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.

Last year, the Washington Legislature enacted a law that made drug possession a misdemeanor, among other provisions.

In response to a Washington State Supreme Court decision that essentially decriminalized possession of controlled substances, Senate Bill 5476 also required police to divert the first two offenses from the criminal justice system. State-contracted care navigators are supposed to work with people who come into contact with law enforcement and refer them to programs including syringe exchanges and clinics that offer medications to blunt addiction cravings, counseling and health care.

Yet, the question remains: how to get the best results for a population that was not seeking treatment at the time of their contact with law enforcement?

Preliminary data from a recent study by the University of Washington’s Addictions, Drug & Alcohol Institute determined that people responded positively when they received personal attention and follow-ups in these new programs.

The study could lead the way to more productive treatment and health outcomes down the road and improved quality of life for communities.


The UW study involved programs in Tacoma, Spokane, Centralia, Walla Walla, Kennewick and North Seattle. About 1,300 individuals began medications for opioid use disorder, typically buprenorphine, between 2019 and 2021 at these locations. They were 80% white and 54% male, reflecting the broader population of syringe-exchange participants.

In addition to medications, participants were offered in-person counseling and emotional support, phone calls and texts. The conversations revolved around staying in the program, current drug use and cravings, and other issues such as lack of housing and family issues. The study documented 12,812 interactions, most commonly in person.

“ … Utilization was high, and the service mix and topics of conversation appear highly relevant for people working to improve their overall health,” the study reported.

If this type of program is to be rolled out further, many challenges must be solved, including how to pay for it. Reimbursing intensive supports with Medicaid, state and local dollars would “substantially expand access to this popular service,” according to the study.

Substance use disorder and overdoses are national crises. To make a difference, innovative strategies and tactics ought to be employed, along with more robust funding. These include having professionals assume the role of trusted friends and knowledgeable guides, when no others can be found.