Community Health & Wellness

Pierce County detox facility extends time patients spend recovering from opioid addiction

Posted on July 10th, 2025 By: Conor Wilson

Pierce County’s only facility offering medically supervised drug detox will double the number of days clients facing opioid use disorder can spend in its care, an effort to improve outcomes and combat the unique challenges of treating fentanyl withdrawals.

For decades, clients have spent up to five days in detox, said Margo Burnison, director of behavioral health for Pierce County Human Services. That standard typically provided sufficient time to remove alcohol and most drugs from the system. Yet fentanyl – an opioid 50 times stronger than heroin and known for its intense withdrawals – has proved to be an outlier.

“Part of our approach was realizing and understanding that things have changed over the past 30 years,” Burnison said. “Some of the standards we still operate off of don’t really apply.”

Low success rates after five days

During a series of roundtable discussions, substance use treatment providers reported clients with past fentanyl use were having low success rates after completing a stay in detox, Burnison said. Patients were leaving lethargic, unable to participate in follow-up inpatient care or otherwise maintain long-term recovery.

Derek Murphy, director of clinical services at the Olalla Recovery Centers, said they noticed some clients would not experience the most acute symptoms of fentanyl withdrawal until they reached their fifth, sixth or even seventh day of detoxing. That is later than other substances and around the time they would be leaving detox for an inpatient facility.

“When those full-blown withdrawals happen in an inpatient setting – and we’re not a withdrawal management unit – that can be very challenging,” he said. As the pain and intensity increases, many clients “make the terrible decision at that point time to leave care and go back out into active use.”

Prolonged stays in detox, they argue, could improve results for these patients. They could be more comfortable during the worst of their withdrawals and going forward be more present for the next phase of their recovery.

Metropolitan Development Council

To test this, the county has given $1.3 million to the Metropolitan Development Council to expand its services and accommodate longer stays through February 2027 at its detox center in Tacoma. They expect about a third of the facility’s 32 beds will be available for up to 10 days for those detoxing from fentanyl. The exact number will vary with demand.

The Metropolitan Development Council building in Tacoma.

MDC, a Tacoma-based nonprofit and community action agency serving Pierce County since 1964, provides a range of services including housing, health care and education aimed at reducing poverty.

Tim Dowling, director of development for MDC, said while standard detoxes last five days, “emerging research and feedback from providers suggest that a 10- to 15-day stay may be more clinically appropriate for fentanyl, which often causes delayed or rebound withdrawal symptoms that are not fully resolved in shorter stays.”

“Internally, we analyzed client data and saw a pattern of individuals returning shortly after discharge,” he wrote in an email. “In speaking with those clients, many shared that they were still experiencing withdrawal symptoms and did not feel stabilized when they left. This first-hand feedback, combined with our clinical observations, confirmed the need for an extended care model.”

Opioid settlement money

Pierce County has partnered with researchers from University of Southern California to produce a randomized, controlled study on how this affects recovery outcomes. This includes looking at program completion, hospital readmissions and successful transition to long-term treatment.

Funding, in part, comes from a flurry of settlement agreements with companies that fueled the opioid epidemic, the county said. Pierce County and its cities are estimated to receive more than $62 million from those settlements paid out in installments over the next 15 to 20 years, according to data from the Washington State Attorney General’s Office.

County Executive Ryan Mello called expanded detox “essential,” as opioid overdoses have continued to be the leading cause of accident death in the county since 2020.

Washington saw a dramatic increase in deaths from opioids between 2019 and 2023, much of it driven by fentanyl. Per-capita death rates more than tripled over that span, according to data from Addictions Drug & Alcohol Institute at the University of Washington.

Preliminary data for 2024 shows a decline in opioid-related deaths for the first time in about a decade, offering a glimmer of optimism even as death rates remain near all-time highs. According to Pierce County, 423 people died from accidental overdoses last year. About 70% of those involved opioids.

“Giving people a few more days in detox, they are more likely to connect with long-term support systems and less likely to be readmitted,” Mello wrote in a statement. “This is a smart way to use our limited resources to save lives and help more people get on a path to recovery.”

‘It becomes so uncomfortable’

Drug detox is often a critical first step in someone’s path to recovery. Ridding the body of a problematic substance often includes uncomfortable or painful withdrawals. Medical professionals can manage those symptoms. Through the process patients are stabilized and can then transition to rehabilitative treatment and therapies.

Yet not enough detox beds are available across the state. It remains unclear how prolonged stays in Tacoma could add to capacity constraints at one of the few detox facilities near the Kitsap Peninsula.

Kitsap County has its own detox facility, the Kitsap Recovery Center in Port Orchard, but it offers only subacute detox, not medical, said Sara Marez-Fields, executive director of Agape Unlimited, a treatment provider in Bremerton. Her agency has found that level of care often does not work for those detoxing from opioids due to the intensity of withdrawals.

“Clients tend to abort because it becomes so uncomfortable,” she said.

When a client is looking for detox, Agape prioritizes an open bed over proximity, Marez-Fields said. MDC’s detox in Tacoma, while closest, is “chronically full.” Her agency tends to have better luck placing people at facilities in Vancouver, Oak Harbor and Bellingham.

Accessing detox facilities

Burnison said concerns about access are part of the reason extended stays will be allowed on only a portion of the MDC’s available beds.

The county is also shoring up partnerships with agencies offering inpatient services, she said, hoping to more easily transfer patients who are ready to their next phase of care and prioritizing individuals who need to detox longer.

Dowling, with MDC, wrote they were very aware of the limited number of detox beds in the region and would monitor the situation closely. Their goal is to reduce the number of people who return to detox shortly after discharge.

“By offering a stay that is more aligned with client needs, we hope to stabilize people more effectively and reduce repeat admissions,” he said. “This could ultimately ease demand in the long term. We are working in partnership with Pierce County to closely track capacity and make adjustments as needed.”