Evergreen Treatment Services is located on Airport Way in Seattle’s SODO district, close to many of the homeless encampments along the busy I-5 corridor. It is an obscure building with a faded awning in the front. When I arrived at 3PM (after dosing hours), the inside of the building felt like a cold maze, with areas sectioned off with crowd dividers. I met with Michelle Peavy, a psychologist at ETS, who told me about the history of the program. It has been around for over 70 years and serves over 1300 clients, with more than 40% of those clients being homeless. It predominantly serves as a medication assisted treatment provider, handling both methadone and buprenorphine prescriptions. Clients can come in at various time day, check in, and line up to go into a small and private room where they receive their daily dose from a dispensing window. During check-in, a screen will tell them if they need to leave a urine sample or not. Michelle talks about how the program recently started prescribing buprenorphine and methadone regardless of whether the patient is using other medications or not. This approach is based upon the philosophy that it is better to have points of contact between provider and patient rather than none at all. The daily dispensing of medication is an intersection point that is a valuable opportunity to reach out to the individual and “check-in”.
There are also additional resources available for patients. There are psychologists on site that do peer-to-peer counseling, an approach that Michelle feels is more effective than group counseling. There are also weekly health clinics on-site, staffed by physicians from Harborview Medical Center. During these clinics, patients can be screen for HIV and hepatitis C. If positive, patients are hooked up to a treatment program and in the case of hepatitis, they can receive their weekly medications at the site.
An interesting resource ETS provides is their acupuncture room. Although Michelle is unsure if the approach is evidence-based to help with substance use, she believes that the quiet relaxing room provides a type of “getaway” from the chaotic lives that some of their patients have. Many patients report feeling decreased stress levels and less cravings with these treatments.
I appreciate that ETS provides something of a “one stop shop” for those who are on medication-assisted treatment programs. Their bare-bones building may not look like much, but that was their goal- to not stand out as a treatment facility, but to normalize it.