Document Type
Portfolio
Publication Date
Summer 2026
Abstract
Goal Statement:
In this portfolio, I identify prevention strategies that address the nested problems of overdose deaths and homelessness in King County, Washington. By examining how housing instability, substance abuse, structural racism, and gaps in coordinated care intersect, this paper advocates for a responsive prevention approach that combines evidence-based substance abuse strategies, phased housing approaches, and culturally responsive care.
Significant Findings:
While recent harm reduction measures have improved overdose death rates in King County, unhoused individuals continue to account for 50% of the county’s still concerning fatal overdose numbers. Data shows that historical racism in King County also shapes who is most affected by overdose deaths, as fatalities are heavily concentrated among Black residents, who face three times the countywide risk, and Indigenous populations, who face six times the risk and are also at greater risk for homelessness (King County, 2026a; King County, 2026b). Increased capacity in emergency services, more accessible recovery supports, and connected housing pathways are needed to serve the County’s unhoused individuals who have substance abuse concerns (Public Health - Seattle & King County, 2025a; KUOW Puget Sound Public Radio, 2025). Clearly, this portfolio shows that overdose deaths and homelessness cannot be addressed as separate problems. For these reasons, replacing siloed housing and substance abuse strategies with culturally responsive, phased recovery and housing options is necessary to address these issues from a more helpful preventive perspective.
Objectives/Strategies/Interventions/Next Steps:
In this portfolio, I recommend a coordinated set of strategies, interventions, and next steps that address overdose deaths and homelessness together in King County. Such an approach applies a well-regarded theoretical framework, the Diffusion of Innovation (DOI) Model (National Cancer Institute, 2005). I recommend that King County employ the DOI framework (National Cancer Institute, 2005) and activate community networks. To do this, King County’s Public Health team would train unhoused peer leaders to distribute harm-reduction tools directly within homeless communities. This evidence-based strategy leverages trusted community relationships to make resources more accessible and, therefore, more likely to be used by those in need (Lynch, 2025). King County should also address isolation risks in current housing strategies by implementing peer-led health monitoring and overdose-detection technologies in supportive housing units. These supports would help reduce the danger of solitary drug use after people transition from encampments or shelters into private housing (KUOW Puget Sound Public Radio, 2025). At the same time, housing and recovery spaces should integrate culturally responsive staff, values, and practices by restructuring housing support teams to include diverse peer workers and culturally responsive principles, as used by organizations such as Chief Seattle Club (Chief Seattle Club, n.d.). Finally, King County should ease transitions between emergency care and early recovery housing by collaborating with local emergency medical services and hospitals to create a system of “warm handoffs” in emergency rooms that facilitate immediate transitions to housing and recovery supports. Supported transitional housing recovery support, like the model adopted in the Central City Concern program in Portland, Oregon, could help bridge the gap between crisis care and permanent housing (Vartanian et al., 2025). These recommendations require King County to reduce administrative barriers to receiving care, a practice that also aligns with the DOI model (National Cancer Institute, 2005). More specifically, King County could consider waiving paperwork requirements for unhoused individuals in crisis (Wolff, 2026). These recommended strategies would create a responsive prevention approach that facilitates harm reduction, consistent housing, recovery support, and culturally responsive care.
