UW drug use survey shows drop in injection use, sparks debate over housing-first approach in Seattle

A new University of Washington (UW) survey is raising new questions about drug use trends in the region, showing a sharp reported decline in injection drug use while fueling debate over how best to respond to the crisis.

The survey, conducted by UW’s School of Public Health, found injection drug use among participants dropped from 93% in 2021 to 44% in 2025, with smoking now the more common method. Researchers also found methamphetamine remains the most frequently used drug, followed by fentanyl.

The report points to housing as a key solution, arguing that stable housing, rather than sobriety requirements, should be the primary focus of public policy concerning meth users.

That approach mirrors recent decisions in Seattle, where city leaders this week approved new measures to expand shelter capacity and directed about $4.8 million toward housing and supportive services, including treatment programs.

But the findings and the conclusions drawn from them are facing scrutiny. The survey itself notes that results across years cannot be directly compared due to changes in the participant sample, raising questions about whether the drop in injection drug use reflects a true shift or differences in who was surveyed.

The data also represents a snapshot in time, meaning it cannot establish cause and effect between housing and reduced drug use.

On the ground, some say the reality looks different. One man living unhoused in Seattle told KIRO Newsradio that fentanyl remains far more common than methamphetamine in his experience, and that both injection and smoking drug use are widespread.

“I would say fentanyl … everybody has it everywhere,” explained Ryan, who was sitting with his dog on a concrete slab against the exterior wall of a condominium in the East Lake Neighborhood. He was using an exterior outlet to charge his laptop computer and cell phone. “I’ve had to save like five people just this month with Narcan, and I don’t even do it, you know, I don’t even do this stuff.”

Where to find the drug

“It’s everywhere … and you can go on 3rd street, or 12th and Jackson, or right there at any of the needle exchanges. There are tons of people who have it, and they just hang out there,” Ryan said. “And it’s like you can’t even walk by there without somebody asking you, and at any of the Plymouth buildings, 710, Cherry Street, the one in Bellevue… just, it’s everywhere.”

The survey collected responses from nearly 1,700 participants through syringe services programs across Washington, where more than half reported being unhoused. Many respondents also expressed interest in reducing or stopping drug use, including through treatment options.

The report adds to a broader debate over harm-reduction and Housing First policies. Supporters said those approaches save lives and connect people to care, while critics argued they do not consistently lead to long-term recovery.

As Seattle and other communities continue to invest in housing and services, the survey highlights both evolving drug use patterns and the ongoing uncertainty over what solutions will have the greatest impact.

As for Ryan, he said he sees people inject and smoke drugs every day. And he said he sees more people arrive in Seattle every day for cheap drugs and services from the city and outreach organizations.

“There’s this guy from Louisiana … he ran out of gas on the freeway, he had a warrant, and the State Patrol picked him up and took him to jail, and then they sent him all the way down to Louisiana,” Ryan said. “And then the second he got out he came right back up here and he’s doing the same thing and it’s like he’s not going to stop.”

He also described a crime-fueled scene on the streets of Seattle where users rob and steal from other users for electronics and other items they can sell on the black market for more drugs.

“I actually had my PlayStation 5 stolen from me. I had my backpack stolen from me.” Ryan said. “They came up and they just, like, totally robbed me … I wasn’t strong enough to get it back from them … and they took it off of me.”

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