Editor’s note: The Mental Health Project is a Seattle Times initiative focused on covering mental and behavioral health issues. It is funded by Ballmer Group, a national organization focused on economic mobility for children and families. The Seattle Times maintains editorial control over work produced by this team. As part of this project, editorial writer Alex Fryer has been examining issues related to behavioral health and substance use disorders.

In the next few weeks, the state Health Care Authority will begin rolling out drug treatment outreach programs and a new therapy for methamphetamine use disorder across Washington. These moves are part of an unprecedented $88.5 million investment for substance abuse services.

Rep. Lauren Davis, D-Shoreline, was instrumental in moving the package through the Legislature earlier this year. She answers questions about the effort, the state Supreme Court’s decision on reducing drug crimes and what communities can expect from the focus on treatment instead of incarceration.

Managing the meth crisis: Paying users to go clean could change lives and communities

Here’s an edited conversation with Davis.

Q: How did the state Supreme Court’s decision in Washington v. Blake decision throwing out drug possession laws evolve into a historical investment in substance abuse treatment?

A: There is a general belief that the criminal legal system was a tool to engage with individuals with substance use disorders into recovery. It is a very flawed belief, but it is pervasive. It is correct that some individuals say, “Going to jail saved my life.” That is the minority narrative. But if you take away one thing, you need to replace it with something else. It (the Blake decision) was a generational opportunity to make substantial historical investments in behavioral health. The data suggests somewhere between 80% and 90% of people with substance use disorder want help and only 11% get it.


Q: Why is there such a large gap?

A: Most of this population is Medicaid eligible, but Medicaid cannot pay for outreach or engagement services. We never funded in a significant way pretreatment services or outreach services. That’s the bulk of behavioral health investments, $45 million over two years. That is a mammoth amount of money.

Q: Why not put more dollars into treatment beds and services?

A: The continuum of care for substance use disorder has three legs. Leg one is outreach. Leg two is treatment. Leg three is recovery support services, which is all the stuff that keeps people well after treatment — housing, employment, family support. We have not funded those for the same reasons you can’t bill Medicaid. We funded one leg of the three legged stool, which is treatment only. And then we blame people for failing treatment. If you actually funded all three parts, people might actually get better.

Q: What do you expect to see for the investments?

A: When a person has primary substance use disorder — which is most of the people in our criminal legal system and most of the people experiencing homelessness — when that disease goes into remission, they are extremely capable of working and parenting. If you can get the substance use disorder under remission, the sky is the limit.

We will start to see reductions in the kind of symptoms of untreated addiction in the community. Some of those symptoms are visible homelessness, property crimes, overdoses. We have a lot more to do, and we owe it to the people who have a horrifically debilitating but also treatable disease for which recovery is not only possible but probable when we provide people adequate access to care.

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