For too many people who struggle with addiction, their story has a tragic ending. Lack of access to affordable treatment is often a barrier to recovery.
Oregon ranks 48th in the nation for access to substance use disorder services, according to a 2019 study by the Mental Health and Addictions Certification Board of Oregon.
Washington County's substance abuse services are particularly strained, with no publicly funded detox or sobering beds available outside hospitals and jails. In Washington County, there are only 28 residential treatment beds. That's well under what experts and advocates say the county needs.
But the county is closing the gap on access to substance abuse treatment. On Tuesday, July 20, county commissioners unanimously agreed to move forward with building what officials are calling the Center for Addictions Triage and Treatment.
The National Survey of Substance Abuse Treatment Centers recommends the county have at least 184 public residential treatment beds. The U.S. Substance Abuse and Mental Health Services Administration, better known as SAMHSA, recommends the county provide at least 37 detox beds.
The CATT facility would add up to 97 additional new beds.
Project manager Kristin Burke wants to move as quickly as possible on building the treatment center. But first, officials have to find a suitable location.
"It's challenging out there," Burke said. "Washington County's commercial land market is really competitive. … We're really digging hard to see what options are available."
Burke said the priority will be finding a site that's close to public transportation and proximal to other social services in the neighborhood.
The facility is estimated to cost $72 million. Much of that money will come from behavioral health reserves and marijuana tax dollars. Opioid settlement dollars are another potential funding source. The services themself will be covered by marijuana tax dollars, Medicaid and insurance payors.
"Our goal is to open the center within the next two or three years," Burke said. "Of course, with any project of this size and complexity, the timeline could shift based on any number of factors. We will have to be patient and stay nimble. In the end, we are going to have a center that will be life-changing for so many of our community members."
Closing the treatment gap
Beds will be divided up between level of care, gender and other types of needs.
"We will definitely have a men's sobering area and a women's sobering area, and then we're looking at how do we support people who are transgender and nonbinary," Burke said.
Mental health support will be another factor.
"We know how mental health needs and addiction can be co-present in the experiences of many individuals who might otherwise fall through the cracks," Board of County Commissioners Chair Kathryn Harrington said. "Moving this community-developed proposal forward quickly will be a critical step toward addressing the extraordinary need for life-saving addiction treatment services in our county."
The county's goal is to provide a center that will keep people out of jail and the emergency room "and connect them instead to peer support and drug and alcohol treatment that is responsive to their individual needs," Burke said.
While CATT will put the county closer toward closing the addiction treatment gap, Burke said it's difficult to know how deep the need is in the county when the data available is primarily based on Medicaid users who rely on publicly funded services, rather than people with private insurance who use commercial services.
"It's hard to have an apples-to-apples comparison, because there are a lot of nuances," Burke said. "All of that said, it will definitely help bring us closer and bring more options available for our community members, so they don't have to leave our community to get services."
Solutions with no judgment
The CATT will offer a wide array of treatment options including detox, residential treatment and stabilization services.
County officials say they interviewed more than 180 people — most of them having experienced substance use disorder and treatment recovery — prior to the plan's approval. They wanted to get a sense of what the greatest needs are and how to meet them.
Burke said the CATT is intended to be nonjudgmental and "safe" for everyone, no matter where they are in the process of recovery.
"Some people's recovery journey might include relapses, and that's OK," Burke said. "We need to support people if they're relapsing … and help them get back into recovery.
Burke said they also intend to staff the facility in a way that represents the community — including employees who are in recovery themselves.
Another goal for the project is to deliver services that are "culturally responsive" — in other words, basing treatment services on an individual's background and lived experience.
"For instance, for some people, some cultures … family is huge," Burke said. "Having their family present for their recovery journey."
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