DESC’s ORCA program is demonstrating an effective and compassionate response to the opioid crisis in Seattle
One year ago, DESC and community partners asked a simple but urgent question: What if we provided people with the compassionate, comprehensive care they actually need after an overdose?
The answer was the Opioid Recovery & Care Access (ORCA) Center, created to fill a critical gap in opioid use disorder care by providing immediate stabilization, a place to comfortably recover, and access to a variety of treatment and recovery services.
Now, the ORCA Center is beginning to transform how Seattle responds not only to overdoses, but to the broader challenges of the opioid crisis and homelessness. Instead of taking someone to a crowded emergency department, first responders can bring them to a welcoming space that offers immediate care, ongoing treatment, onsite behavioral health support, case management, and a pathway toward lasting stability.
But the ORCA Center’s secret to success isn’t in the lifesaving medications or innovative treatments: It’s in meeting people where they are with what they need in that moment.
What is ORCA?
The ORCA program consists of both the ORCA Center — DESC’s brick-and-mortar treatment and post-overdose care center — and the ORCA Patient Outreach Division (POD), its mobile outreach team that brings treatment and care directly to people in the Seattle community, with a focus on supportive housing and shelter sites.
Located inside DESC’s Downtown Behavioral Health Clinic at 515 Third Avenue, the ORCA Center provides 24/7 post-overdose stabilization and daily walk-in access to treatment from 9 a.m. to 11 p.m. Anyone can walk through the doors seeking help with opioid use — no prior relationship with DESC or complicated referral process required.
Guests at the ORCA Center also have access to:
- Hot meals, showers, and laundry
- Peer support
- Access to case management, housing resources, and behavioral health care
The ORCA Center serves as a “front door” to DESC’s broader network of care, including behavioral healthcare, substance use disorder counseling, permanent supportive housing, and more.
Since opening this front door on September 2, 2025, the ORCA program has:
- Provided care through more than 10,000 encounters
- Provided care to more than 500 people following an overdose
- Started nearly 800 people on medication for opioid use disorder (MOUD)
- Started more than 400 people on long-acting injectable (LAI) buprenorphine
But what makes the ORCA program special isn’t just the medications, new protocols, or innovations, said Dr. Callan Fockele, senior medical lead for the ORCA program:
“It’s how we meet people where they are with what they need in that moment,” said Dr. Fockele. “That might look like offering someone a warm blanket and a Cup of Noodles while they receive an injection of long-acting buprenorphine — a medication used to treat opioid use disorder. It’s providing a hot meal, a shower, a bathroom, or a place to do laundry. It’s treating people like human beings, with dignity, that makes all the difference.”
The power of compassionate care
The ORCA program has helped over 800 people get started on MOUD in its first year of opening — people like Travis Gardner, who referred to ORCA in an article by the Seattle Times as his “home away from home.”
Since starting monthly injections of buprenorphine, Travis has been able to stop using opioids altogether. “No, I don’t need it. I don’t miss it,” he said to the Seattle Times.
Travis now visits the ORCA Center monthly for his injection and has since stopped using fentanyl. With this treatment, paired with supportive housing, he now has hope for a different future.
“To be able to look forward and have a purpose again, belonging to something,” he said.
Travis’ story and recent statistics show encouraging progress in solving the opioid crisis in Seattle — fatal overdoses are down 25% this year compared to the same period last year.
Impact through innovation
The monthly injection that people like Travis receive at the ORCA Center is long-acting injectable buprenorphine, or LAI. It is administered using an innovative protocol developed by DESC’s ORCA POD — formerly the Opioid Treatment Network — with promising results published in collaboration with UW Medicine colleagues.
The new protocol’s success lies in greatly reducing the withdrawal people may experience when starting buprenorphine. Because fentanyl produces short, intense effects and severe withdrawal symptoms, stopping can be especially difficult — a challenge compounded by circumstances such as living outside.
DESC’s injectable-only overlapping buprenorphine protocol offers an easier way: People using fentanyl don’t have to stop before or during the process and can come in for injections on a much less frequent basis than other methods.
“We developed this protocol around a simple question: How do we make an effective, life-saving medication easier for people who use fentanyl to start and stay on?” said Dr. Richard Waters, medical director at DESC. “Traditional approaches to starting buprenorphine can have barriers that are especially difficult to overcome for people experiencing homelessness or living with complex health needs. We are seeing that when we adapt treatment to the realities of people’s lives — rather than asking people to adapt to a health care system that isn’t designed to meet their needs — we can achieve improved engagement and retention.”
The protocol is now offered as one of several pathways to start buprenorphine by ORCA Center staff and the POD team. Other medications for opioid use disorder, such as methadone, are also available via both the center and outreach team.
Read the peer-reviewed studyThe future of overdose care
The first year of the ORCA program is just the beginning and a promising foundation for continued progress in supporting people living with opioid use disorder. That progress would be possible without first responders like Health 99, the Seattle Fire Department’s post-overdose response team.
Today, 65% of Health 99 post-overdose transports are brought to the ORCA Center for care. The partnership between the ORCA Center and Health 99 has created a continuum that did not exist before: responding to an overdose, beginning treatment as quickly as possible, providing a welcoming place to stabilize and recover, and connecting people to ongoing care.
“It is no exaggeration to say that the ORCA Center has been a game changer for the Seattle Fire Department, its overdose response team, and for clients around Seattle with opioid use disorders,” said Jon Ehrenfeld, Mobile Integrated Health program manager at the Seattle Fire Department. “The benefits of a specialized post-overdose receiving center cannot be overstated. Our team has witnessed firsthand how the ORCA Center enables a true continuum of care for overdose survivors: beginning with a specialized response in the field and continuing to a patient-centered wraparound clinic that alleviates the strain on hospital emergency rooms. The relationship with the ORCA Center has developed into a cornerstone of the department’s overdose response and will continue to set a national standard for best practices in delivering unparalleled care to this challenging patient population.”
The ORCA program’s first year is just the beginning. Its proven, person-centered model provides a strong foundation for continued progress in supporting people struggling with opioid use disorder and reducing overdose deaths in King County. That work would not be possible without partners such as the Seattle Fire Department, the City of Seattle, the University of Washington, and so many others who have supported and partnered with us along the way.
Learn more the ORCA program here.
Thank you to our partners
ORCA Center and ORCA POD are a community effort with capital funding provided by the City of Seattle, King County, Washington State, and a generous private donor.
Key partners include the University of Washington Addictions, Drug & Alcohol Institute; King County Behavioral Health and Recovery Division; Public Health – Seattle & King County; and the Seattle Fire Department. Funding for operations comes from government partners and Medicaid reimbursements.
Additional funding for ORCA POD is provided by the Pacific Hospital Preservation & Development Authority (PHPDA).