1. What is medication-assisted treatment (MAT)?
MAT has been essential in not just saving lives, but in helping people manage the debilitating nature of addiction. This offers the best opportunity for sustained recovery, with a success rate of more than 75 percent.
MAT uses one of three medications, which reduces cravings, treats withdrawal, blocks effects of other opioids, and prevents overdoses.
Because of the damage that opioids cause in the brain and body, there is very little success in trying to eliminate an addiction without MAT. According to the U.S. Department of Health & Human Services:
A common misconception associated with MAT is that it substitutes one drug for another. Instead, these medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. …[R]esearch has shown that when provided at the proper dose, medications used in MAT have no adverse effects on a person’s intelligence, mental capability, physical functioning, or employability (source).
2. Aren’t these services already available?
No. Some Clallam County residents are traveling to other MAT clinics in Aberdeen, Everett, and Tacoma, but would rather receive care closer to home. Other patients in our area get medication-assisted treatment through their primary care providers, and that has helped meet part of our community’s need. However, just like diabetes or any other illness, different patients need different levels of treatment. Some people need to have their medication administered daily, and they need other services to support their recovery. That is the work of the Healing Campus, and no one else is doing it.
3. Who are the patients?
The average opioid use disorder patient is a white male between 25 and 55 years old. We expect our first group of patients will be self-referred, meaning they are already receiving treatment and would like to do so closer to home. The majority often have jobs and families they care for. Even after the two-year ramp-up period, we expect very few patients to have housing issues.
4. Why is this needed?
Our counties were especially affected by the national opioid crisis, with death and overdose rates far greater than other counties. Between 2012 and 2016, Clallam County had the second highest drug overdose death rate in the state, and overdoses were the leading cause of accidental deaths. While many patients are being successfully treated in primary care, we know that many others need more intense medical supervision to get well.
5. Does the Jamestown Tribe have to follow city, state, and federal regulations?
The Tribe must follow all Sequim City codes and building regulations. Furthermore, we must follow all Washington state and federal regulations regarding the operation of a medication-assisted treatment clinic. The MAT Clinic must also be inspected and certified by the Drug Enforcement Administration (DEA) prior to opening.
6. Why are you building one large clinic rather than several smaller ones?
Every single clinic would need to meet strict DEA guidelines and construction requirements, which would cost about another $20 million. A single location allows us to not only provide treatment and a high degree of security, but wrap-around services such as primary care, dental care, behavioral health, childcare, and transportation. It would not be possible to fully staff 12 separate facilities spread across two counties.
7. Why Sequim?
Sequim is where we operate a 35,000 square foot primary care clinic and is also home to many other health service facilities. That makes it easier for patients who might be receiving care at one of our other locations and makes it more efficient to manage. In addition, the site behind big box stores was chosen because it was zoned as an Opportunity Zone for healthcare clinics and services.
8. Is the Jamestown Tribe contributing funds?
Yes. In addition to the $7.2 million awarded to the Tribe from the State of Washington, the Tribe has bought the land and will provide additional construction funds. We expect our share will be approximately $4 million in tribal funds contributed to Phase I.
9. Is this being built for financial profit?
No. This clinic is being built to improve the health of people in our community and because the services are needed. While the clinic is not technically a nonprofit, excess revenue from Medicaid, Medicare, private insurance, and co-pays can only be spent on healthcare-related issues, programs, and health-related charity care.
10. Do patients just walk in and out of the clinic?
No. Patients receive full physicals and mental health assessments, and treatment plans are set according to their needs. Patients will have different activities and appointments each week they are required to attend. The average daily stay at the MAT Clinic will be between 1-3 hours because we want to give them all the support they need to return to fulfilling, productive lives.
11. How will patients get to and from the clinic?
More than half our expected patients will either transport themselves or have a friend or family member transport them. Those needing transportation will be met by a fully trained driver at a special time and place each day.
All patients leaving the property must leave the way they came. In other words, if a family member brings the patient to the clinic, they must also bring them home. Those who arrive by transportation van must leave the property in the transportation van.
12. Will this cause loitering or panhandling?
No. The well-being of Sequim and the business community is very important to us. Many of our Tribal Council members and department directors live in or near Sequim, and we would not do anything to damage the well-being of residents or businesses. What’s more:
- The DEA does not allow loitering on a MAT clinic site, and the Jamestown Tribe has patient conduct rules, and will not allow any kind of patient disruption outside of our property.
- MAT Clinic patients are self-referral patients who are motivated to change their opioid use disorder condition. Our patients want to be in the program and are motivated to follow the patient conduct rules and end any disruptive behavior they may have previously displayed in the community.
Treatment allows patients to stabilize their lives and rejoin the community. It’s addiction that causes crimes, not treatment.
13. What’s the plan if things don’t go according to plan?
We will start with a small group of patients—about 25. Our patient load will increase slowly over a two-year period so that we can identify and resolve any unexpected problems. We have been in conversation with city staff and law enforcement, and we’ll continue to do so. Although problems at treatment facilities are atypical, and our gradual ramp-up gives us the opportunity to make changes, other aspects of our facility security include:
- Property fencing
- Monitored security cameras
- Security badges for staff and patients within the clinic
- Continued close coordination with law enforcement
We’ve been talking to residents, local government, healthcare providers, and other community leaders to answer questions about the clinic. If you have additional questions, please let us know at firstname.lastname@example.org.