Measure 110 funds new stabilization and recovery area for patients in acute intoxication

Providence Portland Medical Center, located in Portland’s North Tabor neighborhood, recently opened an eight-bed SARA (stabilization and recovery area) unit to serve patients in acute intoxication who need emergency care. The new unit will provide care for patients who come to the emergency department (ED) primarily via ambulances or police vehicles.

Providence Portland’s SARA unit is paid for with funding from Measure 110, Oregon’s 2020 drug treatment and recovery act that focuses on connecting people who use drugs with treatment and recovery resources, as opposed to doing jail time.

The Providence Portland ED documented more than 6,000 visits of patients with substance use disorders (SUDs) per year between 2019 and 2022. While Providence has always supported patients facing SUDs, the medical center has seen an increase in demand due to rising use of illicit fentanyl and methamphetamine.

Dr. Robin Henderson, chief executive of Behavioral Health at Providence Health & Services in Oregon and leader of the new unit, said the Providence Portland ED serves approximately 8-10 acutely intoxicated patients per day. The new unit will provide a safe and quieter environment for patients who previously were placed in the emergency room with others, impacting the level and amount of care.

In the past, SUD counselors and addictionologists (doctors with specific training on treating addiction) would rotate through the busy ED to treat acutely intoxicated patients who sometimes were experiencing behavioral disruptions and suicidal thoughts.

The new Providence unit—a renovation of existing ED space—provides stabilization and recovery areas, also known as sober beds, for individuals experiencing acute intoxication to recover safely. Often established as a way to divert people away from filled EDs and law enforcement, SARA units are innovative solutions for supporting people at risk of drug overdose.

Dr. Henderson explained the new beds allow the Providence Portland team to “coalesce all resources together in one space that’s less stimulating than the ED, and more therapeutic.”

Made possible by a $4.3 million grant from Measure 110 funding, the renovation includes enhanced security and new furniture in the recovery areas focused on patient safety.

The care team serving patients in the new unit will include addiction counselors, addictionologists and peer support recovery specialists—a role of growing importance in recovery. Patients will typically spend 24 to 48 hours in the SARA unit, stabilizing from acute intoxication before being connected to local resources. Once the patients can be discharged, interested patients will receive a referral to a SUD treatment program in the Behavioral Health Resource Network (BHRN)—another component of Measure 110’s grant dollars enabling community-based organizations to work with each other to serve people with SUD and/or mental health disorders.

Greg Bledsoe, a Certified Alcohol and Drug Counselor II and Women’s Services Coordinator in the Addictions, Treatment, Recovery & Prevention unit at Oregon Health Authority (OHA), emphasized the importance of timing for the patient. Staying in the SARA unit is a key opportunity to both introduce patients to, and connect them with, resources across the continuum of care.

“The fact this is coming online is awesome, and we need more of them,” Bledsoe said, adding that patients who are acutely intoxicated are often on the street, in the ED or put in jail.

The SARA unit will provide a safe space for people “at their most vulnerable” to find help, if interested, and break the cycle of repeat stays at the ED.

Additionally, creating this separate space for patients to recover doesn’t impact just the patients and providers. It frees up other beds in the ED—a critical upside as Oregon and communities across the country face overloaded hospitals and climbing rates of SUDs and overdoses. The addition of the SARA unit can potentially increase the medical center’s capacity to see an additional 6,570 visits annually—not only for people with SUDs, but any ailment. It could also reduce ED wait times for patients, which has been rising in Oregon since 2018.

With an estimated 40 similar resources across the country, and only five in Oregon, Providence Portland’s SARA unit helps fill a gap in the state’s substance use response. It will play a critical role in “getting people connected to the right services at the right time,” Dr. Henderson said.

If you or someone you love is seeking help for substance use, check out OHA’s Addiction Services webpage, or call the Alcohol and Drug Help Line at 1-800-923-4357. You can also contact your local community mental health program for help.