Editorial: Facing 37 opioid overdoses in one week

By The Herald Editorial Board

It’s a chilling snapshot. A week’s worth of data that is both frightening and illuminating.

Working with hospital emergency rooms, fire and police departments, ambulance services, a needle exchange program and other sources, the Snohomish Health District collected reports on the number of heroin- and other opioid-related overdoses in the county from July 17 to 23.

During that week, 37 overdoses were reported. In three cases, the overdoses resulted in deaths, two people in their 50s, one in his or her 30s. The actual number of overdoses could be higher, as not all might have been reported.

Even for public health officials with daily experience in the crisis, the numbers were a surprise.

“We had no idea what to expect,” said Heather Thomas, spokeswoman for the health district. “It was shocking to see that amount.”

While one week’s worth of statistics, reported Thursday by The Herald’s Sharon Salyer, can’t deliver a complete picture of opioids in Snohomish County, the information does provide a baseline for more study and some surprising detail about the crisis that should help direct resources and support for greater effort to confront it.

The overdoses were nearly equally split among 19 men and 18 women. Most were attributed to heroin, but a few cases involved combinations of heroin and other drugs, including prescription opioids, cocaine and alcohol.

Everett and Lynnwood each had 11 reported overdoses, though the rest occurred throughout the county, including Arlington, Edmonds, Granite Falls, Lake Stevens, Marysville, Mountlake Terrace and Tulalip. They were also nearly evenly split among those that happened in a public space, a homeless camp or a vehicle, and those that occurred in a private residence (15) or in a hotel or motel room (3).

Most significantly, the data show that 24 lives were saved because naloxone — also known by the brand name Narcan — was administered to rapidly reverse the effects of an overdose and restore normal breathing. For 11 people, the medication was administered by police or paramedics, but for 16 of those suffering an overdose, the rescue drug was injected by a friend, family member or bystander.

Three known deaths in one week from overdose is a terrible cost, but that figure would likely have been much higher without the efforts and the funding in recent years to increase the availability of naloxone.

For this initial report the data were collected at the request of ABC News for a report later this month, but Thomas said the health district wants to continue collecting similar reports from hospitals, public safety agencies and others on a regular basis. Doing so should allow public health and government officials to better direct resources, track the effectiveness of programs — such as naloxone distribution — and monitor the crisis itself.

Last week’s county report came as the opioid crisis saw increased attention nationally following the release of recommendations by the President’s Commission on Combating Drug Addiction and the Opioid Crisis. The commission urged President Trump to declare the opioid crisis a “national emergency.” Such a declaration, similar to what follows a natural disaster, would free up funding and streamline efforts to address the epidemic.

Initial reports seemed to show a reluctance by the president to declare the emergency, but by Thursday, Trump changed course: “The opioid crisis is an emergency, and I’m saying officially right now: It is an emergency,” he said at a press briefing in New Jersey.

This is not natural, but it’s a disaster, and one that is growing in terms of deaths. A report by the Centers for Disease Control and Prevention, showed a total of 47,055 overdose deaths in 2014, 28,647 that involved an opioid. A year later, drug overdoses accounted for 52,404 deaths in the U.S., including 33,091 from opioids. Many expect the number of overdose deaths to have surpassed 60,000 in 2016, based on preliminary data.

What the declaration will do is make money available to states from the Federal Emergency Management Agency’s disaster relief fund; potentially allow the Department of Health and Human Services to redeploy staff from other duties to address opioids; allow the HHS secretary to waive restrictions on doctors’ ability to administer drugs used to treat opioid addiction, such as methadone and buprenorphine; free up restrictions on where Medicaid patients can get inpatient treatment; and spur Congress to appropriate more money toward fighting opioids.

Congress passed legislation last year to address opioid and other addiction issues, but failed to include $1.1 billion to expand treatment programs that was sought by President Obama and Democrats in Congress, including Washington state Reps. Suzan DelBene, Rick Larsen and Sen. Patty Murray.

President Trump now needs to follow through on his verbal declaration by signing a document that directs FEMA and HHS to begin the recommended work. Trump also can lift doubts about adequate funding by rescinding proposed budget cuts to Medicaid and Health and Human Services.

As he stated earlier in the week, Trump is correct to seek increased funding for law enforcement that goes after those dealing heroin and the most addictive drugs and strangles the supply of heroin and its synthetic — and deadlier — cousin, fentanyl. But enforcement also has to be joined by funding and support for treatment, intervention and education at the local level.

“We need more treatment and embedded social workers, prevention and education,” Thomas said. “We need to reduce the number of people waiting in line, the number who are homeless, (provide) more mental health care.”

“None of that comes without funding and resources,” she said. “That’s what’s needed.”