No city in America is immune to the anguish caused by addiction. But, for Seattle and King County, the street-level and public safety impacts are worse than in much of America.

On any trip downtown, we encounter people suffering from substance-abuse and mental-health issues. They crowd the streets near the King County Courthouse and in the retail core. Many Seattleites now fear for their safety when commuting to work, attending events, shopping or riding transit.

The daily turmoil on our city streets appears to be the product of a complicated systems failure due to a shortage of substance-abuse treatment and affordable housing. As the former CEO of Habitat for Humanity for Seattle/South King County, and as COO of Harbor Properties, I learned that it’s much easier to house those whose only impediment to housing is a lack of money than it is to house those with complex issues of mental health and addiction.

As a lifelong Seattle resident, I’ve noticed that when our region has faced seemingly insurmountable challenges, we have found lasting solutions. When I was a child, Seattle dumped sewage into Lake Washington and garbage onto the shore north of Husky Stadium. Community activists created Metro and solved those problems.

Now, a solution employed by some Washington counties appears to offer an effective tool for reaching individuals trapped at the intersection of addiction, criminal activity and homelessness.

In Benton and Snohomish counties, comprehensive Medication Assisted Treatment (MAT) programs are helping every opiate-using inmate entering their jails. The programs are deployed in partnership with Washington state-based treatment provider Ideal Option and overseen by double-board certified addiction and emergency medicine physicians who bring deep experience in treating hard-to-serve populations. These programs are supported by their community-based clinics, offering warm handoffs upon an inmate’s release, allowing treatment to continue along with access to wraparound services.


Why are thousands of individuals suffering from opioid-use disorder passing in and out of our jails without getting help? Without appropriate treatment while incarcerated, addicted inmates will suffer harsh withdrawal symptoms and resort back to using drugs upon release. Worse yet, they may overdose, unaware their tolerance diminished while in jail.

According to the National Institute on Drug Abuse, using medications in criminal justice settings “decreases opioid use, opioid-related overdose deaths, criminal activity, and infectious disease transmission.” Addiction experts now recognize this as the single best intervention for breaking the cycle and essential to recovery.

The results of these programs speak for themselves: Benton County Jail’s MAT program is achieving a stunningly low recidivism rate of around 6% after treating more than 1,200 patients since January.

Nearly 70% of inmates continued with their first treatment appointment upon release. Recently, Snohomish County Jail announced an expansion of its MAT program to serve all inmates in need.

Looking at this model with an eye toward King County, several opportunities emerge at little cost to the taxpayer, whether at the King County Correctional Facility downtown, its West Wing Shelter or the Maleng Regional Justice Center in Kent.

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King County must make critical distinctions when considering such plans. The use of board-certified addiction medicine physicians makes sense. Opioid addiction is a disease that should be treated by addiction-medicine specialists. We should also be seeking providers with both the experience and the capacity needed to match the severity of the problem. We now know that effectively treating thousands of addicts simultaneously in a region like ours is vital for success. Anything short of that strikes me as the equivalent of trying to hold back the tide with a broom.

Ensuring comprehensive and proven addiction treatment within our correctional institutions will not solve all of our region’s troubles. We need to do more to provide those in need with equitable access to affordable housing and other resources. But treating the addicts flooding our jails is not only compassionate, it will help address the problem on our streets.