Drug use in Washington state is changing. More people are smoking and when they look for help, it’s hard to find

A survey of people with substance use disorder across Washington state found that, these days, more people are smoking drugs than injecting them, many people are using both opioids and methamphetamines, and many of those who seek help reducing their drug use are unable to get that help.

The reason more people are smoking drugs is that fentanyl is now more readily available than heroin, and fentanyl is easier to smoke.

“This does represent a really big shift in how people are using drugs,” said Alison Newman, a health educator at the UW School of Medicine. “Smoking has benefits over injecting. It’s just easier to do. You don’t have to poke yourself. It reduces your risk of bloodborne pathogens like Hepatitis C and HIV.”

But people smoking fentanyl can — and do — still overdose and die, Newman added.

Overdose deaths from methamphetamines are also increasing in Washington state, she said. About two thirds of those surveyed reported using both fentanyl and meth.

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A third of the people surveyed said that, in the last year, they tried to get help reducing their drug use, but they weren’t able to because of barriers such as not having a photo ID or transportation, or because no treatment beds were available, or there was a long waitlist.

“People who use drugs often do want care and treatment,” Newman said. “We simply don’t have the capacity to help everyone who’s asking for help.”

Also, she said, there’s a clear need for more “programs that are focusing on what people’s priorities are and then working on substance use disorder treatment when that person is ready.”

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The survey asked people what their top need is, and about half said housing, not drug treatment. About 15% said an income or job was their top need, and only about one in 10 said drug treatment was their top need.

Newman said it’s crucial to meet people’s basic needs before they can address their substance use.

The survey was conducted at syringe services programs in 25 Washington counties between October 2023 and January 2024. More than 1,600 people participated in the 5-to-10-minute questionnaire and, for their time, received a $10 grocery gift card from the state health department.

RELATED: 28% of families in Washington state can't afford basic needs, UW study finds