While Seattle’s outgoing mayor and city attorney credit drug arrests and prosecutions, public health evidence suggests other causes.

By Andrew Engelson

Fatal overdoses have declined for two years in a row in Seattle—a sliver of hope in the ongoing opioid epidemic. Mayor Bruce Harrell has claimed greater enforcement of the city’s drug laws has saved lives. Others, including health experts at King County, argue that evidence-based public health approaches should get the credit.

According to Public Health Seattle & King County, the number of fatal drug overdoses in King County has declined 31 percent since hitting a peak in 2023. So far in 2025, the county has confirmed 796 fatal overdoses, including 564 that involved fentanyl—a slight dip since this time in 2024, following a decline of about 22 percent between 2023 and 2024.

Harrell’s office credited a 42 percent increase in felony drug dealing arrests by the Seattle Police Department, along with new programs that have increased access to treatment and buprenorphine, for lowering the number of overdoses. 

“Our comprehensive approach to the fentanyl crisis is showing real results, helping keep our neighborhoods safe,” Harrell said in a statement. “We are aggressively targeting and arresting the drug traffickers and dealers who bring these deadly poisons into our city, and I am grateful for our strong partnership with King County prosecutors in holding offenders accountable.”

But Brad Finegood, who leads the public health department’s opioid and overdose response, said the drop in fatal overdoses in King County is likely due to a multi-pronged public health effort across the county that includes increased access to injectable buprenorphine, a drug that helps suppress cravings for more dangerous opioids like fentanyl, and a massive campaign to distribute the overdose reversal drug naloxone. 

While the decrease is encouraging, Finegood said the numbers are “still at an unacceptable number, and they could go back up real easily.”.

It’s been two years since the city of Seattle passed a law making it a misdemeanor to possess illegal drugs or use them in public (previously, possession was a felony that the King County Prosecutor’s Office generally declined to prosecute). SPD has used the law to refer about 800 people arrested for minor drug offenses into the LEAD diversion program, which offers people accused of low-level offenses a way to avoid charges and access services. About 500 of those referrals 500 came about as the result of an arrest; the other 300 were “social contact” referrals, in which police officers refer someone to the program without an arrest. 

Meanwhile, outgoing City Attorney Ann Davison’s office prosecuted 215 people under the new drug law between October 2023 and January 2025. Last month, the King County Department of Public Defense (DPD) published a report critical of the law, finding that of the 215 people prosecuted using the law since October 2023, only six completed treatment or received a substance use assessment. 

Drug policy in Seattle will likely look much different in the next four years under progressive mayor-elect Katie Wilson, who campaigned on a public health-focused approach to the fentanyl crisis, and under former prosecutor Erika Evans, who will be replacing Davison, a Republican, as city attorney. Evans says she wants to significiantly reduce the number of people prosecuted for drug use and possession and to “bring back a reimagined community court”—a therapeutic court Davison dismantled in 2023.

Evans called the fact that just six people prosecuted under the drug use law went through treatment or evaluation a “huge failure.” 

“As the next city attorney, [I’m] going to be working to expand our partnership with LEAD to make sure folks that are dealing with substance use disorder are getting connected with services and treatment,” she said.

D. Williams is just one of many people who turned his life around thanks to LEAD.

Williams, who asked PubliCola to use only use his first initial and last name, lives in a cozy 10 foot-by-10 foot shelter at Catholic Community Services’ Junction Point tiny house village in north Seattle. After serving jail time for convictions on possession charges and violating a no-contact order, Williams was in a bad state. 

“It was all bad: homeless, addiction,” Williams said. “Lack of self-worth. A lot of hatred.”

After five people close to him died in close succession, Williams decided he needed to make a change.

In the summer of 2024, Williams asked an officer for a social contact referral to LEAD. He was connected with Casey Pham, a case manager at Evergreen Treatment Service’s REACH program, and started treatment. But like many drug users, Williams only stayed for a few days before leaving the program and going back to using. “I was really sick, real bad,” Williams says of his experience of withdrawal. “But I kept pushing. I kept being persistent.”

Williams said that each time he relapsed, he regretted it. “Every time I did it again, it was with that much more hatred inside of me, and that’s a heavy burden to carry.”

Another time when he sought treatment, William was told he’d need to wait 14 days for an opening. He told the organization, “I don’t know if I’ll even be here. I can’t wait that long.”

Despite the barriers, Williams eventually completed treatment, and though his path to recovery still has its ups and downs, he has a roof over his head and is attending computer science classes at North Seattle College.  “I feel much better. I can lift my head up now,” he said. “I don’t have to walk around with that shame on my back.”

But the fact that the city attorney’s office still prosecuted 215 people was a waste of resources, DPD contends.

Katie Hurley, special counsel for criminal practice and policy at DPD, said many of the people who end up getting prosecuted for drug misdemeanors were arrested for possessing “incredibly small” amounts of drugs. 

In April, according to Seattle Municipal Court records, SPD arrested a man at 12th Ave. S and S Jackson St.—a longtime hot spot for drug activity—and was charged him with possession based on traces of drugs, tin foil, and a straw. The police report did not mention any attempts at diversion. 

Also in April, a man who had previously been found incompetent to stand trial on an unrelated charge was arrested for smoking an unidentified substance. Despite his previous evaluation, Davison’s office charged the man, and two weeks later he was found incompetent to stand trial. He received no referral to LEAD or services.

Last September, another man was arrested at 12th and Jackson for allegedly smoking an illegal substance. He was booked into jail and charged, but later the case was dismissed for lack of evidence.

“It’s an obscene use of resources,” Hurley said. “It’s very dehumanizing that we’re going to lock a person like this up, considering the amount of resources it takes.”  

Tim Robinson, a spokesman for the city attorney’s office, pointed to the city attorney’s new Drug Prosecution Alternative (DPA) program that debuted in August, which offers people a chance to avoid prosecution if they get evaluated for substance use disorder. So far, 34 out of 70 people who received offers to participate in the program have chosen to do so, Robinson said.

DPA participants must agree to a “stay out of drug area” (SODA) order, which banishes a person accused of breaking the city’s drug laws from specific areas; violating a SODA order is a separate misdemeanor.

Evans, the incoming city attorney, said that Davison’s drug prosecution alternative is “pretty ridiculous” because it requires people who are using fentanyl to get an evaluation to see if they have a drug problem. “If they get charged with smoking fentanyl, all that’s required is for them to agree to a SODA order placed on them, and then having to get an assessment that tells them whether or not they have a fentanyl addiction. That is wasting our public dollars.”

The city attorney’s office disagrees, claiming the approach has improved public safety. “Drug overdoses in Seattle have declined since the law was enacted and the areas hit hardest by open-air drug markets have seen some meaningful improvement,” Robinson said. “There is more work to be done, but Seattle is safer today than it was four years ago as measured by crime statistics and public opinion polls.”

In September, SPD’s blog featured a flurry of posts about drug seizures and arrests, with accompanying photos of baggies of drugs, cash, and confiscated guns—part of the surge of felony arrests that Harrell said contributed to the recent reduction in overdose deaths.

But a closer look at the cases reveals that many of these arrests were for small-time deals by people who are likely drug users themselves. 

A post on September 29 celebrated SPD arresting a 34-year old man found with a “handgun, $203 cash, and 0.9 grams of Fentanyl.”

A post on September 24 described the arrest of a man on First Hill who had a gun and about 147 grams of cocaine, meth, fentanyl and heroin (about the weight of a deck of cards) who was booked into jail on gun and narcotics violations.

Another September post officers nabbing a suspect and confiscating a whopping $62 in cash, 4 grams of meth, and a set of brass knuckles. 

SPD did not respond to requests for comment on the increase in drug distribution arrests.  

Evidence suggests that disrupting the illicit drug supply can actually lead to an increased risk of overdose, as drug users switch to lesser-known dealers who may be selling a more toxic supply.

Nabarun Dasgupta, a senior scientist at the University of North Carolina whose work on harm reduction earned him a 2025 MacArthur Foundation “genius” award, said attributing the decline in overdoses to arrests “seems really naive.”

“There’s no reliable evidence that drug seizures of this magnitude lead to declines in overdose,” Dasgupta said. A peer-reviewed study of trends in drug arrests and overdose rates in Indianapolis, published in the American Journal of Public Health in 2023, found that on average, one week after a police drug seizure, the number of fatal overdoses doubled within a 500 meter radius of the arrest.

“I think the way to interpret these data [about overdoses in Seattle] more scientifically is that overdoses are dropping despite the felony arrests,” said Dasgupta, who was involved in the Indianapolis study. “It’s not the other way around.”

Lisa Daugaard, the co-director of Purpose Dignity Action and creator of the LEAD program (for which she, too, received a genius grant) said it’s ineffective to focus on small-time drug dealers, pointing to research by Dasgupta and other scientists.

“Disrupting harmful dynamics has an obvious superficial appeal, but in a time of ultra-toxic illicit drug supply, many interventions that seem appealing actually are counterproductive,” Daugaard said.

Dasgupta, who worked with harm reduction experts in Seattle while conducting his research, says the decline in Seattle’s fatal overdose rate is likely the result of four trends that are happening across the country. First, he says, illicit drug manufacturers are making the drug supply less toxic by improving quality. “This is a market correction, independent of any law enforcement action,” Dasgupta said.

Second, Gen Z is less inclined to use opioids than its predecessors. “We have a million and a half kids who lost parents, uncles, aunts and grandparents to an overdose in the United States,” Dasgupta said. “That experience of going to those funerals, I guarantee you, is way more likely to change their behaviors and attitudes towards opioids than any educational campaign.”

Third, Dasgupta said, drug users have learned not to use alone, and when they have the resources available, to get their drugs tested for potency.

And fourth, Dasgupta credits “all the community-based interventions that are going on. Clinic-based interventions have greatly expanded availability of addiction treatment as well as naloxone, especially having that be accessible with as little red tape as possible.”

The county public health department is on pace to double the amount of naloxone it distributes through community-based organizations in 2025 over last year, with 30,000 doses distributed in the first half of this year. The department has also trained more than 2,700 people in how to administer naloxone since 2024. In addition, the agency has installed vending machines with free naloxone at five sites across the county.

Finegood says community groups have reported back to Public Health that naloxone from those vending machines have reversed at least 800 overdoses, and 85 percent of drug users told county researchers that they now keep naloxone around when they use. 

Making treatment and medications available to those who want to quit using or reduce their drug use has also been a priority, Finegood said. “We’re continuing to work on lowering those barriers so people can provide access.” 

A fleet of methadone vans run by the county are helping bring treatment closer to where people typically use drugs. 

And in August, the Downtown Emergency Service Center opened the Opioid Recovery & Care Access (ORCA) center, which provides 24/7 care to people recovering from overdoses.

Public Health, Finegood said, has also made an injectable version of  buprenorphine much more accessible by setting up a hotline where users can easily and immediately get a prescription when they’re ready. Finegood also praised the city’s first-in-the-nation pilot buprenorphine program, in which Seattle Fire Department paramedics can administer the drug after overdose to anyone who requests it. 

Kristin Hanson, a spokeswoman for the Seattle Fire Department, said first responders have administered 160 doses of buprenorphine since the program began in 2024.

Finegood says continuing to focus on making access to treatment easier has been a key pillar in Public Health’s efforts to stop the deaths. “We need to continue to do what we know is working, and what evidence shows is working: which is lowering barriers to care,” he said. “Because people want care, people want help. We should be giving people access to care when they’re in a place where they’re willing to receive it, and giving them what they want.”