November 18, 2021
In country, town and city, treatment for drug addiction is urgently needed
Heather Spaulding

Addiction treatment programs work when patients are treated as individuals and treatment aligns with the patient, professionals have found. The recent Ralph Munro Seminar convened policy makers and law enforcement and behavioral health experts to share insights on addiction treatment. (Shutterstock image)

November 18, 2021
In country, town and city, treatment for drug addiction is urgently needed
Heather Spaulding

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San Juan County Sheriff Ron Krebs got off the ferry recently in Friday Harbor and noticed two of his deputies assisting a man unconscious on the sidewalk outside the San Juan County Courthouse. Krebs stopped to help. The man was administered Narcan — a medication for treating narcotic overdose in an emergency — and was revived.

“He had overdosed on opiates,” Krebs said, “across the street from the courthouse.”

While some may not believe San Juan County has a drug problem, for Krebs, if one person is using, it’s a problem. “We may not have the problem Everett or Seattle has, but it is a problem.”

Why does a person turn to drugs, how can they overcome addiction, and how can law enforcement, government officials, health professionals and society at large come together to get addicts the help they need? 

These were the questions grappled with when the problems on the street met the expert panel on Nov. 4 at the Western Washington University Ralph Munro Seminar for Civic Education discussion on “How to Reduce Harm? Addiction and Drug Policy in Washington State.”

Panel members included Whatcom County Undersheriff Doug Chadwick, Sen. Manka Dhingra (D-Redmond), Rep. Andrew Barkis (R-Olympia) and Seema Clifasefi, associate professor at the University of Washington’s Department of Psychiatry and Behavioral Sciences and co-director of the Harm Reduction Research and Treatment Center. 

Longtime problem, getting worse

“There has been an uptick in drug use, and we have been dealing with the opioid crisis for a lot of years,” said Chadwick. “There is a huge uptick in overdoses.” During the “war on drugs,” he felt like he was merely putting his finger in a dam to prevent the flow of drugs.

“Twenty-two million people in the United States have a substance use disorder,” Clifasefi said, “and only 10% receive treatment. We have a 90% gap.” The primary reason for that gap is because of the stigma and shame surrounding the disorder. 

At the treatment center, Clifasefi has seen treatment programs work with patients when they are treated as individuals. “We talk to them about using safely, about their goals. As we align with their goals and support them, they end up reducing their use.”

When the staff aligns with the patient, the treatment becomes less oppositional, and there is also less burnout among staff. During the pandemic, workers have been leaving the health care industry in droves due to stress. 

Alternatives to ‘war’

Clifasefi said that the war on drugs isn’t working, that people of color are being punished more severely, and that law enforcement themselves recognized the need for alternative solutions. 

LEAD chapters have been organized around the country; in the Pacific Northwest, chapters are established in several counties and cities and by two Indigenous tribes, to date, with more in process. (Public Defender Association [Seattle] image)

In one program, “police and social services came together in an unlikely partnership,” Clifasefi said. The result was a program called LEAD, which stands for Law Enforcement Assisted Diversion, a community-based treatment approach that reduces criminal justice involvement of people who participate.

LEAD works well, Clifasefi said, because a case manager works directly with the individual not only to assist with treatment but also to find jobs and housing. 

“Basic needs must be met before people can make major changes in their life,” Clifasefi said. 

Clifasefi said that those with substance abuse often have multiple issues, which makes solving a drug problem more complex by involving mental health and physical health professionals. 

“Harm reduction recognizes drug use is here to stay,” Clifasefi said. “Humans have been using drugs for millennia. It is part of human behavior.” When kids and young adults are using drugs, how can adults in their lives talk frankly and honestly with them about the dangers involved, Clifasefi asked?

Urgent cry for help

Barkis disclosed that one of his sons is a recovering heroin addict, despite his telling his boys, “Don’t do drugs, they will kill you.”

“My son wanted to quit, but couldn’t. He felt he would die,” Barkis said. The conversation about drugs is changing, and Barkis thinks a multipronged approach is necessary. “It isn’t just either or. We need both treatment and law enforcement, although law enforcement is typically the first to respond.” 

Both San Juan County and Whatcom County have been taking steps toward drug treatment rather than incarceration. 

In Whatcom, Chadwick said, a major problem is that there are not enough beds in treatment centers or beds to meet the overwhelming need. 

For a San Juan County resident, finding a treatment center with space is doubly hard. After finding a suitable center, the person then must negotiate hours of long ferry and car rides to get there.

“If someone says I want help, you can’t say great, we will call you in three days when a bed is ready; that just doesn’t work,” Dhingra said of the urgency. 

The issue isn’t simply a matter of beds either. Treatment programs are severely underfunded but Dhingra believes the funds are there to make a difference. 

“We need to make it a priority but the political will has not been there,” Dhingra said. Among solutions from the legislature is a 988 behavioral health hotline that should be operating by next summer. Funding for treatment centers, staff and staff training are also being discussed. 

Dhingra did not think police department funding should be cut to make room for some of these budget proposals. “We don’t need to pit programs against one another. Law enforcement needs to spend more time on stalking, sex trafficking and crime. It isn’t about dividing a pie. We can make a couple of pies.”

Law enforcement, she said, got stuck in behavior health because our behavior health system is broken.

“The solution is not just to put [substance abusers] in a hotel,” said Barkis. “They need pathways to treatment. We have the resources available. Policy makers need to look at their priorities,” he said. “And we don’t have a lot of time to deal with the issue at hand.”

Reported by Heather Spaulding

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