Edmonds Beacon - Your Hometown News Source

The opioid crisis in Snohomish County is just as hidden as it is deadly.

“You probably have a neighbor who’s addicted and you wouldn’t know it because they have a job, and they have a house, and the majority of overdoses are not happening on the street; they’re happening in homes, cars, and not in public places,” said Snohomish Health District Health Officer Mark Beatty.

The Snohomish Health District, in a recent report, estimated that between 5,000 and 10,000 people in Snohomish County suffer from opioid substance abuse.

In addition, between 30,000 and 80,000 people in Snohomish County are misusing opioids by using their own prescription – or someone else’s – illicitly, or in a way other than prescribed.

Beatty is leading an effort to interpret data through a project in Snohomish County to assess the scope of the opioid crisis.

He said he’s passionate about his work, as opioid addiction has become the No. 1 health problem in the county.

The data project, which began in June 2017, is funded by the Centers for Disease Control and Prevention for another year, and is part of a study at Providence Regional Medical Center Everett (PRMCE) to conduct surveillance of patients admitted for opioid-related overdoses.

Swedish Edmonds was just added to the program, and has a few months of data.

“In the next six months or so, we should have better data information on overdose specifics in Edmonds,” said City Council President Adrienne Fraley-Monillas, who serves on the Snohomish Health District board. “I’m really interested in zeroing in on what’s occurring in Edmonds.”

Beatty said that at PRMCE, he was typically seeing males aged 20 to 30 overdosing, but at Swedish Edmonds, the preliminary data showed that many younger students were overdosing.

“I had never seen that,” Beatty said. He added that the Swedish Edmonds preliminary data also showed that there was a large group of middle-aged women and people of Asian descent affected by opioids, compared to PRMCE. The formal analysis of this preliminary data has not been completed yet, and is expected to be available in the fall.

“So I think it is really specific to specific areas and one treatment or one action plan is not going to fit every location and certainly a government federal plan isn’t going to work because it’s not one size fits all,” he said.

New issue lurking

The new issue lurking in Snohomish County, Beatty explained, is the use of counterfeit pills with fentanyl in them, causing accidental deaths because of overdoses.

“Fentanyl is 100 times more lethal than other prescription opioids,” Beatty said.

In 2018, the data showed 119 deaths for opioid-related deaths are preliminary and won’t be finalized until the middle of the year, but Beatty is expecting the number of deaths to exceed those that he’s seen before because of fentanyl.

“A lot of it has to do with people not knowing that they’re taking a much more powerful opioid,” Beatty said. “For example, they could buy what looks like a prescription drug on the street, but really it’s illicitly made with fentanyl.”

Beatty and the Snohomish Health District are working on getting this information out and trying to make people aware of counterfeit pills to avoid accidental deaths due to overdosing with fentanyl, he said.

Stigma

“The fact that only 18 to 20 percent of overdoses are actually homeless people tells you how huge the problem must be in people who are not homeless. (Homeless people) are just visible: we see them and that’s how the stigma develops.

“This really is a wide sweeping problem that’s hitting all classes, all ages and really across the economic landscape. It really is a disease and it really is affecting everybody,” Beatty said.

Fraley-Monillas agreed: “It used to be certain age brackets, and now it’s across the board.”

“Data from Providence (Everett) shows that among the total of our patients coming to the emergency room, the majority are not homeless. They were people who overdosed in their own house,” Beatty said.

Judgment towards opioid use disorder interferes with people getting treatment, Beatty emphasized.

“Substance use disorder is a chronic disease, just like any other disease like diabetes or asthma. It’s really important to get that information across because of the stigma associated with opioid use disorder. It really interferes with people getting treatment because they feel judged or other comments or feelings about substance use disorder.”

Steps moving forward

Snohomish County is second to King County in the state for opioid-related overdose deaths broken down by population, although Snohomish County is “middle of the road,” compared to all other counties, according to Beatty’s report.

“We have a lot of deaths for a county of our size,” Beatty said. “Even within the county there are differences in the populations, so it’s going to require different interventions. Part of this is making people aware that there is a risk.

“If you start going down this road of using this particular drug, you could end up addicted. We talk about opioids rather than other drugs right now because opioids are the majority of drug-related deaths.”

The next steps are finding partners to come together to find better ways to treat patients who have overdosed, or who have opioid use disorder, or who misuse opioids.

“The goal is to find out who all the partners are – treatment, housing, vocational rehabilitation, social work – and then get them all in the same room talking and making sure that when a patient shows up in one area, everyone knows exactly who to refer to.”

This collaboration is crucial, Beatty said, because sometimes it could take hours to get someone up properly after discharge, and that takes a lot of time, which costs money.

“I think it’s going to be a grassroots solution of getting all the local partners – including the health district – working together to really address this problem,” Beatty said. “I have a good sense it can be done, it’s just going to take some time.”

Fraley-Monillas said she’s encouraged by Beatty’s work.

“I know Dr. Beatty has been working really hard at training physicians and having more talks with emergency room doctors about number of pills to give people.”