Walking into Pioneer Center North, an abandoned drug treatment facility in Sedro-Woolley, is like walking into a chapter of Washington history. Barbed-wire fences, an empty courtroom and cell-block-style dormitories give it the feel of a minimum-security jail. Upstairs there is a long-abandoned urgent care area with oxygen line connections in the wall, and empty hooks in the ceiling where curtains once hung.
In the ‘70s, soon after it was added on to the old Northern State Hospital, this facility was innovative: The first in Washington to treat both mental illness and substance use at the same time. But funding hasn’t been enough to keep this old building maintained, so in January, the 141-bed facility closed.
It’s one of two facilities that Pioneer Human Services — among the largest providers in Washington, particularly for clients coming from the criminal justice system — has closed just this year. Their remaining facilities are usually full.
"There's never enough capacity. There hasn't been for a very long time," said Hilary Young, vice president of advocacy and philanthropy at Pioneer. "And the state of Washington has notoriously not rated really high on services for people in both the mental health and substance abuse spaces."
Providers like Pioneer have struggled with staffing since the start of the COVID pandemic. But Young said many of their problems stem from decades of underfunding.
"There were some programs, you know, 20-ish years ago, and those predate my work in this field, but I hear a lot about them as sort of the good old days when people could actually get into treatment," Young said.
This month, another behavioral health hospital in Tukwila will close, taking with it around 130 beds, a spokesperson for King County said.
At the same time, on July 1 a new drug law, often called the "Blake" bill, goes into effect in Washington. While lawmakers hope it will push more people into treatment, experts, treatment providers, and system navigators are unconvinced it will help more people out of addiction.
The law makes possessing small amounts of drugs a gross misdemeanor. It positions Washington in the middle of its neighbors: In Idaho, possession carries a felony and up to 7 years in prison; in Oregon, small amounts of almost all hard drugs have been decriminalized since 2020.
Washington’s law also has language encouraging police to offer referrals to treatment. It creates a pre-trial diversion program and a framework for judges or prosecutors to send drug users to treatment programs rather than jail. It funds crisis centers, and expands medication-assisted treatment in jails.
Last month when he signed the Blake bill, Governor Jay Inslee insisted that the new law would push people to get help.
"This bill was not designed to fill our jails. It was designed to fill our treatment centers," Inslee said.
It's unclear how many beds are actually sitting empty right now in Washington: The system is so complicated and poorly tracked, neither the governor's office, nor the Washington Department of Health, nor the Healthcare Authority could provide those numbers.
They also haven't tracked how many treatment centers have recently shut down, although the number of licensed treatment facilities in the state increased from 84 to 129 between 2012 and 2022. That's likely because — such as in the case of Pioneer Center North — large old facilities are often replaced by smaller newer ones, as guidance on congregating clients changes.
The number of people receiving substance use disorder treatment, according to the state Health Care Authority, has stayed relatively flat for the last five years — from about 86,000 in 2018 to more than 89,000 in 2022 — even as drug poisonings more than doubled in that same time-frame.
A spokesperson for the governor said they’re going to keep advocating to expand treatment availability.
“The bill directs badly-needed new resources for more substance use disorder treatment, but it should not be mistaken for being the entirety of the state’s strategy for expanding treatment,” Jaime Smith, Inslee’s executive director of communications, wrote in an email. “This is a constructive start, but more investment will be needed in the future for supports and services such as prevention and early intervention options, in addition to treatment and recovery supports.”
The state’s main call center for treatment, the Washington Recovery Helpline, has seen calls spike in recent years with the opioid and fentanyl crises. Whereas they could usually expect around 20,000 calls a year before the pandemic, last year the helpline got around 33,000 calls.
"We have an AM shift that starts at 7," said Teresa Garza, who manages the helpline. "And so we have a couple ladies that log on. And when the calls start, they come in all of a sudden. It can be just call after call after call."
Getting into treatment requires navigating a haze of bureaucracy: assessments, referrals and intakes. It’s even a nightmare for the people answering the phone – like Alex Pishue, the helpline’s manager of opioid medication.
"I can barely do it sober at work for money, you know, let alone like — if I had a real problem?" Pishue said. "That would be so hard. I couldn't even digest it."
Caleb Banta-Green is a nationally-recognized expert on addiction. His desk at the University of Washington in Seattle is littered with the kind of stuff you might expect from a substance use researcher: A fentanyl test strip, an “I carry naloxone” sticker.
By the window — which looks out on a tiny house village in the University District — there's a letter from Governor Inslee from 2016, thanking Banta-Green for his contributions to the state’s executive order on opioids, and his “research and leadership.”
Banta-Green also advised on iterations of the Blake bill, co-chairing a committee of experts who advised lawmakers.
But the final version made him reconsider 30 years of studying and advocating for more treatment options.
"I wanted to give up. I wanted to just go do something different, and I think everybody kind of felt like that," Banta-Green said, referring to his colleagues in substance use disorder studies. "And then in a couple days, it was like 'okay, back in the trenches we go.'"
He worries the bill will make it easier to shut down clean-needle exchanges, and force people into an ineffective treatment system.
"That model of care isn't working for a lot of people," Banta-Green said. "My staff just wrapped up 30 interviews with people who use fentanyl regularly, and they are very scared of dying, and they feel very stuck and don't know what to do."
It didn’t used to be this way, according to Theresa Anderson-Harper, who got sober over 16 years ago. Introduced to cocaine by an abusive husband, she has been through a lot, even legally separated from some of her children.
"I ended up at the mom's program in Tacoma," Anderson-Harper said. "And it was an outpatient treatment. And I went there for two years and found, like, enormous relief."
There was counseling, and childcare for her kids. That program doesn't exist anymore, Anderson-Harper said.
After sobriety, Anderson-Harper started working as a recovery coach, then a support specialist in King County family court.
But her clients now don’t have access to programs like the ones that got her sober.
"I could get in within two, three weeks, usually a couple of days, within a week," Anderson-Harper said. "Now it could be months — two, three months. How do you expect somebody — and where are you going to find them when, most of the times, we're homeless?"
Asked about the new law that’s supposed to "fill the treatment centers," Anderson-Harper didn't hesitate.
"What treatment centers?" she scoffed.
