Spokane’s Rapidly Evolving Addiction & Safety Crisis

Spokane is no longer just managing a crisis—it is falling deeper into one.

Spokane’s addiction, health, and safety crisis numbers are staggering—and accelerating. Here are just a few facts to consider:

Overdose deaths in Spokane County rose nearly 50% from 2023 to 2024, and we are on track for another 49% increase in 2025. That means nearly 500 people may die from overdose this year—about 10 lives lost every week—against a national backdrop of decreasingoverdose deaths.
In 2022, Spokane County recorded a Neonatal Abstinence Syndrome (NAS) rate of 21.1 per 1,000 births—three times the national average, and nearly double Washington State’s. These are infants born into withdrawal—shaking and in pain—before they’ve even had a chance to begin life.
Spokane has been identified by federal authorities as a central hub for narcotics distribution.
The city now struggles with one of the highest homelessness rates in the country among medium to large cities.

A Radically Changing Drug Landscape

Spokane’s addiction crisis isn’t just worse—it’s fundamentally different.

Fentanyl, already 50 to 100 times more potent than morphine, is now being synthesized into even more lethal analogs like carfentanil, which is 10,000 times more powerful and extremely resistant to naloxone. Illicit M30 pills (“blues”) are routinely laced with sedatives like xylazine, making overdoses significantly harder to reverse—and even harder to survive.
Methamphetamine has evolved as well. Traditional formulations have been replaced by P2P meth, manufactured from legal chemical precursors. This version is more addictive, more neurotoxic, and causes faster psychological decline and more erratic, dangerous behavior.
The economics of the crisis are shifting fast: the street price of counterfeit fentanyl pills has dropped 97% since 2020, and methamphetamine prices have fallen dramatically as well.

These drugs are flooding Spokane—more addictive, more accessible, and far more deadly—while overwhelming every facet of our political and civic response.

Fighting Today’s Battle with Yesterday’s Tools

Many well-intentioned and once-effective programs are still using a 2021 playbook to address a 2025 public addiction, health, and safety crisis. And it’s not just our political leaders who are struggling to keep up.

Today, I’ll focus on two local programs—one that’s adapting, and another that appears stuck in the shifting tide:

1 – Maddie’s Place: A Lifeline Amid Crisis

Maddie’s Place is one of just five facilities in the U.S. where addicted mothers and their infants receive care together. Since opening, Maddie’s Place has treated 122 babies, with 95% remaining with their mothers rather than entering foster care. It delivers better outcomes at a fraction of the cost of hospitalization.

And yet—it’s on the brink of closure due to a funding gap.

If a program that saves lives, reduces taxpayer burden, and interrupts intergenerational trauma can’t stay afloat, something is deeply broken. We must elevate Maddie’s Place—and similar programs—from peripheral support to core infrastructure in our emergency response.

Story: Maddie’s Place in Spokane

Shalom Ministries—shortly after today’s 68th consecutive 5 a.m. walk

Spokane Leadership: A Critical—and Very Hopeful—First Step

At the April 18 joint meeting of the Spokane City Council and County Commissioners, Council President Betsy Wilkerson opened by saying, “Let’s cut to the chase… the opioid epidemic is a crisis that requires a unified response.” That meeting—and all those who attended—should be recognized and applauded.

Nevertheless, it’s important to remember: unity without urgency will simply not be enough. Monthly meetings that don’t produce immediate next steps with clear and measurable outcomes just can’t keep up.

In other words, the only way to defeat a crisis that is evolving daily is to implement an emergency response that evolves even faster.

Joint City Council | County Commissioners Meeting April 18, 2025

Source: King 5 News, “Washington newborns testing positive for drugs at alarming rates,”
April 21, 2025. Retrieved from [King 5 News]

2 – Shalom Ministries: A Case Study in Changing Realities

For over 30 years, Shalom Ministries has served Spokane’s most vulnerable—offering meals, spiritual connection, and community. Located at Third and Howard, it sits just a block from Lewis and Clark High School, where many students themselves experience housing instability.

But the neighborhood—and the nature of the crisis—has changed dramatically. With open drug use and street-level sales of fentanyl and meth now routine outside its doors, the ministry’s presence has, unintentionally, become a magnet for activity that increasingly endangers youth, residents, and local businesses.

This is not a failure of mission—it’s a sign that the entire landscape has shifted. Like many elements of Spokane’s homelessness and addiction response, Shalom Ministries must adapt. A model that once helped now needs to recalibrate—or relocate—to avoid compounding harm. Good intentions alone are no match for today’s rapidly evolving addiction crisis.

Note: New Community has been working with their tenant, Shalom Ministries, to improve the current situation.