Opioid Prevention in King and Snohomish Counties

  • Written by David B. Clark
Centers for Disease Control and Prevention reported that, as of the most recent data collected from 2016, around 46 people die every day from prescription opioids. While this number is difficult to calculate due to the sweeping variety that cloister together under the umbrella of prescription opioid overdoses—street fentanyl, the drug that can be 100 times as potent as heroin, is not in this group whereas its medical counterpart IMF (typically a patch) is—the number of 46 is almost certainly a bit low. The number jumps to 89 overdoses a day if illicit street drugs like heroin are put into the equation. It is not all that rare for someone to overdose on a single opioid and it not be the lone drug in their system. Nevertheless, these overdoses are due in large part to medical prescriptions. This simply makes the current opioid crisis one of the worst manmade epidemics in history. This summer, Snohomish and King Counties felt the horrors of this reality firsthand.
One week in July, Snohomish County reported 57 opioid overdoses; two were fatal.
The most crucial thing to understand about this epidemic is that it is sweeping, unrelenting, and indiscriminate about the communities it affects. Pia Sampaga-Khim, the Healthy Communities Specialist for Opioid Prevention and Outreach in the Snohomish Health District knows that this is not just the cliched street heroin that is mucking the glossed images of Seattle and other urban metropolises. Sampaga-Khim explained that individuals in more affluent and suburban communities need to acknowledge what is happening. She said, “… [the] first step that a citizen can take is to recognize that we have a problem and to talk about it.  One of the biggest barriers is the stigma that surrounds this epidemic.  As more people openly discuss their experiences or their support for services, it reminds the larger community that this affects so many people. I would recommend that they listen to people’s stories and that they look into their cities response to this epidemic to better help their communities.”
Dr. Jeffrey S. Duchin, who is a physician, UW professor, and chief of Seattle and King County Public Health Communicable Disease Epidemiology and Immunization Section, agrees. “This really touches all communities,” said  Duchin. He continued and talked on the heightened stigma, “A lot of people feel it’s a moral failure… We really need to start thinking of addiction as a disease and not a moral failure.” Duchin explained that substance misuse can lead to substance abuse which can lead to addiction. “In our schools we need to screen for substance abuse… we need to expand assisted medication treatment,” said Duchin. Managing this crisis at its earliest stages can help save countless lives and strengthen communities through awareness. If screening for substance abuse became standardized and destigmatized it could act as the cornerstone enabling construction for a healthier, more realistic approach to help those in need. This could curve assumptions that typically bog down mental health and drug awareness. It is becoming starkly apparent that communities that fail to adhere to the clamor of statistics and data but rather cling to presupposed images are hurting. Susan Kingston, who works for the Center for Opioid Safety Education at the UW Alcohol & Drug Abuse Institute, said, “The opioid crisis is often felt more acutely in rural areas where treatment and other social support services are less available. Washington state has recently placed special focus on addressing these gaps in rural areas by allocating federal grant monies to build stronger opioid treatment networks in these areas.”
The National Institute on Drug Abuse reported that in 2017 only about .4% of high school seniors had experimented with heroin but 2.0% had used Vicodin and 2.7% had tried OxyContin. Duchin said that parents and family members need to securely store prescriptions as they would a firearm. “They can be just as dangerous,” said Duchin. 
On July 26, Governor Jay Inslee announced that Washington was 1 of 6 states to receive a grant of nearly $5 million to help Washington residents affected by opioid use find employment. These monies will in part go to support projects in Snohomish county. Snohomish holds only about 10% of the state population but nearly a fifth of all opioid overdoses. Economic stability can be paramount for someone struggling with an opioid problem.
The Workforce Development Councils will assist community organizations that serve populations commonly affected by opioid addiction. These include the homeless (adults and youth), the youth in juvenile detention centers, adults that are either in or have been in county jails, mothers that have or are struggling with addiction while pregnant, and people with mental health challenges.
The epidemic is significantly costly to the state, too. A study by U.S. Senate Health, Education, Labor and Pensions Committee tallied that in a four-year span ending in 2016, opioid overdose deaths cost Washington $34 billion. The year of 2016 accounted for $9.19 billion of that total itself.
The answer is going to be through providing adequate treatment and providing alternative treatment medications, like methadone, to help opioid addicts. Again, the most disconcerting issue is the proliferation of opioids from medicine cabinets to street dealers. Opioids are simply easier to get ahold of than help. That must change.
Sampaga-Khim said, “I think that it’s important that we talk to our children about our expectations around medication.  If you don’t want your child to take an opioid, it’s okay to ask for an alternative. And if you or someone in your home is prescribed an opioid, lock up your medications to ensure they don’t end up in the wrong hands.”
Kingston is very passionate about how communities can better themselves through setting up an understanding on how to act when handling the opioid crisis; sometimes literally. She said, “…naloxone has saved lives. But the availability of and public attention on Naloxone has also helped to start and deepen community conversations about the impact of opioids in their community. These conversations have helped decrease stigma against people who use opioids and who really need their community’s help. Naloxone has catalyzed communities to identify and implement even deeper solutions to the challenges of substance use.”
Sampaga-Khim agrees, “I think that Snohomish County has done a great job in ensuring that our law enforcement agencies and first responders are carrying Naloxone.  With that effort, along with the US Surgeon General’s advisory, I think that citizens are more inclined to carry Naloxone.  It brings awareness to this epidemic and spreads the message that if you know someone who is taking an opioid or is suffering from substance use disorder, that they can save a life by carrying Naloxone.  It’s another way of reminding people that this opioid epidemic affects everyone.”
While this crisis is daunting, it is not unshakable. With support, education, and a shift in popular and personal thought communities can grow healthier, happier, and safer for everyone. Duchin explains, simply, “This is a medical condition. It should be treated as such.”

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