Commentary: How Snohomish County hopes to step up opioid fight

By Snohomish County officials

Since May 2015, 82 lives in Snohomish County have been saved using the opioid overdose reversal drug Naloxone. The complexity and magnitude of the opioid epidemic can be paralyzing. Reports on the number of individuals affected by the epidemic often leave citizens to wonder, “What is being done?”

Snohomish County leaders are aware of the scope and gravity of this epidemic and are taking action. Unfortunately, the extent of this challenge exceeds the county’s current resources, which is why the county’s top legislative priority for the 2017 session was a request for funding of three strategic programs that will prevent opioid overdose and increase access to treatment.

In total, the county is requesting $692,000 in the roughly $43 billion state operating budget that is still being negotiated. As county leaders tasked with managing scarce resources tackle the most challenging issues affecting our constituents, we urge Snohomish County legislators and key budget writers to support the county’s request for these three crucial and strategic programs.

Naloxone kits: The county has trained almost all law enforcement officers to administer the lifesaving antidote Naloxone. When administered to an individual experiencing an opioid overdose, Naloxone immediately reverses the effects of opioids. The county’s training and equipping of law enforcement officers with Naloxone is why 82 individuals are still living.

However, Naloxone has a shelf life of 18 months and the current stock of Naloxone kits is set to expire. The county requested $192,000 from the state Legislature to purchase 2,400 Naloxone kits over the course of the next two years. These kits would be distributed to law enforcement officers, community partners and support networks of individuals being released from detox facilities.

Medication Assisted Treatment pilot program at the County Jail: At any given time, the Snohomish County jail houses between 50 and 60 individuals detoxing from heroin and other opioids. It is clear that we cannot arrest our way out of this epidemic as the costs to the taxpayer are incredibly high with zero return on investment. Instead, we have learned that treating these individuals while they are in jail and then connecting them with community partners to ensure their treatment is continued after their release will reduce recidivism and lighten the burden on the criminal justice and health care systems.

The county requested $200,000 for the medication and lab tests in order to provide medication assisted treatment in the jail. The Snohomish County Human Services Department and Sheriff’s Office already have an effective partnership for providing Jail Transition Services that begin while an individual is incarcerated and continue upon release, with an emphasis on community safety and eliminating the revolving door syndrome at the Snohomish County Jail.

Nurse Care Managers pilot program: Medication assisted treatment (MAT) combines behavioral therapy and medication to treat substance abuse disorders. The two most common MAT options are methadone and Suboxone. While there are currently 2,550 methadone clinic slots in Snohomish County, there are several hundred residents waiting for treatment at any time. Prescribing Suboxone requires that a physician complete detailed reporting that results in increased costs not reimbursed by Medicaid.

Snohomish County would like to pilot a proven, alternative approach that utilizes Nurse Care Managers. Under the pilot program, a physician could focus on prescribing Suboxone while a nurse care manager could focus on addressing each patient’s other life challenges. Snohomish County requested $300,000 to launch this pilot program in various locations through the community.

The above was submitted by Dave Somers, Snohomish County executive; Ty Trenary, Snohomish County sheriff; and the members of the Snohomish County Council: Brian Sullivan, council chairman; Stephanie Wright, vice chairwoman; Terry Ryan, Sam Low and Nate Nehring.