As Overdoses in State, County Soar, Islander Takes Action

State, federal and local officials are witnessing alarming spikes in opioid deaths, including in King County, a hidden crisis raging in the midst of the COVID-19 pandemic.

That inspired islander Jenn Taylor to take action on Vashon and address the lack of accessibility of Naloxone, a medication that quickly reverses opioid overdoses and saves lives, restoring a person’s normal breathing if it has slowed or stopped due to an overdose.

The county’s largest number of overdose deaths since 2008 was seen last year at 432. Since 2011, the number has gradually risen, as the region — and the country — have been grappling with ways to handle the opioid crisis. The number of overdoses resulting from a combination of methamphetamine and opioid stimulants rose to 169 in 2019, up from 130 in 2018. It is a trend that has persisted since then, worrying many that it will only get worse before it gets better.

The situation is not being helped by the economic downturn brought on by the pandemic, which has led to the creation of large gaps in several budgets, notably the county’s Mental Illness and Drug Misuse Fund (MIDD) which supports behavioral health services, funded primarily by sales tax.

Although data collected this year has not been finalized, emerging research indicates that the COVID-19 pandemic is raising people’s risk of mental health issues and substance use disorders, but services are not always readily accessible to all.

“On the rise”

By the nature of being an island, Vashon is used to a degree of isolation in normal times, and although part of the charm of living here, resources have been developed to promote harm reduction for islanders, particularly during the pandemic. VashonBePrepared’s Community Care Team operates a crisis intervention helpline staffed by licensed and trained mental health practitioners who are able to identify mental health needs and make referrals to other agencies, anticipating that the need will be greatest between now and December. Members of the island’s Medical Reserve Corps have also partnered with the Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of the U.S. Department of Health and Human Services, on a regional and national initiative to help communities respond to the mental health issues of COVID-19.

Lisa Bruce, Coalition Coordinator of The Vashon Alliance to Reduce Substance Abuse (VARSA), noted that for young people, the Vashon Island School District is now represented by more mental health counselors than in previous years, including a preventive intervention specialist based at Vashon Island High School.

VARSA’s annual community survey is now open through Dec. 15 to track community attitudes about youth drug and alcohol use and mental health. It is available in English and Spanish online.

But for many with substance abuse problems, the pandemic is making it harder to access treatment or support, all vital for relapse prevention and recovery as a whole, said Allison Newman, a Continuing Education Specialist at the Alcohol & Drug Addiction Institute at the University of Washington, during a recent panel event organized by the Washington Recovery Alliance.

The American Medical Association said that since March, 40 states — including Washington — have seen a rise in overdose deaths, a sign that overdoses have not only escalated since the onset of COVID-19’s domination but seem to be accelerating as it progresses.

The risks driving the climb of overdose deaths are many, and are all being compounded by the pandemic, including social and physical isolation — that is, if a person overdoses, someone isn’t there to respond, as people are remaining distant to reduce the spread of the virus. Job loss and shifts in sources of income, loss of housing, and delays in medical care and treatment are also behind the rising overdose death rate.

Without an end in sight, providers have opted for a virtual continuity of treatment and support programs. Telehealth and video conferencing platforms have been quickly embraced as a solution to the need for stable and safe health care as the pandemic wear on and more Americans suffer from mental health and substance use disorders.

But Tom Walsten, the Opioid Use Disorder Clinical Supervisor at Vashon Youth and Family Services (VYFS), said that telehealth may not function well for those with addiction, depending on the person and how they already engage with treatment providers. Meanwhile, the demand is starting to mount.

“There’s no question, substance use disorders are on the rise, people seeking out inpatient treatment are on the rise. Use is on the rise, and mental health issues such as PTSD,” he said. “When we’re going through the things we’re going through right now with COVID, it triggers so many other things.”

Staff at VYFS carry Naloxone and can give it both as a nasal spray and injection and are trained to use it, he added. “The real thing is just getting the word out that we’re here on the island for the specific reason to help people.”

Effective overdose prevention measures go beyond Naloxone, Newman said, including drug disposal and safe storage, opioid use disorder medications, treatment assistance and relapse prevention, primary care and support for the general health of people who use drugs. But access to Naloxone is critical.

“We really think anyone who’s likely to have or witness an overdose should have Naloxone and overdose education,” she said.

Across the state, the number of overdose deaths continues to rise, with most related to fentanyl, an opioid that is up to 100 times more potent than heroin. It’s commonly used to cut other drugs or pressed into pills. Fentanyl test strips can detect the presence of fentanyl in injectable drugs, powders, and pills, and advocates say that equipping such tools along with Naloxone will be critical going forward, as something has to be done right now to curb the growing number of fatalities. The number of deaths caused by fentanyl has been on the rise for some time as health officials have released grim figures in recent years.

According to Conrad Otterness of the Washington State Department of Health (DOH), the rate of confirmed overdose deaths from synthetic opioids in Washington, such as fentanyl, was almost three times higher in the last six months than all of 2017. As of Oct. 19, the state has already surpassed the number of fentanyl-related deaths that occurred last year, up to 343 from 310.

“I’ve got to fix this”

Even before the pandemic, the state’s opioid crisis was escalating out of control. Dr. Kathy Lofy, the state health officer, signed a “standing order” for Naloxone, also known by the brand name Narcan, last year. The order allows the drug to be ordered from any pharmacy in Washington without a prescription from any individual or organization. It’s also available via home delivery.

Wanting to start carrying the medication with her after the death of a friend and witnessing a few close calls, Taylor said that she figured it was going to be easy enough to come by Narcan on Vashon, as simple as calling the pharmacy and asking for it. But she found that the drug was in short supply on the island and potentially out of reach to those without health insurance.

Many plans cover Naloxone, but for people without insurance, one nasal spray kit costs about $177.

“That is groceries for somebody for a whole week,” she said. “If you have three kids or you’re like a four-person household, you know, two parents, two kids, $177 bucks — that’s your groceries for the week.”

“I was like, ‘this is crazy.’ And I said, ‘I’ve got to fix this.’”

Frustrated that Narcan is widely available for free elsewhere across the region, Taylor reached out to the department of health, and on Monday, officially obtained a one-year supply of Narcan kits containing two doses in nasal-spray form from the state through her new 501(c)(3) called Project Narcan Vashon, sponsored by King County Needle Exchange.

The medication will be available at three locations at no cost to islanders, including the Vashon Eagles, VARSA and Euphorium Vashon.

“It all comes down to, where are you and who’s with you? And do they know how to help you?” Taylor said in an interview.

In addition to the distribution sites, volunteers are offering to deliver Narcan to islanders privately any time, day or night, after business hours. While Project Narcan Vashon has to inform the state how much Narcan is distributed or if it has been used to prevent an overdose, the service is confidential and judgment-free. Anyone who asks for the medication will remain 100% anonymous.

“If somebody calls us and we need to get them something at one o’clock in the morning, somebody will get it to them,” Taylor said. “If you’re just looking for the medication, you’re worried, [or] you know a loved one or somebody who’s going to use tonight, we don’t care what time it is. Call us. No judgment. We will come and drop it off.”

The state is also prioritizing education about Naloxone. A volunteer for Project Narcan Vashon will soon be giving virtual demonstrations on how to use spray effectively, and Taylor has recently appeared as a guest at the Jonny Bullets Podcast to discuss what she is undertaking.

So many people have offered support since announcing the project last month that Taylor has more volunteers than work for them to do.

“It’s very obvious that the community needs this and wants this,” she said.

According to the department of health, Naloxone only reverses overdoses; it is safe and has no adverse side effects if given to someone who has not used opioids. Taylor said she believes that educating people about the use of Narcan is as vital as ensuring that the drug is readily accessible if anyone on the island shows symptoms of an overdose or if an overdose is suspected.

“When people don’t know what Narcan is, they don’t understand that it’s safe. Somebody could be having a heart attack, and you can mistake it for an overdose. It is still safe to give to that person. You’re not going to hurt the person by giving it to them,” she said.

Since revealing her plans, Taylor said that she has spoken extensively about her intentions with community members who have misunderstood what the program is for.

“We are not enabling [drug abuse]. We’re not setting up a site where people can come and use,” she said. “The only thing that we’re doing is, we’re setting up a free distribution for medication that will save people’s lives. And there is no stigma involved in anybody carrying that around. There shouldn’t be. Everybody should have it.”

Washington state has “Good Samaritan” laws preventing people who are overdosing, or who call 9-11 to report an overdose, from being charged with drug possession. Go online for more information about King County’s overdose prevention and response work.

More information for helping someone in a crisis is listed below. Dial 9-11 if anyone is in life-threatening danger, trying to harm themselves or someone else.

Stop Overdose

This website is a project of the Center for Drug Safety and Services Education (CDSSE) at the Alcohol & Drug Addiction Institute of the University of Washington. CDSSE provides training and technical assistance to individuals, practitioners and communities in Washington State who want to learn how to prevent and respond to an overdose and improve the health of people who use drugs.

stopoverdose.org

Find Substance Abuse Treatment

If you or anyone close to you needs assistance with a drug use problem, speak to your doctor or call the National Helpline of SAMHSA.

(800) 662-HELP

Or, go to the Mental Health Care Resources Locator of SAMHSA online at findtreatment.samhsa.gov.

Crisis Connections

Formerly known as Crisis Clinic, this agency serves teens, adults and older adults in crisis in King County and greater Washington.

Crisisconnections.org

(206) 461-3210

Washington Recovery Help Line

This is a 24-hour helpline for substance use, problem gambling and mental health challenges.

warecoveryhelpline.org