Auditor: City needs to implement smarter strategies to reduce overdoses and drug-related crime

Auditor: City needs to implement smarter strategies to reduce overdoses and drug-related crime

By Erica C. Barnett

The city auditor’s office released a report Tuesday calling for a “place-based, problem-solving approach” to combating overdoses and drug-related crime, basing its recommendations on local and national research as well as a case study centered on two blocks of Third Avenue between Blanchard and Virginia streets, where there have been 11 fatal overdoses, 10 of them inside or outside the area’s three permanent public housing buildings.

According to the audit report, this section of Third Avenue had the fourth highest concentration of overdoses and “criminal incidents” in the city; the top ten locations on that list are all in or around downtown, encompassing much of Third Avenue as well as hot spots just outside of downtown, including 12th and Jackson in the International District, around Harborview Hospital on First Hill, and the area around Pike and Broadway on Capitol Hill.

According to the report, a “place-based” approach to combating overdoses and street crime would involve making areas where drug use and illegal street vendors are concentrated more attractive to people who use the streets for other purposes, essentially dispersing drug activity and improving overall street safety by activating sidewalks. For example, the report suggests opening sight lines in areas currently blocked by construction scaffolding and low-growing shrubs, opening up currently vacant storefronts to increase “natural protection,” and making other site-specific changes to conditions, such as eliminating reverse-angle parking on Blanchard Street.

City Council Public Safety Committee Chairman Bob Kettle issued a statement in response to the audit, saying it demonstrated the need for “significant additional measures that include a coordinated effort to address permissive factors at the intersection of public safety and public health.” However, few of the recommendations explicitly involve policing or cracking down on the “permissive environment” that Kettle often cites as a reason for crime. (The report recommends that Seattle police begin investigating fatal overdoses and says King County Transit Police should “increase patrol enforcement at bus stops and shelters” and enforce the Metro code of conduct.)

The audit instead highlights the Rainier Beach Community Project: A Beautiful Safe Place for Youth, which used a framework developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) to identify non-arrest interventions to address youth crime and victimization in Rainier Beach. While the project was not linked to an immediate reduction in crime, a follow-up report found that it “significantly improved community members’ perceptions of serious crime and the police in the short to medium term” and suggested that “even communities with entrenched crime problems can leverage this capacity to reduce crime in the long term.”

The report also highlighted the need for “evidence-based” approaches to drug use, including medications such as naltrexone and methadone that help people reduce or eliminate their opioid use, “supportive social services”, recovery housing and harm reduction for people who continue to use drugs.

Although City Councilwoman Sara Nelson, in a letter responding to the audit, wrote that the increase in fatal overdoses “reveals the limitations of our current harm reduction approach to combating a drug that is so cheap, ubiquitous and deadly,” the report actually endorses harm reduction strategies like needle exchanges and naloxone distribution, and calls harm reduction “an essential component of the overdose prevention framework.”

The report emphasizes that housing is not a panacea for preventing overdoses, which occur both indoors and outdoors. In 2023, 279 people living in subsidized, permanent, or abstinence-oriented housing died of overdoses in Seattle. “While housing is critical to addressing homelessness, new research suggests that housing alone is not enough to reduce overdose risk,” the report says.

Nelson, a proponent of abstinence-only treatment, said the finding shows the city should consider “changing our current low-barrier, housing-first model for city-funded affordable housing projects.”

However, the research cited in the auditor’s report did not advocate erecting barriers to housing or adopting a “treatment first” model that would require people to become sober before they are “eligible” for housing and to remain sober if they want to keep it – quite the contrary.

In fact, the author of the forthcoming study wrote that existing research suggests the need for low-barrier housing and “co-location of safe consumption sites, provision of on-site harm reduction supplies, and expansion of peer workers” in permanent supportive housing sites. The study itself is intended to confirm that it is possible to implement “gold standard” strategies like harm reduction in permanent supportive housing, not to test whether these strategies are worth pursuing.

The study involves implementing three evidence-based strategies – overdose response, harm reduction, and substance use disorder treatment support – in 20 existing permanent public housing buildings in New York City.