Reimagining Recovery: Transforming Vacant Spaces into Compassionate Substance Abuse Treatment Facilities
Monday, October 27th, 2025
Team members from Pope Design Group, Dunham Associates, and Innovative Structural Solutions shared their experiences and perspectives on converting existing structures into substance use treatment and recovery environments.
The urgency in finding solutions to the rising rates of substance use disorder has made the need for accessible treatment options more critical than ever. With an abundance of vacant and underutilized commercial properties available, and the lack of substance abuse treatment facilities for individuals seeking help, adaptive reuse of these empty spaces offers a functional solution to both challenges.
Pope Design Group, an architecture and interior design firm based in St. Paul, Minnesota, and Fargo, North Dakota, has supported our clients in revitalizing underutilized buildings as treatment centers through an inclusive design process that involves providers, developers, contractors, and engineers. From abandoned churches to former senior living facilities, together the collective team works to transform existing spaces into welcoming, non-institutional, and effective recovery environments. Each conversion project presents both unique challenges and opportunities for compassionate design.
The Challenge of Conversion
“Every building tells a story,” says Jim Johnson, Senior Project Manager at Pope Design Group. “Some of the spaces we’ve worked with—like senior living facilities—fit the program of substance abuse recovery remarkably well. Others, like an old church we’re converting in St. Cloud, are much more challenging. The church was set to be demolished, but our client saw potential and acquired it for a dollar. It’s being stripped down to the bare bones and rebuilt. That’s an anomaly, though, as most conversions aren’t quite so extreme.”
Michael Van De Riet, Partner at Innovative Structural Solutions, P.A. (ISS) in Minnesota, notes the unpredictability inherent in these projects from a structural engineering standpoint. “The biggest challenge with buildings from the 1950s or 1960s is the sheer number of unknowns. Rarely do we have original structural drawings, so it becomes a puzzle. You peel back finishes and discover inconsistencies — columns hidden in partition walls, roof decks that are far more deteriorated than expected. Even after a thorough field investigation, surprises can still come up during construction.”
From an electrical engineering perspective, Mark Azure, Partner and Electrical Engineer at Dunham Associates, echoes this sentiment regarding a project in Worthington, Minnesota, for New Life Treatment Center, which was previously a Nobles County detention center. “In that case, you’re taking what was almost a prison-like environment and trying to make it into a residential-type space. That’s always a big challenge—taking something sterile and institutional and turning it into a place that feels like home.”
Engineering Comfort and Control
Azure stresses that while safety and function are essential, comfort is inseparable from healing. “In these spaces, giving residents some amount of control over their environment is key. Lighting, for instance, has come a long way. We now use fixtures that look like what you’d find in a traditional home but are designed to be safe and durable for behavioral health and substance use recovery settings.”
He continues, “At Nobles County, much of the investment went into lighting controls. Residents can dim, brighten, or turn off their own lights. That sense of control—when they can’t control much else—goes a long way toward creating a healing space.”
This blending of function and empathy mirrors trends across healthcare design. Environments once dominated by white walls and fluorescent lighting can now resemble spas or boutique hotels. As Azure puts it, “We’re finally treating these individuals as people who deserve to heal in dignified environments, not to be hidden away in gray boxes.”
We’re finally treating these individuals as people who deserve to heal in dignified environments, not to be hidden away in gray boxes.
Balancing Safety and Humanity
Designers and engineers alike recognize that every aspect of these spaces must balance compassion with caution. Azure explains, “In a high-acuity behavioral or substance abuse setting, we have to make sure the residents or patients can’t get behind panels, access wiring, or use fixtures in harmful ways. We specify tamper-resistant, impact-tested products—but nothing is truly tamper-proof. You can only design to minimize harm to the best of your ability and foresight.”
His team rigorously evaluates lighting and electrical systems, including those whose design has been rigorously tested by the manufacturers for durability and safety. “We’ve previously had products fail within a week after installation — fixtures listed for behavioral environments that residents managed to defeat,” Azure admits. “That experience reinforces how vigilant we have to be.”
Despite the difficulty, he insists, “The goal isn’t to make these spaces prison-like. It’s to make them safe and humane. If something breaks and needs repair or replacement but no one gets hurt, that’s a trade-off I’ll accept.”
Materials and finishes are chosen for both durability and comfort. “Luxury vinyl tile is used almost everywhere for easy cleaning. Carpeting is limited to lobbies and offices. Paint colors are kept generic so maintenance is simple since after a resident leaves, rooms often need repainting due to wear and tear,” says Johnson
Furniture is also selected for durability, and exterior spaces are softened with patios, sheltered areas, and picnic spaces. “We encourage residents to be outside as much as possible. Most facilities offer nice outdoor amenities, and it’s essential to provide designated areas for residents to relax. All doors are secured, so movement is controlled for safety.”
From an engineering standpoint as well, the design effort must always begin with safety. Van De Riet stresses, “Our role is ensuring the structure is sufficient to support these new uses—therapy rooms, dining areas, communal lounges. In older buildings, it’s not just about aesthetics. It’s about knowing whether beams and joists can carry the loads required of a treatment and recovery facility.”
Navigating Codes and Costs
Each adaptive reuse project involves navigating complex codes and cost constraints. Azure notes, “When you shift a space from institutional to residential occupancy, the codes completely change. We have to rethink the entire electrical infrastructure as it’s not just plug-and-play from a healthcare project.”
Budgets are another challenge. “You can always make a building or space beautiful and functional if you have unlimited funds,” Azure says. “But most of these projects don’t. They’re built with tight budgets and high purpose, so we have to make smart choices that maximize comfort and safety without excess.”
They’re built with tight budgets and high purpose, so we have to make smart choices that maximize comfort and safety without excess.
Van De Riet explains that older buildings often carry unforeseen costs. “When you peel back finishes, you find surprises—deteriorated decks, hidden columns, structural gaps. Those discoveries can shift a budget fast and can affect cost projections.” He continues, “Owners aren’t always anticipating the degree of remediation required. For example, on the St. Cloud [church renovation] project, large sections of the roof deck were in far worse shape than anyone expected. Once the ceiling was removed, we realized replacement was unavoidable in certain areas.”
He highlights another reality: the delicate balance between what can be salvaged and what must be replaced. “When deterioration is uncovered, sometimes we can reinforce; other times it’s replacement. Occasionally, the repair costs force owners to consider whether demolition is more cost-effective. In one case, a facility in Buffalo, Minnesota, lacked foundation support entirely, and we had to conclude it wasn’t salvageable.
“It’s impossible to know everything upfront. That’s why many projects build in a contingency fund—money set aside for the inevitable surprises. When you hit a $50,000 roof replacement, it’s much easier to move forward when that cost has already been anticipated.”
Operational Realities and Staff Training
Design alone cannot guarantee safety and success. “The biggest challenge is often staff,” observes Eric Young, Project Manager at Pope Design Group. “No matter how much training or how good your building is, it’s up to the staff operating it to regulate where residents are going. If staff get comfortable in their routine or distracted, incidents can happen. The building design should help, but ultimately, it’s only as effective as the people operating it.”
That said, design solutions can help mitigate risks. “We try not to make patient wings too long, so staff aren’t separated from residents. Materials are chosen to prevent self-harm—sealants, for example, can often be picked out by residents, so we use tamper-resistant options. Every exit must be secure but allow emergency egress, which means working closely with fire departments and local jurisdictions.”
Azure agrees. “You have to design for functionality, comfort, and safety simultaneously,” he says. “That’s the eternal triangle. It has to function, it has to feel comfortable, and it has to be safe.”
That’s the eternal triangle. It has to function, it has to feel comfortable, and it has to be safe.
Creating Welcoming, Non-Institutional Spaces
The experience of entering a treatment facility can be daunting. “We really try to make the reception area comfortable and inviting. The intake process is stressful, so having a warm, welcoming entrance is crucial,” says Johnson.
One of the most significant challenges is community acceptance. Providers nationwide, such as Ascension Recovery Services, which recently opened two new ThriveNow Recovery Centers in Iowa, have pointed out that the success of a facility is closely tied to its ability to integrate seamlessly into the surrounding community, reducing stigma and building local support.
“If you had a senior living facility next door and suddenly found out it was becoming a substance abuse treatment center, you’d probably have concerns,” Johnson notes. “Our partners at Ascension [Recovery Services] are excellent at engaging the community. They hold multiple neighborhood meetings, inviting everyone to learn about the facility and who it serves. Once neighbors understand that these are local people who need help — someone’s daughter or son — support grows. It goes from ‘not in my backyard’ to ‘hurry up and build this thing.’”
Young adds, “Getting public buy-in is always an interesting challenge. There are numerous discussions about who will use the facility, what the ultimate goal is, and what safety measures are in place. Sightlines are critical—nurse stations need clear views, and there can’t be hidden corners. Locking door access and controlled flows of people and materials are essential for safety.”
Industry Trends and Research
Recent industry research highlights the growing demand for substance abuse treatment facilities and the trend toward adaptive reuse. According to KPMG’s 2023 M&A update, the U.S. addiction treatment market is highly fragmented, with consolidation driven by new regulations that increase access to care and introduce economies of scale. The Affordable Care Act and Mental Health Parity and Addiction Equity Act have expanded insurance coverage, making treatment more accessible and fueling investment in new and repurposed facilities.
Van De Riet, reflecting on broader construction trends, notes that while adaptive reuse spiked after the 2010 recession, the past decade has seen a balanced mix of conversions and new builds. “Vacant commercial properties may create more opportunity for reuse, but structurally, we still see an even mix between new and old.”
The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that facilities providing both substance use and mental health treatment have seen high response rates and utilization, reflecting the urgent need for integrated care environments. Our experience aligns with these trends: private insurance often enables higher-quality environments, while state-funded facilities may face more constraints.
Bringing Humanity into Engineering
For Azure, the most significant challenge is maintaining the human lens in a technical field. “As engineers, we think function first,” he says. “But in this environment, form and feeling matter just as much. Everything can work perfectly on paper—but if it doesn’t feel right, it’s not doing its job.”
He continues, “We have to take off our engineering hats and imagine being the resident, the patient, or the visiting family member. You have to bring the human aspect into it. Otherwise, why are we doing this? If it’s not about making people better, what’s the point?”
That mindset—shared across each of these firms and their broader network of design, engineering, construction, and development providers —defines this new era of compassionate design in recovery environments.
For Van De Riet, the reward lies in transformation: “With new construction, you get to see a polished, beautiful building rise from the ground. But when you take something that was completely decrepit —trees growing in corridors, water damage everywhere—and you bring it back to life as a safe, supportive facility, that’s a reward of a different kind. You know you’ve given that building another 30 or 40 years of purpose, and more importantly, you’ve created a space where recovery can happen.”
You know you’ve given that building another 30 or 40 years of purpose, and more importantly, you’ve created a space where recovery can happen.
By transforming vacant structures into welcoming, functional treatment centers, these teams not only revitalize communities but also extend a lifeline to those in need. “These are not institutional environments,” Johnson emphasizes. “They’re places where people come to rebuild their lives.”
Azure’s words echo that sentiment: “Everybody wants to feel like what they do makes a difference. And I truly believe this work does. We’re giving people—and buildings—a second chance.”
This article was developed by Pope Design Group with input from employees, colleagues, Dunham Associates, Inc., Innovative Structural Solutions, P.A., and the sources hyperlinked within the article above.