Commentary: Fighting the opioid epidemic by understanding it

Editor’s note: This is the third in a series of commentaries examining Snohomish County’s opioid crisis from different perspectives.

By Mark Beatty

Over the last two weeks, you’ve heard from Snohomish County Executive Dave Somers and Sheriff Ty Trenary about how agencies across the county are collaborating in a new — but still familiar — ways to tackle the opioid crisis. By coming together as we do in emergencies, we can work across sectors to start thinking out of the box to find real solutions to this complex problem.

As your health officer, I am required by state law to take actions needed to maintain the health of Snohomish County. That includes controlling and preventing the spread of any dangerous disease. And that is what the opioid misuse and abuse is — a life-threatening disease.

I’ve stated before that the scope of the opioid epidemic is likely far greater than any one of us can appreciate. That is why data is critical to the goals and objectives laid out by our multi-agency response group. It allows us to determine the true size of the problem, specifically the number of people afflicted with this disease, so we can ensure the proper location and amount of services are available to meet the need. Data will also help us to target our interventions across agencies, as well as hone the information needed to educate and prevent further addiction.

Just as a physician would do with any other disease, we need to fully assess the patient and his or her particular condition. A diagnosis should be followed with a customized treatment plan that can be targeted to achieve the best possible outcomes. This includes gathering information about personal and environmental factors to identify any barriers to receiving treatment. Finally, there are check-ups and testing done to confirm the treatment plan is working.

Unfortunately, up until recently, we’ve only been able to provide statistics on lives lost due to an opioid overdose. Then there was the added ability to track lives saved by law enforcement and first responders through the use of Naloxone. Even then, all of the data was “stale.” It could take up to 18 months to see if we were doing better or worse.

Through this coordinated approach, we’ve been able to look at the data pieces each partner has available to help better understand the epidemic. We are starting to identify gaps and critical elements for tracking, and we are working on strategies to intervene at key points.

For instance, thanks to a grant from the Centers for Disease Control and Prevention, the Snohomish Health District has partnered with Providence Regional Medical Center to track opioid overdoses seen in their emergency department in Everett. Not only are we able to capture important data, but a nurse also follows up with patients and makes connections for those interested in referrals for treatment.

We’re working to expand efforts like this to other hospitals, as well as continuing to build on our partnerships with the county, law enforcement, fire, EMS, the syringe exchange and others to complete the picture. A comprehensive data dashboard is in development, with a public facing portal to be released in the coming months. This composite view of the most up-to-date data available will also allow the team to quickly assess whether the interventions are working and make adjustments as needed.

One of those adjustments is ramping up efforts around prevention and education. Opioid misuse and abuse is 100 percent preventable and 100 percent treatable. In order for those numbers to become a reality, we need to reframe the messages around addiction and pain management. Opioid use disorder is not a failure of will, but rather a chronic disease that must be met with determination, urgency and compassion.

We also have a responsibility to protect the community from harm. We have an obligation to our children — the county’s next generation — to prevent them from experiencing the trauma of growing up with a loved one struggling with addiction, and from becoming addicted themselves. You will begin to see a lot more efforts focused in this area, from community-wide awareness campaigns to partnerships with schools on age-appropriate curriculum options.

This opioid epidemic has been officially declared a public health crisis, and that’s certainly true. Public health is an essential partner in these efforts, but public health alone cannot solve it. It requires each of us working together with a shared purpose — a proactive community coming together to look out for, and to take care of, its own.

For more information on our coordinated efforts — including its objectives, action team leads and future progress reports — please go to www.snohomishoverdoseprevention.com. This website and accompanying social media accounts were developed to be a one-stop shop for resources.

Whether trying to understand the problem, prevent addiction, or save a life, this is a place to find information for that first next step.

Dr. Mark Beatty is the health officer for the Snohomish Health District. Prior to joining the district, he served as an epidemic intelligence service officer with the CDC, working on disease surveillance and outbreak response around the world.