By The Herald Editorial Board
Sam Quinones, the author of two books on the nation’s fentanyl and methamphetamine addiction crisis, is a heart attack survivor. And there is something he noticed with the continuum of care he received after his heart attack that he does not see happening now for those suffering with addiction, especially with fentanyl, other opioids and meth.
There is none. In other words; there is no consistent path of contact, treatment and support for those with addiction to bring them back to sobriety and begin restoring lives.
“For me, the continuum of care for a heart attack was pills, meetings with cardiologists, lots of exercise and that sort of thing,” Quinones told The Herald Editorial Board in a phone interview earlier this week. “They don’t just put a stent in you and say, ‘Adios, you’re on your way.’ Right?”
Uncoordinated care: Instead, addicts are left to make do with a scattershot approach that tries to reduce the harms around addiction and persuade those with addictions to seek treatment, a hard sell made even more difficult for those — knowingly or unknowingly — using fentanyl, an extremely addictive narcotic that is acutely effective in locking people into that addiction, even after surviving multiple overdoses.
And, especially because of fentanyl’s hold on its victims, Quinones believes some time in jail — with necessary supports and treatment — needs to be part of that continuum of care.
“There’s no compassion in leaving those with addictions out on the streets,” he said. “And in a time of fentanyl and meth, that’s a huge mistake.”
Quinones, author of “The Least of Us” and “Dream Land,” both addressing the nation’s addiction crisis, is scheduled to speak Thursday evening at Cavelero Mid High School’s commons at 6:30 p.m. Thursday, Sept. 28. The event is sponsored by the countywide Mayors and Business Leaders for Public Safety group that formed a year ago in October, seeking to draw attention to the opioid crisis and other public safety concerns and reforms to state laws and practices.
Lake Stevens Mayor Brett Gailey, having attended an earlier speech by Quinones and having read his books, said he wanted to bring Quinones back for another forum, but also take the opportunity for the journalist and author to talk with local state lawmakers, judges and other local officials.
Gailey, a former police officer who saw the progression of drug problems from local meth labs to prescription opioids to fentanyl, found Quinones’ books an uncomfortable but important read, and agrees that a range of solutions is necessary.
“We need to have multiple, multiple ways that people can get off their addiction. I think that this is absolutely a way we can provide the possibility (for treatment) in jails,” Gailey said.
No rock bottom: Everett Mayor Cassie Franklin, also part of the mayors and business leaders group, says that fentanyl’s grip on people will require a change in how addiction is addressed. With most other drugs, there’s a rock bottom that people hit that leaves an opportunity in a willingness to seek treatment and commit to it. Fentanyl, however — even after multiple overdoses — is so addictive and so deadly that for some that realization never comes.
“There’s no rock bottom with fentanyl,” she said. The only rock bottom “is death.”
Jail isn’t ideal or necessary in all instances, and Franklin still holds to the maxim that communities “can’t arrest our way out” of the drug addiction crisis.
“But the criminal justice system is a necessary part of the solution, especially since we don’t have enough treatment beds. And right now our jail is our biggest treatment center in the county; it is our biggest mental health center,” Franklin said.
Suboxone, which treats opioid addiction, and other medication-assisted treatment is available to all those in the Snohomish County Jail, and the county also offers a 44-bed diversion center that offers short-term placement in treatment and shelter to homeless adults with substance use disorder or other behavioral health issues.
Quinones, in a June article in The Atlantic magazine, explains why jail-based treatment programs must be part of the continuum of care he considers necessary:
“Taking away a person’s freedom is never something to be done lightly,” he writes. “But once addicted to fentanyl or the new meth, many users are not ‘free’ to choose treatment — or any path out of addiction — in any meaningful way. Time away from these drugs, I believe, can help them regain their agency.”
Jail, itself, isn’t enough: But neither can it stop at incarceration alone, he told the editorial board. There is no panacea.
“If more counties in America can develop and maintain a continuum of care for addiction that begins with jail and leads maybe two of three years after jail, then we will be a stronger country. We do not have anything remotely close to that right now,” he said.
And jails will have to offer more intensive treatment and recovery programs than now provided in most cases. Quinones’ Atlantic article details an effort at the Kenton County Jail in northern Kentucky, which has opened a 70-bed “recovery pod” for men and a 35-bed program for women that provide medication-assisted treatment, but also fills the day with GED courses and classes on parenting, anger management and other life skills as well as inmate-run 12-step groups.
While these are the kinds of programs that can be found on the outside, Quinones writes, jail ensures those with addictions stay long enough — and mostly absent the temptation to use again — to allow brains to heal and provide a better chance at long-term sobriety.
Thursday event: Lake Steven’s Mayor Gailey said he’s hoping for a good turnout on Thursday night, but also wants the meeting with lawmakers and others to provide perspective on the need to provide more treatment and support, in and outside of jails, and greater flexibility for judges to divert those with addictions into longer, jail-based treatment programs earlier in a person’s addiction and not five or more criminal charges down the road.
“I’ll tell you what, families would love that program. But we can’t do that right now,” he said.
All efforts have to be employed in addressing addiction, now especially as fentanyl has become the leading cause of overdose deaths in Washington state and in Snohomish County.
Ever-spiraling tally of OD deaths: A month ago, the editorial board cited data from the Centers for Disease Control and Prevention that showed the rate of overdose deaths — about 90 percent of which are attributed to fentanyl — was the fastest growing in Washington of all 50 states; for the 12-month period ending March of 2023, the state had an estimated 3,024 overdose deaths; one month later, for the 12-month period ending April of 2023, that count had grown to 3,155 overdose deaths in the state.
That ever-spiraling increase in overdose deaths — deaths happening every day in our communities and far too frequently among our family members — is the buried lede of this editorial.
Lawmakers have to consider how programs outside and inside of jails can be expanded and funded. The current law passed this year that makes drug possession a gross misdemeanor needs an immediate evaluation regarding its ability to adequately address fentanyl and move those with addictions into treatment. Local officials should welcome and encourage drug treatment and behavioral health facilities into their communities and educate their constituents as to their necessity. Shelters and supportive housing programs, with a keener emphasis on treatment, need funding and program support. And the county and the cities should continue to work collaboratively on how they might pool the resources they have individually received from recent legal settlements with opioid manufacturers and distributors.
And community — with a shared commitment to the full range of solutions — must be built.
“I think continuum of care for addictions is so important,” Quinones said, “because it’s really about building community in ways that we have never done and in ways that we need.”
Fentanyl and public safety
Author Sam Quinones will speak at 6:30 p.m. Thursday at Cavelero Mid High School’s commons, 8220 24th St. SE, Lake Stevens. The event is free; register at tinyurl.com/SamQuinones. Copies of Quinones’ books will be available for purchase, $25 each or $40 for both, cash or Venmo accepted.
Correction: An earlier version of this editorial gave an incorrect date for the Sam Quinines event. It is Thursday, Sept. 28.