Substance Use Disorder Prevention and Treatment in King County
The State of Washington Division of Alcohol and Substance Abuse (DASA) established a statewide system for delivery of alcohol and drug treatment services. In most cases, residential treatment is contracted directly through DASA. Sobering, detoxification, outpatient treatment, and SUD prevention services are the responsibility of King County. Per Chapter 70.96A RCW, eligibility to receive state and federal funds from DASA to support county alcoholism and other drug addiction programs is dependent upon the following:
- Establishment of a county alcoholism and other drug addiction board (see King County Alcoholism and Substance Abuse Administrative Board).
- Appointment of a County SUD Prevention and Treatment Coordinator by the county legislative authority.
- Provision of a 10 percent match from local public or private sources.
The SUD Prevention and Treatment Program Coordinator in King County serves as one of the two Assistant Division Directors for the King County Behavioral Health and Recovery Division (BHRD). The coordinator is responsible for planning and implementing prevention and SUD treatment services within King County as outlined in the King County Strategic Plan. This is a coordinated effort involving stakeholders representing the entire community. This coordinated response to prevention and treatment services is accomplished through collaborative relationships developed in the community and by the work of the King County Alcoholism and Substance Abuse Administrative Board.
The King County Strategic Plan addresses county-specific needs, resources and implementation strategies for community-based SUD Prevention, Intervention, Treatment and Aftercare/support services (P-I-T-A) - viewed as a continuum of services.
A comprehensive SUD continuum combines many programs, policies, and practices. A continuum of care may include local services ranging from prenatal parenting classes, to student assistance programs, to outpatient and residential treatment, to community-based ongoing sobriety support services.
King County Prevention and Treatment System
King County provides SUD prevention and treatment through two mechanisms:
1. Direct county services
2. Contracted county services provided through contracts with community treatment agencies.
Direct County Services
Involuntary Treatment Services: This is a therapeutic intervention for chemically dependent persons who are incapacitated, a danger to themselves or others, and/or unable to make rational decisions about their need for treatment due to their drinking or drug use. Trained clinicians investigate and evaluate the facts to determine whether a person is incapacitated as a result of their chemical dependency. If the clinician determines there is reliable evidence to support a finding of incapacity, a petition for commitment is filed on behalf of the incapacitated person and the Court may then commit the person to a treatment facility for intensive long-term treatment.
Emergency Services Patrol (ESP): Provides direct assistance and transportation of intoxicated/incapacitated individuals to appropriate services and treatment exclusively in the city of Seattle. The priority population is Seattle's homeless chronic public inebriates. The ESP responds to calls from 911 dispatch operators in response to calls from public safety personnel, merchants, intoxicated individuals, and/or concerned citizens. Clients receive services from a multi-disciplinary team made up of ESP van drivers as first responders; Sobering Service staff providing temporary sleeping and screening/referral services (contracted service described below); and REACH case management staff who provide long-term follow-up for more chronic repeat utilizers of the service (contracted service described below).
Contracted County Services
Community Mobilization: The Community Organizing Program works to reduce substance abuse and violence, and provides support to local communities in planning and implementing intervention and/or prevention strategies. Selected prevention and/or intervention strategies may include the award of mini-grants by the Community Organizing Program to assist in implementation of the identified strategy.
- Prevention Services: Prevention services foster a climate in which alcohol use is acceptable only for those of legal age and only when the risk of adverse consequences is minimal, and tobacco and illegal drugs are not used at all. Prescription and over-the-counter drugs are used only for the purposes for which they are intended. Other abusable substances, such as gasoline or aerosols, are used only for their intended purposes. Pregnant and women who may become pregnant do not use alcohol, tobacco, or other drugs.
- Chemical Dependency Information/Referral and Crisis Calls: The 24-Hour Alcohol and Drug Helpline provides crisis services and chemical dependency information and referrals. All calls are staffed with qualified individuals trained to provide accurate and timely information about alcohol or other drugs and make referrals to appropriate treatment facilities. This service is available 24 hours every day of the year.
- Detoxification Services: Provides medically monitored withdrawal services to low-income and indigent clients who are recovering from the effects of acute or chronic intoxication to alcohol and/or other drugs. Clients receive a physical examination and medication as necessary to manage withdrawal symptoms. Upon completion of detoxification services, clients are referred to either inpatient or outpatient services based on clinical need.
- Sobering Services: Provides homeless chronic public inebriates who congregate in downtown Seattle a safe and secure place to recover from the effects of acute intoxication. These clients are in the chronic stages of addiction and are refused admission or banned from other shelters due to behaviors associated with intoxication. Clients receive medical screening and are referred to case management and other support services.
- Opioid Treatment Programs (Methadone): Opioid treatment programs provide medically supervised treatment services to persons with chronic opiate addiction. In addition to physical exams and medical monitoring, clinics provide individual and group counseling, medication, urinalysis screening, referral to other health and social services, and patient monitoring.
- Adult Outpatient Treatment: Provides services to adults who need treatment for recovery from alcohol or other drug addiction. Services are designed to assist clients in achieving and maintaining sobriety. This includes individual or group counseling, case management, job seeking assistance, and referral to other appropriate recovery support services. The King County adult treatment system provides services to more than 8,000 individuals each year. The 25 treatment providers under contract with the county have access to a variety of treatment funding including state and Medicaid.
- Youth Outpatient Treatment: Services include development of sobriety maintenance skills, family therapy or support, case management, and relapse prevention. Services are designed to improve school performance and peer/family relationships while decreasing risk factors associated with substance use and abuse. The King County youth treatment system provides chemical dependency services to more than 1,000 individuals each year. The 18 youth treatment providers under contract with the county have access to a variety of treatment funding including city, state, and Medicaid.