Drug injection rates cut nearly in half at WA needle exchanges, UW survey finds

A recent University of Washington (UW) survey found that the number of respondents reporting injecting drugs in a given year has dropped nearly 50% from 2021 to 2025.

In 2021, UW recorded 93% of survey respondents had injected drugs that year, and in its latest data collection, syringe use had dropped to 44% in 2025, according to UW Medicine.

While drug injection rates plummeted, 90% of respondents reported smoking drugs in the previous week in 2025.

UW’s biennial survey finds trends in drug-related behaviors, housing statuses, services used and desired, among other experiences of visitors to needle-exchange programs.

The recently published report collected survey responses from 1,694 clients at 24 of 40 programs across Washington. The programs provide clients with supplies to use drugs more safely, naloxone (an overdose-reversal medication), and products for hygiene, wound treatment, and survival.

“The providers’ aim is to save lives and reduce harms among this population, so they also connect clients with health and substance-use treatment services,” UW Medicine stated.

Survey finds most respondents using meth, fentanyl, cocaine want to quit

The survey also found that a majority of respondents who take illicit methamphetamine, fentanyl, cocaine, or other drugs expressed that they want to stop using.

The “most striking” data related to the availability of smoking supplies at these programs, and the lower rate of drug injection among respondents.

“At the 13 sites that offered smoking supplies, the survey responses showed that people were much less likely to inject drugs, 35%, versus 70% of respondents at sites that did not offer drug-smoking supplies,” said Caleb Banta-Green, addiction researcher at UW Medicine.

Banta-Green also noted the data was “an extremely compelling data point” that goes against certain programs’ decisions not to offer smoking supplies at their facilities.

Banta-Green said the decision not to provide smoking supplies may be based on the assumption that drug-smoking supplies don’t have the same apparent motive that sterile syringes do to reduce the potential spread of HIV and other infectious diseases.

He then countered that understanding by claiming the reason behind people attending the facilities is for receiving smoking supplies, and inadvertently finding help resources.

“Getting smoking supplies are why the majority of people are showing up at these sites today. And they are as likely to be interested in stopping their use and getting health care, mental health and substance-use treatment services,” Banta-Green said.

Key findings: Meth tops drug use at 90% as housing instability runs rampant

Other key findings in the survey included methamphetamine remaining as the most frequently used drug at 90%, followed by fentanyl (58%), cannabis (50%), alcohol (26%), crack or cocaine (26%), and heroin (9%).

UW also found that 76% of syringe-service visitors were unhoused or had unstable housing. Respondents were also interested in services, with 53% drawn to drug testing, while a strong majority wished to improve their physical (75%) and mental (69%) health.

For opioid addiction treatment, 42% were interested in methadone, while 26% were interested in buprenorphine. Other respondents who used stimulants showed interest in medications that may reduce use (39%) or improve their mental health (33%).

Banta-Green noted that there is no coincidence that so many people who use methamphetamine are also homeless.

“Many people use methamphetamine because they are unhoused. There is great demand for hygiene supplies and basic survival stuff among this population,” he said. “Stopping meth use isn’t the solution; getting housing is the solution, and then they can take steps to reduce their substance use.”

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