An emergency overdose kit with naloxone located next to an emergency defibrillator at Mountain View student housing at Everett Community College on Tuesday, March 5, 2024 in Everett, Washington. (Olivia Vanni / The Herald)

An emergency overdose kit with naloxone located next to an emergency defibrillator at Mountain View student housing at Everett Community College on Tuesday, March 5, 2024 in Everett, Washington. (Olivia Vanni / The Herald)

As deadly overdoses decline, Snohomish County builds on what’s working

Opioid-related deaths have decreased 20% compared to this time last year. Local health officials say there’s “still much work to do.”

EVERETT — Opioid overdose deaths have been trending down nationwide — and in Snohomish County — since winter. Meanwhile, the county’s opioid crisis response is only growing.

From 2019 to 2023, opioid-related deaths in Snohomish County increased 355%. Opioids caused 269 out of 334 overdose deaths last year, an all-time high. The powerful synthetic opioid fentanyl has powered the rise, causing 95% of those deaths.

This year, 106 residents had died from opioids as of May. The latest monthly peak, 31 deaths, hit in February. But overall, overdoses have declined 20% compared to last year. In a county Board of Health meeting Tuesday, Health Officer James Lewis said local substance abuse prevention efforts are likely contributing to the downturn.

(Chart provided by Snohomish County Health Department)

(Chart provided by Snohomish County Health Department)

Since 2022, the county has distributed more than 500 kits of Narcan, the name-brand version of the opioid-reversal medication naloxone, and trained more than 140 residents on overdose response. First responders have performed more than 400 successful overdose reversals, and provided more than 70 Narcan kits as part of the nationwide “Leave Behind” program.

In April, the county also began distributing thousands of its $28.9 million in opioid settlement money, the first part of a 17-year installment plan, to local recovery agencies.

“We are starting to make a dent,” Lewis said. “But there’s still a lot of work to do.”

The county’s substance use prevention team, supported with five state and federal funding sources, is creating work groups to tackle areas of need. An epidemiologist, Kali Turner, recently joined the team for $125,000 a year thanks to opioid settlement money.

The team works closely with the county’s Opioid Multi-Agency Coordination Group, or MAC Group, revived last May after a directive from Snohomish County Executive Dave Somers. The MAC Group has rolled out several new “smart objectives” for the next few years.

One main focus is equitable care. The county is facing the “impact of racial inequality” on overdose rates, Brenna Smith, a healthy community specialist on the team, said at the Board of Health meeting.

Native American and Black residents are over-represented in the county’s overdoses, and the problem has only worsened since 2021. Last year, Native Americans visited emergency rooms for overdoses at a rate of 73.3 per 100,000 residents, while Black residents did so at a rate of 44.3. White residents, the largest demographic in the county, visited the hospital at a rate of 15.4 per 100,000.

Data is available to the Health Department through a syndromic surveillance system called ESSENCE, which includes all hospital facilities in Snohomish County. (Chart provided by Snohomish County Health Department)

Data is available to the Health Department through a syndromic surveillance system called ESSENCE, which includes all hospital facilities in Snohomish County. (Chart provided by Snohomish County Health Department)

Resources also need to reach East Snohomish County, as overdose rates are disproportionately high in rural areas, said Abi Sauer, another healthy community specialist on the prevention team.

The county plans to hire and train outreach teams who are “culturally relevant” to residents, Smith said, and strengthen partnerships with local agencies to reach those “disproportionately affected and historically underserved.”

The team is also working on a multicultural communications campaign and a new peer support program. The county is planning two free events, June 26 in Darrington and June 27 in Monroe, about reversing substance use disorder stigma. Those who attend at least one event are then invited to a peer training on June 27 in Everett.

Ideal Option, a nationwide network of recovery clinics, just launched a free shuttle for appointments between Index and Monroe. The provider is now working with the county on another transportation pilot for rural residents.

Ideal Option also agreed to provide drug testing data to the county for a better understanding of the local drug supply. And in the fall, the county will perform an overdose fatality review to identify patterns and improve data collection, outreach efforts and policy recommendations.

It’s unclear exactly how many people in the county use more than one drug at once, a behavior known as polysubstance use. When someone uses multiple drugs, treatment is more complicated.

“Many people in Snohomish County are not using opioids alone,” Sauer said.

Starting next month, the county will collaborate with local outpatient clinics on medications for opioid use disorder. The goal is to facilitate quarterly conversations with providers about best prescribing practices to treat opioid and polysubstance use disorder.

The county is also helping local harm reduction center Sound Pathways apply for a state Health Engagement Hub pilot program. The state health department is looking to work with existing medical, treatment and social services to create an accessible one-stop shop for patients.

The county plans to spend about $1.5 million of initial opioid settlement installments on its direct opioid response efforts. State and federal grants are filling in the gaps.

Like many local programs, the substance use prevention team needs more sustainable funding. The money should be flexible, too, Sauer said, as many federal grants so far don’t allow the county to buy more Narcan

“We want to focus more on the work,” Sauer said, “instead of trying to find funding for the work.”

Upcoming events

• Community Conversation in Darrington: 3-5:30 p.m. June 29, at the Darrington Library, 1005 Cascade St.

• Community Conversation in Monroe: 10 a.m. to 1 p.m. June 27, at the Monroe Community Center, 17150 W Main St. Suite B

• Train the Trainer in Everett: 2:30-5:30 p.m. June 27, at the Snohomish County Department of Emergency Management Training Facility, 720 80th St. SW, Building A

Sydney Jackson: 425-339-3430;; Twitter: @_sydneyajackson.

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