Tag: overdoses

Drugs, Police, public safety, Transportation

Full 911 Audio Sheds More Light on SPD’s Explanation for Deadly Crash; Bill Expanding Police Pursuits Passes Legislature

1. Unredacted audio of the 911 call to which Seattle police officer Kevin Dave was allegedly responding when he struck and killed student Jaahnavi Kandula in January further confirms that the caller had used cocaine, not opiates, and was breathing heavily but calm when he called 911 to report that he was “freaking out.” PubliCola obtained the audio through a records request.

Police Chief Adrian Diaz has said Dave was responding “as an EMT” to provide medical aid at a Priority 1 overdose call when he hit Kandula. Dave is certified as an EMT, but there is no evidence beyond Diaz’ statement that he was responding as a medic rather than a police officer, and the 911 call itself contradicts that claim.

SPD has also said police need to be present when Fire Department medics are reviving someone from an opiate overdose in order to provide backup if the person is violent when they come to and to keep people from stealing items or intervening while SFD medics are occupied with rescue breathing and other lifesaving measures. However, the full recording of the 911 call makes it clear that the caller had used cocaine, not opiates, and told the dispatcher his symptoms were “starting to go away” by the end of the six-and-a-half-minute call.

In the first moments of the recording, the caller, a man in his 20s, told the dispatcher, “I did cocaine and I don’t know if I’m having an overdose. I think I’m over-amped.” After being transferred to a dispatcher for Medic One, the Seattle Fire Department’s emergency medical response team, the caller added that he was “trying not to freak out” and was standing outside his apartment building. “Do you think you’ve overdosed?” the dispatcher asked. “I looked it up and I think so,” he said. “I’m extremely anxious,” the caller added, and “shaking a little bit.”

The original dispatcher then kept the man on the line, telling him to breathe and getting more information. “Am I going to get in trouble?” the man asked. “Oh, no,” the dispatcher responded. “I’m still just kind of freaking out right now, but it’s starting to go away,” the caller said. By the end of the call, the dispatcher and caller were joking about the weather. “At least it’s not raining today, right?” the dispatcher said. “That’s one way to look at it, yeah,” the caller responded.

SPD is doing an internal investigation into whether Dave was acting within SPD policy when he hit Kandula in a marked and lighted South Lake Union intersection. Three months after the crash, the department has not said when it will conclude its investigation.

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2. The state senate gave final approval Monday to a bill that will lower the standard of evidence required for police officers across the state to initiate vehicle pursuits, sending the bill to Governor Jay Inslee’s desk.

Under SB 5352, sponsored by Senator John Lovick (D-44 Lake Stevens), officers will only need to have a “reasonable suspicion” that a driver has committed a violent crime or is driving under the influence. The bill reverses a 2021 change in state law that raised the standard for most offenses, apart from DUI, to a higher “probable cause” standard, which requires more evidence, with the aim of reducing pursuits overall.

The policy change nearly failed to move forward earlier this session, when state house leaders declined to bring their version of the bill to the floor for a vote ahead of a key deadline, prompting state senate leaders, in a dramatic move, to bring the bill to the floor even though it had never received a hearing in that chamber.

“I am asking you to vote no because the people trusted us, and they are disappointed that we are rolling back something that they thought put us on the first step to accountability.” —Debra Entenman (D-47, Covington)

Inslee is expected to sign the bill. “I think we need to move this needle, I think that’s where the public is,” he said in early March. 

The house approved the bill on April 10, with opposition from both Republicans who wanted it to go further and allow more pursuits for non-violent offenses like auto thefts, and from Democrats who say the current policy, which allows fewer pursuits, is saving lives.

Many Democrats view the reversal as a step back for police accountability in Washington. Before the house floor vote earlier this month, Representative Debra Entenman (D-47, Covington) noted that the bill reversed recommendations made by legislative task force created in 2020 in response to nationwide protests over racial injustice.

“I am asking you to vote no because the people trusted us…and they are disappointed that we are rolling back something that they thought put us on the first step to accountability,” she said. 

Last year, the legislature rolled back another 2021 law that prevented police from using force to prevent people from walking away from investigative stops, also known as Terry stops.

A previous version of the pursuit bill included a 2025 sunset date, but that’s no longer in the bill. Some of Washington’s largest police departments, like Seattle and Tacoma, already have policies in place that require a higher standard of evidence to pursue a suspect.

—Erica C. Barnett, Ryan Packer

Drugs, Police, public safety

Caller Was Lucid, Waiting to “Flag Down” Aid Car, When Officer Heading to Scene Struck and Killed Pedestrian Nearby
File:Seattle Fire Department - Aid 2 (Medic One vehicle).jpg
Photo by Joe Mabel; CC by 2.0 license.

By Erica C. Barnett

The 911 call to which Seattle police officer Kevin Dave was allegedly responding when he struck and killed student Jaahnavi Kandula in a marked crosswalk was not, as police and fire officials have implied, an opiate overdose that had to be reversed by paramedics under police supervision. In fact, a single aid car responded to the caller, who was lucid and alert when he dialed 911, and was finished within about 20 minutes. The call came from an apartment building 6th Ave. North, a few blocks from where Dave struck Kandula on Dexter Ave. on the night of January 23.

At first, SPD said Dave (who they did not initially identify) was responding to an emergency “at the request of” Seattle Fire Department first responders; later, they said he was heading to the scene “alongside” SFD. After SPD, in response to questions from PubliCola, said the call was an overdose, the Community Safety and Communications Center told us that police are dispatched to overdoses as a matter of longstanding policy. Later, Police Chief Adrian Diaz said Dave was responding “as an EMT” to a medical emergency.

In mid-February, Fire Chief Harold Scoggins repeated this explanation in a letter to the Community Police Commission, saying “overdose patients can become violent” after an overdose reversal, which can send an overdose victim into withdrawal. Officials from the fire department elaborated on this statement to PubliCola, saying they need police present when responding to overdoses because people revived from opiate ODs may have used stimulants like meth, whose effects come on in full force once the opiate overdose is resolved. They also said that other people on the scene can threaten or steal items from paramedics working to revive an overdose victim.

“I’m just trying to breathe right now and I’m trying to not freak out,” the man says. “It’s hard to think.” The dispatcher says he’s sending an aid car and tells the man to “flag them down” when he sees them.

But a review of the 911 call that resulted in Dave’s response—which PubliCola obtained, along with the incident report, through a record requests—reveals that the person who called in to report the “overdose” was a man who had walked down from his apartment and into the street to call 911 about what he thought might be a drug-related medical emergency.

In the call, which the fire department partially redacted, the caller is lucid, rational, and a bit frantic; he gives his full address and says he’s “freaking out” and having trouble staying calm. The caller sounds like he’s overstimulated, not overdosing on an opiate like fentanyl, as both police and fire have repeatedly implied.

“I’m just trying to breathe right now and I’m trying to not freak out,” the man says. “It’s hard to think.” After hearing more about the man’s symptoms, the dispatcher asks him if he’s been through this before and if he has any other relevant medical history or complications; the man answers no. Then the dispatcher says he’s sending an aid car and tells the man to “flag them down” when he sees them.

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An aid car is the lowest level of response to a drug-related call like this one. A spokesman for the fire department confirmed that the department sends one aid car staffed with EMTs trained in basic life support when a person is having a “suspected overdose” and is awake, as this caller was. The department sends an additional advanced life support medic unit with two additional paramedics when the person is awake and has a “confirmed overdose,” and sends two basic life support units and an advanced life support unit when the overdosing person is “unconscious, unresponsive, and not breathing normally,” the spokesman said.

Overdose deaths from stimulants are less common than deaths due to opiates, but they do happen; last year, according to the King County Department of Public Health, there were 158 stimulant-related overdose deaths, and there have been 18 this year so far.

A police department spokesperson did not respond to questions about SPD’s policy about driving practices when responding to a low-level drug call like this one. Nor have they responded to questions about how fast Dave was driving or whether he was taking reasonable care when he struck and killed Kandula in a marked crosswalk a few blocks away. “I am not able to share any further information than what’s already been shared since this is an open case,” the spokeswoman said.

The man who placed the initial call declined to comment.

Drugs, Health, Police, public safety

More Cops Are Training as Emergency Responders. Is That a Good Thing?

By Erica C. Barnett

The death of pedestrian Jaahnavi Kandula, killed by a police officer driving to respond to a suspected overdose, has revived a longstanding dispute between Seattle’s fire and police departments about who should respond to medical emergencies, particularly overdoses.

Last month, after SPD announced that officer Kevin Dave was rushing to respond to an overdose in his capacity as an emergency medical technician (EMT), SFD union leader Kenny Stuart wrote a letter to Mayor Bruce Harrell objecting to the “troubling trend” of SPD officers “being trained and certified as Emergency Medical Technicians (EMTs) and … deployed to medical emergencies in our city.”

The issue with this, Stuart continued, is that the fire department—not SPD—is responsible for emergency medical response as part of the county’s Medic One system; “randomly allowing additional EMTs from other city departments to self-dispatch or to perform EMS functions” has “led to delayed scene security, delayed medical care, decreased continuity and coordination of care, and general confusion in life-threatening emergencies.”

Mayor Bruce Harrell’s office did not immediately respond to an email seeking his response to Stuart’s letter, if any, on Friday.

SPD’s EMS trainings are not funded by the city; instead, the Seattle Police Foundation solicits donations to pay for trainings and equipment. The police foundation website says the police need trained EMTs to respond to life-threatening situations at active crime scenes before it’s safe for fire department medics to enter. The head of the EMS program, SPD officer Tyler Verhaar, did not immediately respond to a request for an interview; we’ll update this post with his comments if we hear back.

“If police continue to respond to [medical calls] unchecked, you will end up with officers who are EMTs jumping calls so they can get some good publicity, and that’s not what it’s about.”—Retired assistant fire chief A.D. Vickery

Stuart, from the firefighters’ union, declined to talk on the record about the union’s opposition to SPD officers responding to medical emergencies. But former SFD assistant chief A.D. Vickery, who started at the department in 1968 and retired in 2020, said he’s heard alarming reports about police officers “racing to the scene, putting everybody at risk, so they can be the first one to the patient.”

“The Fire Department responds to hundreds of thousands of alarms. We are very cautious. There’s lots of people on the rig all working to make sure we get to the scene in a  appropriate period of time without creating a hazard,” Vickery said. “If police continue to respond to [medical calls] unchecked, you will end up with officers who are EMTs jumping calls so they can get some good publicity, and that’s not what it’s about.”

SPD has declined to comment on the circumstances that led to Dave striking and killing Kandula in a crosswalk the night of January 23. Initially, an SPD blog post said the then-unidentified officer was responding to a nearby emergency call “at the request of” the fire department; later, a department spokeswoman updated the post to say SPD was responding “with” Fire. Subsequently, police chief Adrian Diaz said Dave was “responding as an EMT” to the initial 911 call itself.

Many police department officers are equipped with Narcan (naloxone) nasal spray, which can restore breathing by rapidly reversing the effects of opioids like fentanyl, sending a person who is overdosing into abrupt withdrawal. Although fire department EMTs have carried nasal naloxone since July 2022, the department prefers to deliver oxygen first to restore an overdose victim’s breathing.

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“With the increase in people using both methamphetamine and fentanyl at the same time, our teams then work to stabilize the patient’s breathing with small doses of naloxone ([which]also avoids a painful opiate withdrawal from excessive naloxone) and reverse the overdose,” SFD medical director Dr. Michael Sayre said.

According to one theory, bringing people back slowly also makes it more likely they’ll agree—in their groggy state—to go to the hospital, where they can access opiate withdrawal meds and learn about treatment options. “Some patients, once recovered from the drug’s effects, may refuse transport. That is a concern because it is a lost opportunity to connect patients with support services… that could be offered through the emergency department,” Sayre said.

Although the fire department doesn’t want SPD responding to medical emergencies themselves, they do want police on site when they respond to overdoses. One reason, which Fire Chief Harold Scoggins cited in a recent letter to the city’s Community Police Commission, is that overdose patients can purportedly “become violent” after they’re revived. A spokeswoman for the fire department said patients who overdose on fentanyl while also using meth, in particular, can “become quite agitated… risking harm to themselves and others around them,” because “when both substances are present, the sedative effects of fentanyl are reversed by naloxone, and the stimulant effects of methamphetamine then predominate.”

Curious how often first responders actually encounter hostile situations from bystanders, I requested the fire department’s database of assault reports from EMS calls. In 2022, first responders logged 135 such incidents, which ranged from verbal abuse and threats to punches, “donkey kicks,” and a “wrestling match”; one person threw a hamburger at a fire truck.

But the main reason fire EMS wants police at the scene of overdoses, according to Vickery, is to “control the scene to allow the EMTs or the medical personnel to do their jobs” without having to worry about bystanders or opportunistic thieves. “The environment that the overdoses take place in now is a much more hostile environment,” Vickery said. “In 1968, you might have an overdose in a particular area and it really was isolated to the room and the people that knew them, but there was not this the hostility that exists today.” Overdoses often occur on streets or in encampments, including many that first responders won’t enter without SPD backup.

Curious how often first responders actually encounter hostile situations from bystanders, I requested the fire department’s database of assault reports from EMS calls, which only includes incidents that involved formal reports (in other words, it isn’t comprehensive). In 2022, first responders logged 135 such incidents, which ranged from verbal abuse and threats (“Stated that he was going to kill us and that we were ‘motherf***ers””) to punches, “donkey kicks,” and a “wrestling match”; one person threw a hamburger at a fire truck.

Only a few of the reported incidents involved people brought back from an overdose with naloxone who were “combative” afterward and had to be restrained.

Overall, the reports unsurprisingly include many people in obvious crisis—like the person who was “slamming his head against the sidewalk several times before being restrained by SFD crews for his own safety as well as ours,” or the “well-known [patient]” who threw water on fire fighters before “barricading himself” inside a bathroom.

The tension between police and fire about their roles as first responders isn’t going away, as the police foundation continues to solicit donations for “training, certification, and medical supplies” for cops to respond to emergency calls. Vickery says he has no problem with police officers getting EMT certification on their own time, but says “there needs to be clear delineation” between the role of police providing backup at medical emergencies and fire personnel responding to those emergencies as EMTs. “The fire department doesn’t arrest people—stay within the realm of what your responsibilities are and support each other,” he said.

Addiction, criminal justice, Drugs, legislature

New Drug Possession Bill Emphasizes Coercive Treatment

State. Sen. June RobinsonBy Andrew Engelson

Democrats in the legislature are making procedural moves that will decide what the state’s new drug possession law will look like—an exercise that became necessary after the state supreme court’s 2021 ruling Blake v. State of Washington invalidated existing law. 

Whatever bill emerges will correct the element of current law the court found unconstitutional:  that someone who “unknowingly” possesses drugs could still be convicted. But the legislature is also taking the opportunity to debate what the state’s approach to drug use, and an unprecedented overdose crisis, will be. Various camps in this debate favor a criminal justice approach; a coercive treatment approach; or a public health approach focused on decriminalization.

The bill that has emerged from committee in the senate favors the “middle” option—coercive treatment—and amendments added in the past few days double down on that strategy.

Sen. Manka Dhingra (D-45, Redmond), who chairs the Law & Justice committee, is a strong supporter of decriminalization and safe supply. But her bill moving things in that direction,  which would implement recommendations in a report issued in December by the Substance Use Recovery Services Advisory Committee (SURSAC), didn’t have the votes to pass the Senate and never made it out of committee.

What did survive is a bill sponsored by Sen. June Robinson (D-38, Everett), that would make possession of a “small amount” of schedule 2 drugs (which include cocaine, fentanyl, and methamphetamine) a gross misdemeanor and require prosecutors to offer defendants diversion to treatment instead of jail time. 

“We’re basically saying: Upon conviction, you’re auto-enrolled in a substance abuse treatment program. But if for whatever reason you fail, if you choose to exit the program because you don’t feel like doing it—now there’s going to be consequences.”—Sen. Mark Mullet (D-5, Issaquah)

Last Friday, when the bill was in the Ways and Means committee, vice chair Sen. Mark Mullet (D-5, Issaquah) succeeded in adding a major amendment to the bill empowering (and in some cases requiring) judges to impose jail sentences on defendants who fail to complete treatment.

Mullet told PubliCola he filed the amendment with input from Sen. Jesse Salomon (D-32, Shoreline), whose own drug possession bill, which is more punitive than either Dhingra’s or Robinson’s, failed to make it out of committee.

“We’re basically saying: Upon conviction, you’re auto-enrolled in a substance abuse treatment program,” Mullet told PubliCola. “But if for whatever reason you fail, if you choose to exit the program because you don’t feel like doing it—now there’s going to be consequences.”

This sort of language, focused on pushing drug users into treatment and demanding results, mirrors testimony that Salomon, who works as a public defender, gave during a committee hearing for his bill on Feb 6. Introducing that bill, Salomon expressed concerns about an “unacceptable level of public, open drug use,” and then told a story about seeing people using fentanyl outside his child’s day care, lamenting what he called  “a high level of public disorder and a decrease in public safety.” 

“Our current referral system… “ Salomon said in his testimony, “effectively only asks people to get help, but has no consequences when those folks don’t get help.”

Caleb Banta-Green, a researcher on substance use disorder at the University of Washington— and a member of the SURSAC committee that recommended decriminalization—says this approach ignores the realities of opioid and stimulant use. 

“You don’t treat substance use disorder,” Banta-Green said, “You manage it as a chronic relapsing condition. One of the challenges when the criminal legal system is involved is that if you have a return to use, you’re a failure and you’re committing a crime. Rather than: you’re showing symptoms of your disease and we’re going to continue to provide you care.”

Mullet’s amendment would give judges discretion on the first offense, but on the second offense, those who fail to complete treatment will face a minimum of 21 days in jail, and for a third offense a minimum of 45 days—sentences Mullet said are often be knocked down, with good behavior, to 14 days and 30 days, respectively.

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“Our hope is that in those 14 days, people can go through that kind of challenging withdrawal process where they don’t have access to substances,” Mullet said. “Then hopefully, at the end of those 14 days, now they’re in a better spot to realize: oh, maybe I should get treatment.”

Banta-Green says this is the approach the state has used for decades, and he believes it’s ineffective and harmful. “Incarceration is not innocuous,” he said. “I think legislators think it’s like having to go to a Motel 6 for the weekend and miss out on some parties.” A drug conviction and jail time can be a “scarlet letter” that limits a person’s future opportunities; it also “dramatically increases [the] risk of overdose,” Banta-Green said.

Two academic studies of people released from Washington state prisons have shown that the majority of deaths among those recently released from prison were overdoses and that within two weeks of release, inmates were 129 times more likely to overdose than the general population. 

Michelle Conley, director of integrated care at REACH, which serves unhoused Seattle residents with substance abuse disorders, says that for many of her clients who end up incarcerated, jail is detrimental to recovery. “People are traumatized by jail,” Conley said. “And then we’re 15 steps back from where they were. As providers we have to engage with them and rebuild trust… to make sure they see us as a provider and not just a part of the system.”

Even the bill’s seeming compromise between criminalization and decriminalization—coercive treatment—is problematic, Conley said.

Conley said the expectation that someone can be pushed into recovery with one session of 30 to 90-day inpatient treatment is unrealistic, especially if they’re released from treatment without ongoing support. “Churning people through this kind of treatment mill, and then sending them back on the streets, really serves as little more than a moment of respite,” Conley said. “Especially when people are released back to the same circumstances that drove them, oftentimes, to aggressive use.”

Not everyone who uses drugs needs to go to treatment, Banta-Green said, and people who would benefit from services “don’t want the treatment we have,” which often takes an all-or-nothing approach to sobriety. Instead of coercing people into conventional treatment with the threat of jail time, Banta-Green believes the state should implement one of the SURSAC committee’s recommendations: aggressively funding “health engagement hubs” that offer a range of services and treatment options to people who use drugs, including comprehensive harm reduction, health care, mental health care, addiction treatment, and medications.

“I absolutely believe that the criminal justice system is not the right place to deal with addiction. It’s just—this is where we are. And we need to move to provide alternatives, to provide other systems, and to fund and destigmatize other ways of helping people through addiction.”—Sen. June Robinson (D-38, Everett)

Banta-Green’s research team has worked with local public health agencies to establish pilot hubs in Seattle, Kennewick, and Walla Walla. He says the state would ideally have one of these hubs for every 200,000 residents, for a total of about 38 such facilities statewide.

Robinson’s bill directs the Washington Health Care Authority to “make sufficient funding available” to create health hubs within a 2-hour drive of all residents at the ratio to population Banta Green recommends. The bill also appropriates a $51 million—much of it from the state’s legal settlement with prescription opioid manufacturers—to fund opioid use disorder medications, crisis relief centers, and grants to LEAD and other programs that offer alternatives to arrest or jail time.  

Among other provisions, the bill legalizes handing out drug paraphernalia (such as smoking supplies) statewide, but an amendment added in the Ways and Means committee by Sen. Keith Wagoner (R-19, Sedro Woolley) would allow cities to opt out of that provision.

Dhingra added language to the bill that would set up a working group to study the creation of a safer drug supply system. Canada has incrementally started to experiment with prescribing pharmaceutical-grade drugs such as fentanyl to drug users to reduce the risk of overdose from street drugs, whose contents are unpredictable. However, that language also got stripped out of the bill in Ways and Means.

Following a year when King County had a record 998 fatal drug overdoses, all options should be on the table, Dhingra said.

 “If you want to help people get to recovery,” she said, “you have to make sure they’re alive in order to do that.”

Sen. Robinson, who sponsored the bill now moving forward, told PubliCola she believes her legislation offers a politically viable balance between restoring some criminal penalties and providing options for treatment.

Robinson, who has a masters in public health, said, “I truly believe all the research” about the need for a variety of approaches to drug use and addiction. “I absolutely believe that the criminal justice system is not the right place to deal with addiction,” she said. “It’s just—this is where we are. And we need to move to provide alternatives, to provide other systems, and to fund and destigmatize other ways of helping people through addiction.”

Robinson’s bill will likely get a floor vote this week, and it’s also likely that supporters of each competing approach to drug policy will offer a frenzy of competing floor amendments to shape the final bill. 

Drugs, Police, public safety

“Overdose Patients Can Become Violent”: Fire and Police Respond to Questions About Pedestrian Death
File:Seattle fire department medic 80.jpg
Atomic Taco, CC BY-SA 2.0, via Wikimedia Commons

By Erica C. Barnett

On Wednesday, the Seattle Police and Fire Departments responded to questions from the Community Police Commission about some of the circumstances that may have contributed to the death of Jaahnavi Kandula, a 23-year-old pedestrian who was killed in a marked crosswalk by SPD Officer Kevin Dave. Dave was driving to join Seattle Fire Department EMTs at a suspected overdose in South Lake Union. According to the response from Seattle Fire Chief Harold Scoggins, Seattle Fire Department policy requires police to be present when SFD responds to overdoses, because “overdose patients can become violent during treatment to reverse the overdose.”

The CPC asked the Fire Department to explain the reason it requires police officers to be present when Fire responds to overdose calls, posing four questions about the policy, how it came about, and “What percentage of drug overdose calls prior to the implementation of this policy included compromised safety, assaults, and/or injuries to SFD personnel related to reversing the effects of an overdose?”

In his response, Seattle Fire Chief Harold Scoggins said that the requirement “goes back at least 20 years and is designed to provide scene safety for firefighters and paramedics as overdose patients can become violent during treatment to reverse the overdose.” He did not answer the CPC’s question about how common it is for people coming out of overdoses to be violent, saying only that “[e]ncountering combative patients or bystanders on emergency responses has unfortunately become a reality for firefighters and paramedics.”

Narcan (or naloxone), the widely available overdose reversal drug, is used daily by non-emergency responders, including drug users themselves, and other public employees are trained to use it in the absence of paramedics or any armed response. In 2019,  then-Washington state health officer Kathy Lofy signed a “standing order” that made Narcan available over the counter without a prescription to any person who wants it, calling it a “very safe,” life-saving medication.

“When weighing the decision to respond using emergency driving, officers must consider if the incident is life threatening, road conditions, vehicle and pedestrian traffic, weather, speed, lighting, and their own driving abilities.”—Police Chief Adrian Diaz

In his letter, Scoggins said SFD has developed a “new method for tracking assaults and threatening behavior experienced by firefighters in the field,” in general, and has begun reporting this information. PubliCola has asked SFD for this data and will update this post with additional information when we receive it.

Seattle Police Chief Adrian Diaz also responded to the CPC’s questions. After describing the training officers receive in “emergency driving”—driving under emergency circumstances, such as a high-priority call where someone’s life is at risk—Diaz said officers are justified in taking “risks [that] “can result in severe consequences for the public and the officer. … When weighing the decision to respond using emergency driving…. [o]fficers must consider if the incident is life threatening, road conditions, vehicle and pedestrian traffic, weather, speed, lighting, and their own driving abilities.”

Diaz said the fact that the overdose was a Priority 1 call would not, in itself, necessitate emergency driving. “The priority level is a factor to consider but is not generally controlling,” Diaz wrote. “While many Priority 1 calls would warrant emergency driving under our current policy and training, not all do and officers are expected to consider the totality of the circumstances.”

PubliCola has filed a records request the audio from the initial 911 call; SPD categorically denied a separate request for all recorded audio related to the Kandula’s death, citing their ongoing investigation into the incident.

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In a conversation with PubliCola last week, SPD Chief Adrian Diaz noted that Dave is a licensed EMT who was headed to the scene of a medical emergency, implying that he was on the way to respond to the reported overdose, not to provide security for the Fire Department. On February 6, the head of the Seattle Fire Fighters Union, Kenny Stuart, expressed frustration about SPD officers getting trained as EMTs and responding to medical emergencies like overdoses directly, saying this was the responsibility of the fire department, not SPD. (It’s a longstanding, ongoing issue.)

“Our EMS delivery system under the Medic One program is arguably the best in the country, and randomly allowing additional EMTs from other city departments to self-dispatch or to perform EMS functions at an incident does not improve or support the level of care we demand from this program,” Stuart wrote. “In fact, it unnecessarily complicates our response and diminishes the service that the public depends on and expects.”

Seattle Fire Department firefighters and paramedics are “the only personnel that are dispatched as EMTs” to medical emergencies, Stuart continued, “and they should be the only personnel who deliver EMS to the people of Seattle. We need our police officers to provide scene security and protect us so we can do our jobs effectively.”

Several years ago, SFD’s medical director told PubliCola the fire department preferred to use rescue breathing—a method to restore breathing in overdose victims without Narcan—followed by intravenous naloxone to facilitate a slower return to normal breathing without putting a person into instant opiate withdrawal. We’ve asked SFD whether this is still the department’s policy, and how the emergence of fentanyl has impacted overdose response, and will update this post when we hear back.

PubliCola has also reached out to Stuart.

Drugs, Health, legislature, public disclosure

Bill Would Expand Access to Fentanyl Testing, PubliCola Updates Seattle Employee Directory
Image source

1. As King County hit a demoralizing new record of 1,019 overdose deaths in 2022—a jump of nearly 30 percent over the previous year—a Republican state senator has introduced a bill that would make it easier to access test strips that can indicate the presence of fentanyl in drugs.

As PubliCola has reported, fentanyl is now the default opioid for drug users in King County, a trend that has driven the huge spike in overdoses. Even people who don’t seek out opioids can be at risk, because drugs like cocaine and methamphetamine can be contaminated with fentanyl. Test strips, which can detect the presence of fentanyl in a small amount of a drug, are an essential part of harm reduction efforts, but state law still classifies them as prohibited “drug paraphernalia,” limiting their availability.

Last year, GOP state senator Jim Honeyford, R-Sunnyside, filed a bill that would have changed that designation, but it died in committee. This session, Sen Ron Muzzall, R-Oak Harbor, reintroduced the legislation.

Muzzall told PubliCola that while substance abuse has always been an area of concern for him, it’s also a personal issue. Muzzall is friends with Skagit County Commissioner Lisa Janicki, whose son Patrick died of a fentanyl overdose in 2017 after becoming addicted to pain pills. Muzzall says he knew Janicki’s son and that his death made a deep impression. 

“When a mistake like that leads to having to bury your child.. . well, that emptiness never goes away,” Muzzall said. “And that was a tragedy that was brought about by a prescription of Oxycontin. The liability lies with the pharmaceutical industry that led up to that. And it’s just invading our communities.”

Janicki has been a vocal advocate for Attorney General Bob Ferguson’s successful lawsuit against opioid manufacturers, which will add $476 million to the state’s harm reduction and treatment efforts over the next 17 years. 

The fentanyl test strip bill is an essential part of those efforts, Muzzall said. “It’s just silly that we don’t make these as easily accessible as possible,” he said. “This bill will take the criminality out of providing them.”

Muzzall, who says fatal overdose is a behavioral and mental health crisis that will likely cost the state a billion dollars to address, is working alongside Democratic Sen. Annette Cleveland of Vancouver on a number of bills to address the issue, and hopes to successfully move the test strip bill through committee this time around.

“If an individual is compassionate, bipartisanship comes easily,” he said.

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2. In 2021, then-mayor Jenny Durkan’s information technology department took the public-facing directory of city employees offline, removing a vital resource that allowed members of the public and journalists (as well as city of Seattle employees themselves) to contact people who work at the city. Public employees’ contact information is a matter of public record, and keeping this information secret violates a long tradition of transparency that persists in other government entities across the state, from King County to the entire State of Washington.

Durkan, who falsely claimed the directory would be online again in a matter of months, is no longer in office, but her successor, Bruce Harrell, has made no moves to restore this resource. The former city employee directory website is now a static page with links to a list of the city’s official media relations officers, the websites of various city departments, and the city’s data portal (which does not contain the directory).

Because we believe the city directory is a valuable public resource, PubliCola has taken it upon ourselves to maintain an updated database of city employees and their contact information ourselves. Here’s the latest searchable and downloadable version, with information current as of January 5, 2023. We will continue maintaining and updating this database until and unless the city of Seattle decides to put theirs back online.

—Andrew Engelson, Erica C. Barnett

Addiction, Drugs, Health

King County is on Pace for a Record Year of Overdose Deaths
Overdoses in King County, 2012 (L) and 2021 (R)
Overdoses in King County, 2012 (L) and 2021 (R)

By Andrew Engelson

Tricia Howe, who directs an outreach program for drug users at REACH, Evergreen Treatment Services’ homeless outreach program, had firsthand experience of King County’s overdose crisis earlier this summer. In a matter of weeks, there were two overdoses outside REACH’s Belltown office.

“One of our case managers came into my office and said, “I think there’s somebody outside who doesn’t look like they’re breathing,” Howe said. “I grabbed a whole bunch of Narcan out of my drawer and ran outside.”

The man’s lips were blue, Howe said, and he wasn’t breathing, though he did have a pulse. She gave him a standard dose of naloxone nasal spray (Narcan), which can reverse the effect of opioids and restore a person’s breathing, but he failed to revive. So Howe gave him a second dose. “He took one deep breath, but was still not responsive,” she said. As Howe was preparing to administer a third dose, first responders arrived, put the man on oxygen, and he finally started breathing.

Based on the man’s response, fentanyl was almost certainly involved. The drug, which is up to 50 times more potent than heroin, can cause overdoses even among frequent opioid users. According to Howe, because fentanyl is cheaper to manufacture, it is quickly replacing heroin and oxycontin as the primary drug available to people who use opioids.

Data from the Washington State Patrol shows that the share of fentanyl in King County drug seizures has climbed dramatically, from around 10 instances in 2018 to more than 100 in 2021. Howe said that all of the counterfeit oxycodone (OxyContin) pills her staff have recently tested have been positive for fentanyl.

“It’s so available now and people are actually seeking it out at this point, where that was not the case before.” According to Howe, because fentanyl is cheaper to manufacture, it is quickly replacing heroin and oxy, and is making overdoses more common and more difficult to reverse. 

Though former mayor Ed Murray expressed early support for what would have been the first such sanctioned site in the US, Jenny Durkan’s administration showed little enthusiasm for supervised consumption. Durkan downgraded the plan in 2019 to a single site in a mobile van, citing concerns about the Trump administration’s legal action against a proposed consumption site in Philadelphia. 

A 2017 study showed that 83 percent of fentanyl overdoses in Massachusetts required a second dose of naloxone. Howe notes that overdoses of heroin or oxy were easier to reverse than fentanyl. “In the past, you could definitely expect the person to wake up and almost walk away,” says Howe.

Seattle and King County are in the midst of a severe overdose death crisis that began to spike during the pandemic and shows no sign of abating. People without shelter are particularly at risk. A ten-year study published in September by the King County Medical Examiner’s Office and Public Health Seattle-King County found that that accidental deaths nearly quadrupled  between 2012 and 2021 among people living unsheltered, and that overdoses now account for 71 percent of such deaths. 

As of last week, according to King County Public Health, there had been at least 710 fatal overdoses in the county this year. Of those, at least 473 involved fentanyl. That number has already eclipsed last year’s 708 overdose deaths, including 385 caused by fentanyl.

“When we first started our heroin and opioid task force in 2015, there were three fentanyl overdose deaths,” said Brad Finegood, a strategic advisor at the public health department. “The numbers have grown exponentially.”

Drug users tried to avoid fentanyl when it first arrived on the West Coast, Finegood said, but that attitude has dramatically shifted, and now people are actively seeking out fentanyl. According to a Pew study published in 2019 on drug use in San Francisco, more than half of opioid drug users now actively seek it, despite the dangers. Complicating matters, fentanyl is either smoked or vaporized and then inhaled, so traditional initiation barriers have fallen away.

“For younger people who are experimenting with drugs,” Finegood said, “that makes it much more feasible because they don’t have to use a needle.” Public Health and REACH have had to counter the misinformed belief that fentanyl is safer because it’s smoked rather than injected.

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According to the US Department of Justice, most fentanyl originates in China and is made into pills or powders by cartels based in Mexico. Batches of fentanyl that are poorly blended can result in what Finegood calls the “chocolate chip cookie effect,” in which pockets of higher concentrations cause accidental overdose.

A young man named Ian who was living in an encampment near the Home Depot in the Bitter Lake neighborhood said in August that he had no choice but to start using fentanyl. Originally from Wasilla, Alaska, Ian said he first became addicted to opioids while taking Oxycontin for pain. “Then oxy disappeared,” he said. In 2016, the CDC advised doctors to lower prescription levels of oxycodone and this, combined with the Drug Enforcement Agency’s recent crackdown on illegal and fraudulent prescriptions, has made medical-grade pills rare.

Ian said that in the absence of oxy, he did heroin for a while. “Then that disappeared. Now it’s all fetty.”

Half a dozen people at the encampment told me they use fentanyl and know many others who do. Nearly everyone had witnessed overdoses and several said they knew people who’d died.

“Everyone’s doing fetty,” said Jessie, who’s 26 and has been using drugs, including meth, since she was 11 years old. She didn’t live in the Bitter Lake camp, but was helping a friend pack up their belongings before the city came to sweep the site. “I’ve been sober, but it didn’t last,” she said. When asked if she’d seen friends overdose, Jessie said, “Yeah, of course.”

The transformation of fentanyl from risky outlier to the opioid of choice in King County mirrors national trends. In 2021, fentanyl accounted for the majority of overdose deaths in the U.S, though methamphetamine continues to be a close second, both nationally and locally. 

Although Seattle, King County, and the cities of Renton and Auburn formed an opiate overdose task force in 2015, local leaders have shelved a key recommendation from the task force’s report: establishing two supervised consumption sites in King County. 

Seattle could have been home to the first such sanctioned site in the U.S., following the lead of Vancouver, B.C. and 200 other sites currently operating elsewhere in Canada, Europe and Australia.

Though former mayor Ed Murray expressed early support for what would have been the first such sanctioned site in the US, Jenny Durkan’s administration showed little enthusiasm for supervised consumption. Durkan downgraded the plan in 2019 to a single site in a mobile van, citing concerns about the Trump administration’s legal action against a proposed consumption site in Philadelphia. 

“It’s a no-brainer. If you don’t want people to use right in front of you and you don’t want needles all over your parks, then you’ve got to give people a place where they can go.”—Tricia Howe, REACH

Even as the Biden administration changed course and said it would consider allowing sites, neither Durkan nor Mayor Bruce Harrell followed through on the scaled-back plan. Earlier this year, New York City moved past Seattle and opened two safe consumption sites that have already succeeded in preventing 500 deaths.

Kris Nyrop, who spent two decades working on HIV prevention among drug users in Seattle and helped design Seattle’s Law Enforcement Assisted Diversion (LEAD) program, says the window for action in King County is quickly closing.

“We have two years,” Nyrop said. “Biden is not going to prosecute if Seattle moves forward. So how do we get Mayor Harrell and a majority of the council behind this?”

In fact, Councilmember Lisa Herbold added $1.1 million to the 2021 Human Services Department budget to create safe consumption spaces in existing social services facilities. The city did not move forward on that approach and Harrell’s proposed 2023-2024 budget does not fund it. 

Instead, Mayor Harrell has vowed to crack down on people who sell and use drugs, in a highly publicized effort to target “hot spots” such as the intersection of 12th and Jackson in Little Saigon. Anyone walking through the area today can see that this short-term strategy was ineffective at reducing public drug use and sales in the area.

Howe said that the only effective way to reduce visible drug use on the street isn’t more policing, but sanctioned consumption sites. “It’s a no-brainer. … If you don’t want people to use right in front of you and you don’t want needles all over your parks, then you’ve got to give people a place where they can go.”

In the absence of sanctioned sites, Public Health has been quietly moving forward on other, lower-profile strategies aimed at empowering drug users to consume drugs as safely as possible. 

In addition to social media campaigns to educate young people about the extremely high risks of fentanyl pills (“blues”), Finegood says Public Health is doing more targeted educational outreach to users about safer consumption practices. 

This includes training drug users to recognize the symptoms of overdose, encouraging people not to use alone, and making the overdose reversal medication naloxone widely available. Finegood said Public Health has set up the first mail-order naloxone program in the country, and is working extensively with local pharmacies to offer the drug free, without a doctor’s prescription. “We’ve also set up a couple naloxone and fentanyl tester vending machines,” Finegood said. Continue reading “King County is on Pace for a Record Year of Overdose Deaths” →

Drugs, Health, Mayor Harrell, Morning Fizz, Transportation

Ban on Narcan Continues Amid Overdoses at Libraries; Harrell’s Pick for SDOT Director Answers Council Questions

1. Last month, we reported on the Seattle Public Library’s directive telling staff not to carry or use Narcan, or naloxone—a nasal spray that can restore breathing in people overdosing on opioids—because of potential liability issues.

The state’s Good Samaritan law exempts people who provide emergency care from civil liability, but a library spokeswoman said City Attorney Ann Davison’s office advised the library that library staffers were “likely” not covered by the law. King County Public Libraries, which operates outside Seattle, also bars staff from using Narcan.

Public libraries are among the only indoor places where people experiencing homelessness can go during the day without being expected to make a purchase or explain why they’re there. They’ve also been the location for dozens of fatal and nonfatal overdoses in recent years. According to data provided by the King County Department of Public Health, there have been at least 42 likely overdoses in or outside public libraries in King County since 2019, including 16 inside library branches. Since 2017, at least eight people have died of drug-related causes at libraries in King County, half of them in Seattle, including at least four involving opiates like heroin and fentanyl.

Bans on using Narcan force library staffers to call 911 and wait for emergency responders to arrive, adding several potentially fatal minutes to the time an overdosing person is unconscious and not receiving oxygen to their brain.

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A review of recent fire department reports for overdoses at Seattle Public Library branches shows that it takes emergency responders between three and five minutes to arrive on the scene of an overdose and start administering aid. These reports also show that on at least one occasion, back in April, someone at the downtown Seattle library revived a patron with Narcan, the drug library staffers were formally barred from using just three months later.

The ban on using Narcan is based on the belief that library staffers, unlike other Washington state residents, are not protected under the state’s Good Samaritan laws when they administer aid. By that standard, library staffers shouldn’t be able to offer first aid to patrons experiencing minor medical emergencies, or attempt to assist people experiencing heat stroke when they come to the library to cool off in the summer. And yet they manage to do both. Why are overdoses categorically different?

2. Greg Spotts, Mayor Bruce Harrell’s nominee to lead the Seattle Department of Transportation, submitted detailed answers this week to a list of questions from the city council’s transportation committee about his goals for his first year, plan to get Vision Zero back on track, and ideas about how to create a more equitable transportation system. Spotts’ responses t check off a lot of boxes for people who support urbanism and alternatives to driving alone.

For example, in response to a question about creating “connected safe spaces for people to move throughout the city” without a car, Spotts noted that in many cases, “pressure to preserve just a few curbside parking spaces stands in the way of conveying cyclists safely across a busy intersection. Too many of our bike and pedestrian routes have discontinuities that render the route significantly less safe, useful and attractive than it could have been.” In 2019, former mayor Jenny Durkan killed plans to build a protected bike lane along a dangerous stretch of 35th Ave. NE after neighborhood and business groups argued that removing a few curbside parking spaces would devastate businesses in Wedgwood and Ravenna.

However, Spotts also hedged a bit when talking about commitments to new bike infrastructure, responding to a question about whether he would support creating new protected bike lanes as part of road resurfacing projects with an artful dodge. “I fully intend to support projects and routes as called for in the Council-approved Bicycle Master Plan; and will be engaging with staff, subject matter experts, and community as these projects are developed and constructed,” he wrote. As the Urbanist has reported, the city is currently working to integrate all its transportation related “master plans” into a single mega-plan, a move that some advocates worry could further reduce the city’s commitments to nonmotorized transportation.

He also ducked questions about whether parking enforcement officers belong at SDOT and if he would commit to removing the large concrete “eco-blocks” that business owners place illegally in the public right-of-way to keep people living in oversize vehicles from having a place to park. (Councilmember Sara Nelson, whose own business, Fremont Brewing, continues to flagrantly violate this law, is not on the transportation committee).

 

Previous SDOT directors learned the hard way that specific commitments can be tough to implement if they conflict with what their boss, the mayor, wants—which is probably why, when asked about equity in transportation investments, Spotts said only that Seattle’s most deadly streets for cyclists and pedestrians, Rainier Ave. S and Aurora Ave. N., “can potentially be reenvisioned to meet community needs.” Harrell has made it clear that his top transportation priorities include maintaining and repairing basic infrastructure like streets and bridges, not big-reach projects like protected bike paths connecting every part of the city.

Seattle will hear more from Spotts next month, when the transportation committee considers his nomination again after the council returns from summer recess.

Bikes, City Council, criminal justice, Drugs, Featured, human services, Mayor Durkan, Morning Crank, Transit, Transportation

Cyclists Pack Pedersen Forum, Libraries Still Lack Narcan, and an Update on LEAD

1. Bike and bus advocates showed up in force for a “town hall” meeting featuring District 4 city council member Alex Pedersen in Eastlake last night, but many said afterward that the moderators who chose the questions from a stack of cards submitted by the public—a representative from the Eastlake Community Council and a Pedersen staffer—rejected or ignored their questions.

I was live-tweeting the forum, and noticed early on that most of the questions seemed to be from people opposed to a planned protected bike lane on Eastlake, rather than the dozens of bike lane supporters in the audience. For example, early questions centered on how businesses were supposed to deal with the loss of hundreds of parking spaces directly on Eastlake Avenue; why cyclists couldn’t just ride on a parallel greenway somewhere near, but not on, Eastlake’s business district; and what can still be done to prevent King County Metro from replacing the milk-run Route 70 with a RapidRide bus route that will be faster and more frequent but won’t have as many stops.

During the meeting, I noticed that a pile of questions had been set aside, and that the moderator seemed to be favoring questions from people who opposed bike lanes and RapidRide over questions from the bike lane supporters who packed the room. So I asked via Twitter: If you were at the forum and asked a question that didn’t get answered, what was it?

Pedersen was fairly circumspect in his responses, suggesting repeatedly that people contact his office and promising he would get back to them by email. He did, however, say he supported changing the Eastlake bike lane plan—which has been debated, studied, and affirmed repeatedly over a period of several years—so that cyclists would have to shift back and forth between the arterial and short stretches of “greenway” on unnamed parallel streets. “I think [the Seattle Department of Transportation] should look harder at a combination of protected bike lanes on some part of it and greenways on some of it,” Pedersen said.

Invoking the specter of 35th Ave. NE, where a long-planned bike lane was scuttled after neighborhood activists complained that the loss of on-street parking would destroy local businesses, Pedersen added: “There was a lack of transparency” about the proposed bike lane, which he opposed. “People were just trying to figure out what was going on with it.”

“I think [the Seattle Department of Transportation] should look harder at a combination of protected bike lanes on some part of [Eastlake] and greenways on some of it.” — City council member Alex Pedersen

During the meeting, I noticed that a pile of questions had been set aside, and that the moderator seemed to be favoring questions from people who opposed bike lanes and RapidRide over questions from the bike lane supporters who packed the room. So I asked via Twitter: If you were at the forum and asked a question that didn’t get answered, what was it? Here are some of their (slightly edited) answers:

• Given that every study shows bike lanes make streets safer for everyone and are good for business (and that cyclists spend more than drivers), what data are you paying attention to? How will you incorporate the data that already exists about protected bike lanes around the world?

• Have you seen any analysis of the percentage of people who are NOT in Eastlake that commute to Eastlake for any of the businesses that are afraid of losing 320 parking spots? Do people drive to 14 Carrots from other parts of the city?

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• Have you seen any research about the actual impact of bike lanes on businesses?

• What options are you prioritizing to help my whole family get around without using a car?

• Many people bus and bike through Eastlake, but don’t stop because traffic is so dangerous. What can be done to make Eastlake more welcoming to visitors and encourage fewer single occupancy vehicles, supporting the goal of Vision Zero?

• When will the city consider a residential parking zone in Eastlake (which prevents people from commuting in by car and parking all day in neighborhoods)?

• Why is the RapidRide and bike lane project important for Eastlake and the surrounding area?

Jessica Westgren from Welcoming Wallingford, a group that supports housing density and alternatives to driving, asked Pedersen verbally why he wouldn’t return calls and emails from her organization. Pedersen responded that she should send him an email, ideally including specific information such as “I’m having this issue on my block.”

 

Mayor Jenny Durkan, flanked by parents who lost their son to an opioid overdose and local officials

2. Mayor Jenny Durkan announced that the city will be distributing 700 doses of naloxone (Narcan), a drug that can reverse opioid overdoses, in response to a surge in overdoses from fentanyl in counterfeit oxycodone pills—and, in particular, an increase in the number of teenagers who have died of fentanyl overdoses. Fentanyl is especially deadly, and overdoses happen quickly; an overdosing person can die long before first responders arrive, which is why having Narcan on hand (and knowing how to use it) is so critical.

Durkan said that kits will be distributed in schools, bars, and nightclubs—”any place where it is likely that someone might overdose.” The city is also planning 25 Narcan training workshops.

Since Seattle public libraries are among the places people use opioids—and are, because staff are always present, safer consumption sites than alleys or parks—I asked if the libraries would also start stocking Narcan, and if library workers would be trained to use it. (The library system has been slow to adopt harm reduction policies, and only added sharps containers in restrooms after I published several stories on the issue last year.) Durkan said “we’d like them in the libraries,” but her staff added later that this would be an issue for the library union to negotiate.

Library spokeswoman Andra Addison later confirmed that the library does not have current plans to stock Narcan or train library workers to use it. “The Library currently uses 911 for all medical emergencies. Use of Narcan in our libraries would involve union representatives, and those discussions are just under way,” Addison says. Asked to clarify what the issue would be for the library union, Addison said, “working conditions and the impact on working conditions.”

3. City council member Lisa Herbold has released a copy of the letter I mentioned on Wednesday, urging Durkan to confirm that she will release all the funding the council provided for the Law Enforcement Assisted Diversion program in its adopted budget no later than March 1, and to affirm that LEAD—which offers alternatives to arrest for people suspected of committing low-level crimes—is a crime prevention program, not a homelessness program. Durkan has hired a consultant to look at LEAD’s performance and to determine performance metrics for the program; currently, LEAD is classified as a homelessness intervention and required to meet housing goals, even though more than a quarter of its clients are not homeless. Continue reading “Cyclists Pack Pedersen Forum, Libraries Still Lack Narcan, and an Update on LEAD” →