Homeless Alcoholics in Seattle Find a Home

JOHN YDSTIE, host:

This week we're talking about the chronically homeless. The quarter of a million people in America who find themselves on the street, night after night, year after year. Many are dealing with drug or alcohol abuse.

In a moment, we'll hear about a facility in Seattle, where homeless alcoholics can live, and drink in their rooms.

RENEE MONTAGNE, host:

First, we turn to some homeless here in Santa Monica, California, who are dealing with their own alcohol issues.

Ms. ANITA LEE RANDALL(ph) (Homeless, California): I used to be an assistant manager of Macy's, down here on Santa Monica.

MONTAGNE: Anita Lee Randall's slide into homelessness began, as she tells it, when she was assaulted, then lost her job.

Ms. RANDALL: And I ended up moving in at another friend's house. He was real heavy drinker. I started drinking hard alcohol, real heavily.

MONTAGNE: In her two years of homelessness, Anita has been stabbed, but she says that she prefers to live on the street with her boyfriend, Tony. And she says she only drinks now and then.

It was a cheerful group, sharing lunch, sitting on a curb in a grocery store parking lot, and taking in the sun. Stuart Ashmore(ph) has been homeless, here, for four years.

Mr. STUART ASHMORE (Homeless, California): I just drink beer, and I know when to, you know, turn myself off it. And I can drink one beer and my mother would call me drunk. So therefore, I want to drink more. Some I'm like, well, mother, if you think I'm drunk on one, you ought to see me after I drink four and six of them.

MONTAGNE: But, just beer?

Mr. ASHMORE: Yeah. Just beer. I don't drink hard stuff, because I know my system can't handle it. And nobody else's system can handle that stuff.

MONTAGNE: At the other end of the spectrum from this group, are chronically homeless alcoholics who are literally falling down drunk. They cost taxpayers millions. In Seattle, the county government estimates the 40 most severe alcoholic homeless, cost it tens of thousands of dollars each year, in emergency room and other services. So, the county decided to try something new, and also controversial.

Last December, it opened a facility where the worst drinkers can live and drink, with no strings attached. Bill Hobson, who is director of Seattle's downtown emergency service center, runs the facility.

Mr. BILL HOBSON (Director, Seattle's Downtown Emergency Service Center): The King County government prepared for us a list of the most expensive utilizers of Harbor View Emergency Department, the King County Jail, and our sobering and detox facilities. It was a rank-ordered list of 200 individuals.

We started with number one on that list, and proceeded down it, until we had 75 residents.

MONTAGNE: You've been quoted as saying that these people, your folks, are the unsympathetic homeless.

Mr. HOBSON: I think we all know that. I think we all know that from our own experience. I mean, think about when you see someone in the downtown area of your city, who is passed out on the street, constantly intoxicated, urinating in doorways. That doesn't illicit a whole lot of sympathy. You may have some inkling of compassion, because it's a human being in a very wretched state of existence, but I think they're unsympathetic to the extent that, historically, we have not put any kind of public resource at their disposal to help change their lives.

MONTAGNE: Well, traditionally, shelters and other facilities, these are all aimed at getting people off the street, but through strict rules against drugs and drink. But these folks in your facility can continue to be alcoholics, if they feel like it, in the comfort of their own rooms.

Mr. HOBSON: Well, I think addictions medicine specialists, would tell you that once you're an alcoholic, you're always an alcoholic.

MONTAGNE: So what, you're facing reality, basically?

Mr. HOBSON: Yeah. I think conventional alcohol treatment works for the overwhelming majority of alcoholics. But for a small subset, it doesn't work.

MONTAGNE: What's the worst thing a critic has said about this?

Mr. HOBSON: Um, bunks for drunks. I think that very bright people still can't get over an alcoholic that can't stop drinking or won't stop drinking. What we're doing is acknowledging that the likelihood is that they're never going to stop drinking. What we want to do is help them discover ways to reduce the levels of consumption, around a bunch of people that actually care about them, and reduce their utilization of these other expensive services.

MONTAGNE: So, when we talk about expensive, what we're talking about here is paramedics going out, police making arrests, jail time being paid for, emergency room services, really big-ticket items.

Mr. HOBSON: Big-ticket items. You walk into the emergency department of Harbor View, and an attending physician simply touches you: $461 roll over on the cash register. Many of our folks have multiple trips to the emergency department. I've heard anecdotally, from a physician at Harbor View, that one of our residents had over 200 visits to the emergency department in 2004.

MONTAGNE: Wow. So when you say that King County knows these people, it's actually not such a hard thing to imagine. That is, it sounds like they're part of the community of the emergency room.

Mr. HOBSON: They're part of the emergency room...

MONTAGNE: And the jail.

Mr. HOBSON: ...and the jail. And also the detox facility - sobering facilities here. And political leadership in Seattle and King County, it challenged the community to come up with another way of looking at this, another way of dealing with this problem. Many people say that we're encouraging the consumption of alcohol. That is actually 180 degrees in the opposite direction.

MONTAGNE: But surely there must have been some controversy. The people in the neighborhood, did they really welcome this facility?

Mr. HOBSON: The facility was developed, is developed, and exists sort of on the periphery of downtown Seattle. Everything around it is commercial kinds of business enterprises. There are no residential properties. And then it has two natural barriers: the Denny Street overpass, on one side, and the interstate 5 corridor, on another.

MONTAGNE: So you solved the, not in my backyard, problem.

Mr. HOBSON: No, I didn't quite solve that. I'd like to believe that we did.

MONTAGNE: But it being located in this out of the way neighborhood, can you imagine a facility like this in and around homes and schools?

Mr. HOBSON: No, I can't. And not so much because we're concerned about any risk that our population would pose. They're simply not pleasant to look at. I'm the father of a nine-year-old daughter. There are certain things I want to shield her from until she's old enough to understand the social dynamics and social implications that drive this.

MONTAGNE: Back to this whole question of how you ended up getting the facility. When the county handed you this list of people they wanted in your facility, how hard was it to get them in?

Mr. HOBSON: Not very hard at all. We went to number one. Number one was already dead. We got number two and number three in. Number four and number five were dead. And people had disappeared. But of the folks we actually contacted, we only had to approach 79 to get 75 acceptances to move into the project.

A lot of people think these folks don't want to come in. that they just want to stay out on the street. We've never believed that. But even we were somewhat surprised at the rate of acceptance.

MONTAGNE: Bill Hobson runs the facility called Eighteen-Eleven Eastlake, for chronic homeless alcoholics. Most arrive there in very poor health, he says. Four of the residents have already died there.

Our next conversation: a proposal to transform abandoned VA buildings into facilities for homeless vets.

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