With settlements being reached in lawsuits by state attorneys general nationwide against the pharmaceutical that produced opioids for their part in feeding the opioid epidemic, local and state governments are working to apply that money into programs to prevent future opioid overdoses and treatment and recovery programs to reduce overdoses and deaths from these dangerous drugs.
Washington State’s share of the settlement money so far is $1.29 billion according to the Washington State Attorney General’s Office.
This money comes at a time when drug overdose deaths have fallen slightly between 2022 and 2023 for most of the country, except for Washington which is among 12 states that have seen an increase in drug deaths, according to the Centers for Disease Control and Prevention (CDC). In fact, Washington and Oregon are among the three worse states for an increase in drug deaths. Washington has seen a 24.85% increase from 2022 to 2023 and Oregon has seen a 22.78% increase.
Earlier this year Representative Rick Larsen’s (D, 2nd Congressional District) office issued a report, “The Opioid Crisis in Washington’s Second Congressional District and a Comprehensive Solution,” with a plan to battle the opioid epidemic. The report focuses on four pillars to address the opioid crisis, Prevention, Interdiction, Treatment, Recovery:
· Prevention- The report’s goal to prevention is “… to prevent individuals from relying on opioids, instead of implementing stopgaps that simply mitigate the impacts of the crisis.” It lists a variety of programs within the 2nd Congressional District that work on prevention including the Snohomish County Human Services contract with school districts within in the county that provide Student Support Advocates as well as youth substance use prevention for teachers and counselors. The programs concentrate on youth to try to steer them away from using opioids. The report also lists other programs that use different strategies to reduce dependence on opioids and encourages the development of help to local governments to add other strategies such as helping with mental health and chronic pain.
·
Interdiction- The report lists several federal
agencies that are responsible for interdicting drugs. For example, the U.S.
Coast Guard patrols our coastal waters to intercept drugs before they land on
our shores. The Drug Enforcement Administration (DEA) investigates domestic and
international narcotics traffickers. The U.S. Customs and Border Patrol (CBP) intercepts
drugs and ports of entry and between ports of entry. In Fiscal Year 2023, CBP
seized 27,023 pounds of fentanyl, an 84% increase from 2022. The report notes
that more than 90% of CBP fentanyl seizures occur at Land Ports of Entry rather
than between ports of entry, with an average of 1,797 pounds of fentanyl seized
per day. The report advocated for improved advanced screening technology at
ports of entry. The report also noted that local drug task forces have an
important role in interdicting drugs before they are sold to drug users. The
Snohomish Regional Drug Task Force seized more than 500,000 fentanyl pills and nearly
5,000 grams of fentanyl from January to July 2023. The report advocated for
more support and resources for local drug task forces and for local tribal law
enforcement.
·
Treatment- The report notes that there
are many challenges to treating someone who is addicted to opioids. It notes that
people with Opioid Use Disorder (OUD) are physically and psychologically
reliant on opioids so that anyone who tries to stop taking opioids suffers
severe withdrawal symptoms that can include generalized pain, chills, cramps,
diarrhea, restlessness, anxiety, nausea, vomiting, insomnia, and intense
cravings. As a result, someone with OUD is susceptible to relapses, disability,
and death. It advocates for a “holistic” approach to overcome the challenges
and includes normalizing harm reduction, ensuring that there are enough beds
for recovery treatment, improving OUD coverage for Medicare and Medicaid,
investing in a robust health care workforce, leveraging the justice system with
incentives to seek treatment, and meeting patient where they are.
·
Recovery- In conjunction with treatment,
someone with OUD also needs support to ensure long-term success in staying off
of opioids. Individuals often need help with acquiring housing, employment,
education, transportation, or legal services. Currently, support can come from
local government and nonprofit organizations. The report also notes that
support from family and friends can be especially important.
A recent article in The Herald summarized the efforts within
Snohomish County to reduce overdose deaths from opioids. While the county has
seen a dramatic increase in overdose deaths in recent years. However, through
the end of May, there has been a 20% decline in overdose deaths compared to the
same period last year. Through May, there have been 106 opioid deaths, with a
peak death toll of 31 deaths in February. At least one health department
official attributes the decline of deaths to the county’s efforts to prevent
opioid overdoses.
Some of those prevention efforts include:
·
Distribution of over 500 Narcan kits since 2022.
·
In April, the county began distribution of its
$28.9 million in opioid settlement money to local recovery agencies. The focus
of some of the agencies are,
o
Populations of minorities bear an
over-representation of overdose deaths. Native Americans represent a rate of
73.3 per 100,000 residents for opioid overdose related visits to emergency
rooms while blacks represent a rate of 44.3 per 100,00. Whites, which is the largest
demographic in the county, visited the hospital at a rate of 15.4 per 100,000.
o
Overdose rates are disproportionately high in
rural areas such as East Snohomish County. The county is working on a multicultural
communications campaign that will include multicultural outreach teams and a
peer support program. Ideal Option, a recovery clinic with a new downtown
Monroe office has begun to offer free shuttle along Highway 2 from Index to
Monroe for those who need transportation to appointments.
o
In July, the county will begin to collaborate with
local outpatient clinics to develop better opioid and polysubstance use
disorder practices.
o
In conjunction with the Washington State Health
Care Authority, which is working with medical, treatment and social services to
create Health Engagement Hubs; a series of one-stop clinics where people who
uses drugs can access a range of medical, harm reduction, and social services, the
county is helping the local harm reduction center, Sound Pathways, to apply for
the Health Engagement Hub program.
As local governments apply the funds from the opioid settlements,
they will have to use those funds on programs that truly reduce addiction to
opioids. The challenge will be to stay away from feel good or punitive programs
that are based on preconceived notions and to move those funds to programs that
show evidence that they are effective in keeping people away from opioids.
The following episodes of the Freakonomics Radio podcasts give good insights into the elements and challenges of treating people with OUD and are well worth listening to.
Freakonomics Radio:
https://freakonomics.com/podcast/why-has-the-opioid-crisis-lasted-so-long/
https://freakonomics.com/podcast/can-55-billion-end-the-opioid-epidemic/
https://freakonomics.com/podcast/the-opioid-tragedy-how-we-got-here/
Centers for Disease Control and Prevention:
https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
The Herald:
https://www.heraldnet.com/opinion/editorial-rep-larsen-outlines-to-do-list-for-opioid-crisis/
https://larsen.house.gov/uploadedfiles/rick_larsen_district_opioid_report_final.pdf
https://www.heraldnet.com/news/as-deadly-overdoses-decline-snohomish-county-builds-on-whats-working/
For information on drugs and resources to find help with drug addiction check out this website from the Snohomish County Health Department,
Snohomish Overdose Prevention:
https://snohomishoverdoseprevention.com/
