(The Center Square) – As overdoses rise and 1,800 people remain homeless, Spokane Regional Health Officer Bob Lutz argued Tuesday that taxpayers must bear some of the costs to maintain public safety.
Lutz emphasized the effectiveness of “harm reduction” strategies on Tuesday while providing an opioid treatment presentation to the Spokane City Council. It follows the deadliest year on record in terms of overdoses in Spokane County, with Medical Examiner Dr. Veena Singh recording more than 350 in 2024.
Psychiatric Nurse Practitioner Kayla Cross compared using sunscreen and wearing seatbelts to offering hypodermic needle exchanges and naloxone. She and Lutz also highlighted a list of services, including medication-assisted treatment, supervised consumption sites, drop-in centers, “Housing First” and more.
Cross said ideally, the city and county would offer every option. However, not everyone has the money or insurance to pay for those services, requiring taxpayers to foot the bill for individuals on the street.
“Okay, and then with all of those services being provided, in your mind, what is the costs that should be borne by the taxpayer to ensure that all of these services are available?” Councilmember Jonathan Bingle asked both of them.
Cross said that it depends on several factors; medication-assisted treatment is covered by insurance in many cases, “unless they’re completely uninsured.” The federal government provides taxpayer-funded insurance, called Medicaid, to individuals experiencing homelessness; however, not everyone qualifies.
That’s where other taxpayer-subsidized programs come into play. Spokane allocates some of the general fund to homelessness, but most of the resources behind these efforts come in the form of state and federal grants. Those are also paid for by taxpayers and fund shelters, street outreach and other services.
According to Spokane County’s 2025 Point-in-Time Count, of the 1,806 individuals living on the street, 43% of the adults reported suffering from mental illness, and 52% reported struggling with addiction.
Singh said earlier this year that around 78% of the 2024 overdose deaths involved fentanyl, and that fentanyl-related deaths skyrocketed by more than 19,000% from 2018 to 2023. Lutz noted Tuesday that overdoses continue to rise in 2025, primarily driven by a significant spike in January and February.
“If I drop that down, I think we could maybe see a little bit of a plateauing and a trending towards a plateau,” he explained to the council on Tuesday, “but right now we’re certainly not seeing a decrease.”
Cross said that incarceration and involuntary treatment increase the risk of overdose upon discharge.
Lutz said some harm reduction strategies are “idealistic,” adding that Spokane won’t have supervised consumption sites any time soon. He argued that the conversation around this has been “politicized,” and said that if people want a safer community, the reality is that taxpayers will have to create that.
“At the end of the day, we all have to bear some of the cost for those who are far along this path so that we can create a safer, healthier community,” Lutz said. “I would ask you, are there other public health issues that we ask the taxpayers to bear for the general benefit of the entire community?”
