox, which were housed in a Spokane County-owned building on Eighth Avenue, were closed.
The rent from the county had gotten too high, Kent explains, so STARS has instead set to work remodeling its Third Avenue location to ultimately house those 16 withdrawal management beds.
In the meantime, there are some beds available for sobering or withdrawal management at two treatment houses STARS operates in other parts of the city (one for men, one for women), but particularly for those who need to sober up before deciding which treatment they want, there may be few options, Kent says.
"We don't want to have somebody who's highly intoxicated around somebody who's been sober three months," Kent explains. "We try our best if we have a room we can isolate that person in, we will bring them in and they will be a sobering patient, basically, until we can get them into other services."
If those isolated beds aren't available, people may be left to go through diversion services with police officers or hospitals.
It can be tough to get people into detox when those options are limited, says James Tillett, a peer coach and peer services specialist for Peer Spokane, which pairs people with lived experience together with those who need help as they get sober, deal with mental health issues and sometimes cope with lifelong medical conditions.
"That's honestly a huge barrier right now," Tillett says. "I'm only 18 months into recovery, so I have friends I run into in active addiction, and they're like, 'How do I get to where you are?' The detox seems to be a big hindrance."
But while STARS works to build out its 16-bed withdrawal treatment unit, there are other forms of help available, including peer coaching, and by this fall, another large outpatient medication assisted treatment facility could open.
IMPORTANCE OF LIVED EXPERIENCETillett says he understands some of the challenges of getting treatment firsthand. As someone who struggled with addiction for many years, relapsing after his mother passed away just as he was going to college for a psychology degree, he says he tried at various times to seek treatment but wound up being pushed away.
For instance, there's the time he tried to check in with a treatment facility when he was on work release, but when they asked who he was supposed to check in with and learned that he wasn't ordered by the courts to be there, they told him he didn't need to show up.
"This was a person who had never done drugs and didn't understand it. ... She said, 'You don't have to be here,' instead of being a former addict and realizing the person who wants to be there is who you probably hold onto instead of letting them go," Tillett says. "It was a big miscalculation, and it was probably another 10 years after that before I actually got clean."
Through Peer Spokane, Tillett helps coordinate a network of peer coaches who can help those going through recovery, utilizing a harm reduction model. The idea is to keep people on the positive path of reducing and ultimately eliminating their substance use.
"It's working away from that everyday usage, and if you do have a slip up," Tillett says, "that doesn't mean you end a year's worth of hard work."
For those who are looking for treatment to help with the first days of detox from drugs, it can be a challenge, Tillett says, because the only 24-hour option that appears available to most people is the hospital, where they may face stigma.
"I know firsthand hospitals are very rude to a lot of people coming in off their drugs. They're not trauma informed about how they talk to them and what they say to them," Tillett says. "That causes this negativity around it to make it harder for individuals to be willing to go through that step."
People can also flag down police officers and get referred to treatment through Pioneer Human Services, he says, but that route can also look less appealing to some struggling with addiction.
STARS does offer intake 24/7 for their withdrawal treatment beds that are operating out of their two residential houses, Kent says. People can call their main line at 509-570-7250 and select the option for withdrawal to start that process.
Once the 16-bed withdrawal treatment unit is up and running on Third Avenue, Kent says that those beds, plus the ones currently operating in the residential units, will be able to fluctuate and provide some sobering options. For example, if only 10 beds are currently being used for detox, he says, the others could accept sobering patients.
"I am so passionate because I utilized these services when I first got out of treatment myself. When we are isolated and going through our darkest times we think we're the only ones going through these issues."
"It's a vital service that we want to make sure we can provide as soon as possible," Kent says. "We're doing the best we can now to provide it with what we have."
Peer Spokane can also help people with other stages of regaining power in their life, Tillett says, from free assistance building their résumé and applying for jobs to seeking help with housing and getting signed up for insurance and other services. Intake can be started online at PeerSpokane.org.
"I am so passionate because I utilized these services when I first got out of treatment myself," Tillett says. "When we are isolated and going through our darkest times we think we're the only ones going through these issues. But as we interact with others that have very similar stories, we're able to see we're not as alone as we thought we were, and to develop that sense of community."
At 4:30 pm on Aug. 16, a virtual public hearing will be held by the Washington State Department of Health to accept public comments on the proposed "Spokane Treatment Center" at 82 E. Francis Ave. The center, which will be run by Oregon Recovery and Treatment Centers (ORTC), will offer an outpatient medication assisted treatment program for those dealing with opiate addiction. Depending on staffing, the goal would be to help between 300 and 500 patients at a time, says Kirsi Kirk-Lewis, director of systems management for ORTC.
"We have been speaking with local business people and universities and realized there is a need," Kirk-Lewis says. "We do operate a center in Richland, and through our contacts in the Tri-Cities we became aware there was a need for additional treatment in Spokane as well."
People can participate in the public hearing online or public comments can be sent to OTPComments@doh.wa.gov before 5 pm Aug. 16.
If all goes according to plan with licensing, the facility could be up and running by the end of October, Kirk-Lewis says.
Compassionate Addiction Treatment of Spokane also offers medication-assisted treatment to people regardless of their housing situation, along with a slew of other peer and community-building resources. More information can be found at CATSpokane.org. ♦