In addition to the immense emotional cost in lives and suffering, figures show that the opioid epidemic is financially burdensome for society as well. In 2018 alone it cost the United States $696 billion – that’s 3.4% of the country’s GPD.3

Treatment

Opioid use disorder (OUD) can be treated through medication-assisted treatment (MAT): the use of medication combined with behavioral therapy. Along with counselling and social support, methadone is administered to patients to reduce withdrawal symptoms and opioid cravings. Compared to going to rehab for long periods of time, treatment at a methadone clinic is both cost- and time-efficient by allowing patients to continue living their lives once enrolled, attending the clinic mainly for counselling and to receive medication. This allows patients to work, stay close to their families and, in extension, re-enter society. MAT programs have been shown to reduce opioid death by 50% or more.4

Methadone is a synthetic opioid that was developed in Germany during the 1930’s. Since the 1960’s it has successfully been used to reduce heroin withdrawal symptoms and cravings. Nevertheless, a common misconception about methadone is that it is a drug in the same sense as other opioids, and that using it means replacing one addiction with another. This is not correct. While methadone is also an opioid, proper administration blocks the effects of illicit opioids while also reducing withdrawal symptoms and cravings for drugs, without providing the high other opioids give.5

The effects of methadone last for 24-36 hours, which means new doses must be collected from a methadone clinic daily. While vital to OUD treatment, the task of procuring methadone every day can be burdensome, especially if your methadone clinic is located far from where you live or work. The shortage of methadone clinics is a problem not only in the countryside, but also in urban areas.

To ease access to methadone, medication units are being introduced as a complement to existing methadone clinics: small facilities (connected to a main methadone clinic) where those enrolled in an MAT program can receive methadone, making it easier for people not living near a main clinic to collect their daily dose. Patients will still have to attend the main clinic for counselling and therapy.

Stigma

Drug use has long been regarded as a criminal problem rather than a health concern. This has over time established the idea that a person addicted to drugs should be punished rather than be given help to overcome the disorder. Even individuals struggling with OUD can share these preconceptions, and might hesitate to seek help believing they don’t deserve it – or because they don’t want to be judged by society.

The stigma of addiction has played a huge role in why the opioid epidemic has spiralled into a national health crisis. Consequently, it is also a fundamental part of the solution.

Solving the opioid crisis requires efforts from the government by making addiction treatment available and accessible to those who need it, regardless of geographic location or socioeconomic factors – but as with many other issues, politicians won’t act until enough members of the public demand so. And if the general public believes addiction is a moral failure and a crime, it will continue to be treated as such. Conversely, if enough people started viewing addiction as a health problem – and demanded it be treated as such, policy, health care and more would soon be reformed to address the demand.

This would also make a difference on an individual level, making those struggling with addiction more comfortable in addressing the problem and seeking help, knowing they won’t be judged when doing so.

Goal

The goal of Emotions, Architecture, Opioids is to design a methadone medication unit located in Venice, Los Angeles.

Proposals should address the stigma surrounding opioid dependency: in addition to administering methadone, the medication unit and its setting should offer an environment that is appealing regardless if you struggle with OUD or not.

Inviting two disparate groups to share the space has the aim of dispelling prejudice and building trust, on both sides: someone struggling with OUD isn’t necessarily a bad person, and someone with limited exposure to addiction isn’t necessarily judgemental.

Whether this is achieved by design, concept, the incorporation of a secondary function – or a combination of all of the above – is left to the discretion of each participant.

Further considerations

Explore the emotional impact of architecture and how it can be used as a design tool

Take into account that different user groups might use the site differently

Consider potential issues with introducing a drug treatment facility into a busy urban location and how they can be mitigated

Site usage, building size etc. is left to the discretion of each participant

While there are functional matters to consider (like parking, restroom dimensions etc.), priority should be given to the issues mentioned in the Brief section above

Assume that there is an established connection between the medication unit and a main treatment facility

Staff training, warrants and other legal obstacles to a methadone clinic are not the focus of the competition and can be ignored

Specific requirements for the medication unit are available in the competition package.

Submission requirements

Site plan:the only specific requirement – can be either detailed or schematic, but should illustrate any components of the proposal

Visual material:any drawings, renderings, photographs, diagrams, illustrations or collages required to ex-plain the proposal.

Written material:any text required to explain the proposal.Please note that the upper limit for text is 300 words total.

All entries should be submitted on a single digital A2 (594mm x 420mm) board in landscape orientation. Entries must be submitted in PDF format, no larger than 6MB – other formats or larger files won’t be considered. The file name should be the unique, six-digit number given when registering. This number must also be visible in the lower-right corner of the board. See further submission instructions in the competition package (available to download after registration).

To ease publication and promotion, awarded participants will also be asked to submit their proposals as individual images (JPEG or PNG format).

Competition package

Upon registering and paying the entrance fee, each competitor/team will be able to download a package containing context photographs along with specific requirements for the medication unit.

Timeline

The competition begins on April 9 2020. The registration fee is €70 until April 26, when early registration ends and standard registration begins (fee €90). Standard registration ends July 19. Late registration (fee €110) ends on August 2 – one week before the submission deadline, which is on August 9. Winners will be announced no later than September 27