Tag: overdoses

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

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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.

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

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.

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”

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.

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.

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”