Changing Course with Chronic Addiction.
Other cities lead with policies helping people.
Other cities are changing course on chronic addiction homelessness. Seattle must stop doing the same thing over, and over while expecting different results.
I’ve spent years on the ground with the We Heart Seattle team doing treatment-first outreach across this city’s streets. We meet people where they are — in encampments, doorways and under bridges. We work to connect individuals to real recovery programs — and not just another tent or low-barrier shelter.
We Heart Seattle is a privately funded group. Our budget is dwarfed by the billions of dollars spent by Seattle and King County on chronic addiction homelessness.
Despite the massive sum of tax dollars, there are still too many overdose deaths, untreated mental illness and neighborhoods that have lost their sense of safety.
Things need to change, and hey can.
Democratic mayors in Philadelphia, Houston, Austin, San Francisco, and Portland have turned toward solutions that actually save lives and restore public safety. This direction is a break from the failed status quo of repeating the same housing-first approach that enables the tragedy of chronic drug addiction on our streets.
As Seattle prepares to host the FIFA World Cup, Mayor Katie Wilson has a critical opportunity and responsibility to change course.
Philadelphia’s Mayor Cherelle Parker took on Kensington, the East Coast’s worst open-air fentanyl market. She opened Riverview Wellness Village, a true recovery campus with 340 beds that quickly reached 95% occupancy, with 60% of residents staying 90 days or longer. She tied shelter beds directly to treatment and created the Kensington Neighborhood Wellness Court to move people into care the same day rather than cycling them through jail. The streets are getting cleaner and violent crime is dropping because Mayor Parker chose real intervention.
Houston’s Mayor John Whitmire is working to end chronic addiction homelessness with a $70M plan. People are moved from encampments into shelter or housing with mandatory services and a 90-day accountability clock. Police, outreach teams and treatment providers coordinate so individuals get help for addiction and mental health issues. Public spaces are returning because the focus is on recovery.
Austin’s Mayor Kirk Watson acknowledged the old permanent supportive housing and low-barrier model wasn’t delivering results. His 2025-27 plan shifts the focus from just counting beds to real outcomes: shelter capacity up 70% since 2022, permanent housing placements up 35%, plus stronger behavioral health services, cleanup crews and better case management for addiction and mental illness.
San Francisco’s Mayor Daniel Lurie has moved the most aggressively with “Breaking the Cycle.” He’s added nearly 600 new treatment and recovery beds, opened drug-free interim housing sites and launched a RESET Center that works closely with police. Outreach teams are now unified and accountable by neighborhood. Encampments are down 44%.
Under Lurie’s leadership, San Francisco ended the practice of handing out fentanyl-smoking kits without treatment referrals. Housing now comes with or after treatment.
San Francisco also practices Good Neighborhood agreements, where you’re not handing out tents and other enabling items in the name of harm reduction, but agreeing that there will be a zero tolerance for loitering and tenting in a neighborhood by neighborhood basis
Portland’s Mayor Keith Wilson, who took office in January 2025, has added over 1,500 new shelter beds, including those dedicated to recovery and psychiatric needs. This approach has already reunited 127 people with their families. He’s enforcing the camping ban and building a fuller continuum of care.
Portland still has room to make treatment truly non-negotiable, but they’re heading in the right direction.
These five mayors have realized what we all see on the ground: the old playbook of housing first no matter what, harm reduction without recovery and hard drug decriminalization — simply leaves people to die and neighborhoods to suffer.
We must pair shelter with accountability and build real recovery infrastructure. Success needs to be measured by lives changed and people getting clean and stable — and not just beds opened. This means returning to proven programs like Drug Court / Deferred Prosecution.
Here in Seattle, Mayor Wilson’s push for more tiny homes by June 15th and additional shelter sounds like action, but it continues to measure success by counting the number units opened instead of real recovery outcomes.
Seattle is doing the same thing —over and over— while expecting a different result. No wonder the situation is getting worse!
Mayor Wilson needs to break away from the doom loop and look at other cities who are making actual progress .
Let’s create a recovery campus like in Philadelphia, create a 90-day accountability standard like Houston and unify outreach with real neighborhood accountability like San Francisco.
I propose we link every bed to mandatory treatment pathways, sobriety milestones and family reunification like Portland is doing.
It’s time to judge success by impact with people exiting the streets clean and stable — and not just by how many tiny homes or shelter beds we open.
Let’s stop repeating what hasn’t worked. The people suffering on our streets, the families and businesses in our neighborhoods and our city’s future, deserve better.
Andrea Suarez is drug and homelessness policy reform advocate.
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