The opioid treatment provider CODA sits along the east side of U.S. Highway 101 just south of Avenue U in Seaside.
Only a few hundred yards to the east, homeless encampments in the Mill Ponds park are littered with trash and drug paraphernalia. Needles by the hundreds are haphazardly discarded.
In an interview from her office in Portland, Alison Noice, CODA’s chief executive officer, said staff at the CODA Seaside office are aware of drug-related activity in the Mill Ponds, a problem that preceded CODA’s arrival in late 2019.
“It is a safe assumption at least some of the folks that are living back there are struggling with opioid use,” she said. “It could be amphetamine use as well. Likely it is.”
The Seaside clinic exclusively treats opioid users. CODA receives reimbursement for patients, not outreach, for which they rely on support from law enforcement, coordinated care organizations and Clatsop County.
CODA does not provide a needle exchange, a service provided by the county and local hospitals.
“As an industry, our weakness is the we sit at the front door and wait for people to come to us,” Noice said. “The model needs to change. I think of it as the ‘pre-work.’ Before you start treating somebody, how can you reach them enough to see the value of trying?”
The Seaside clinic operates from 5:30 a.m. to 11 a.m.
Of 108 active CODA patients at the Seaside facility, 92% of them are housed or temporarily housed.
But for those living in encampments or on the streets, housing is an important step in beginning recovery.
“I have a hard time imagining how someone finds the motivation to begin recovery without a place to live,” she said. “Temporary safe, low-barrier housing is often a strategy that works for a lot of people. Some people will begin to thrive simply because they start to build that back into their daily routine. There’s an opportunity there to say, ‘OK, today is the day that we decide to go further.’”
The COVID-19 pandemic has brought masks and social distancing to every phase of life, but CODA remains “completely available” to patients and new patients continue to enter every week, she said. “We have not had any COVID transmission, which has been fantastic.”
Seaside has put homelessness at the top of its goals list. Noice plans to take a role in the conversation.
“As a treatment provider, on behalf of our patients, we do have some expectation we are contributing,” Noice said. “To our community, we know what happens around methadone maintenance. There’s still a lot of education that needs to happen, and some relationship-building that I would like to see us do. There’s a lot of misconception.”