WASHINGTON OPIOID CRISIS TRENDS: AN EXCEPTION THAT PROVES THE LETHAL RULE
No mysteries here – as in San Francisco once Washington, late to catch on, got serious about targeted, intensive naloxone campaigns to moderate lethal effects of expert, gold standard treatments, overdose deaths dropped as they have consistently elsewhere
by Clark Miller
Published March 7, 2025
Washington, just across the Columbia River from decriminalization state Oregon, had come to be seen as another liberal, West Coast wayward anomaly while most other states evidenced dramatic, sudden drops in opioid overdose deaths last year or earlier, in 2023.
From an October 2024 report in Stateline –
Despite an encouraging national dip in the past year, overdose deaths are still on the rise in many Western states as the epicenter of the nation’s continuing crisis shifts toward the Pacific Coast, where deadly fentanyl and also methamphetamine are finding more victims. …
Alaska, Nevada, Washington and Oregon have moved into the top 10 for rate of overdose deaths since 2023, according to a Stateline analysis of federal Centers for Disease Control and Prevention data.Meanwhile the biggest one-year improvements were in Nebraska (down 30%), North Carolina (down 23%), and Vermont, Ohio and Pennsylvania (all down 19%).
But then, suddenly, things reversed in Washington, as described in this recent post –
In the dramatic drops over the past one or two years after decades-long mounting opioid overdose deaths, drops established as attributable – more than attributable – to targeted, intensive, direct outreach community naloxone campaigns, the state of Washington has been “late to the game”, woefully and lethally late, remaining through 2023 and into 2024 at or near the top of the few states with seemingly anomalous increases in those deaths as others started seeing relief.
Late to the game in initiating efforts toward the the types of neighborhood level, targeted, intensive campaigns of Narcan distribution and training begun widely in other states years earlier, with examples of dramatic results tied to naloxone as early as 2018 in Ohio and earlier in Utah.
Back to our current post.
Then came a remarkable reversal of years of mounting opioid overdose deaths, only starting late last year, 2024, as heralded in this editorial piece reprinted from the Seattle Times (behind a paywall).
The number of drug overdoses nationwide dropped this year for the first time in 10 years, and the same is true in Washington and King County.
There are many reasons for the decline, experts say, but one overarching reason could be that public entities have listened to those most affected by the crisis and acted. …
In King County, deaths from overdose rose from 344 in 2015 to 1,370 in 2023, according to Public Health — Seattle & King County. The numbers are now trending downward. As of Tuesday, 954 people have died from overdoses in the county this year.
In Washington, the annual number of opioid drug overdose deaths nearly doubled, from 827 deaths in 2019 to 1,619 in 2021. Between 2022 and 2023, Washington had the largest increase in overdose deaths of any state at 40%.
But starting this year, the numbers have dropped. …
Again, from the previous post –
Late is better than never, and preliminary results of increases in free, more accessible naloxone are in evidence as downward shifts in OD deaths over the last quarters of 2024.
For Kitsap County, as reported in May of 2024,
On a single weekend day within the past month, staff at the Salvation Army shelter on Sixth Street shelter in Bremerton responded to seven overdoses, Lance Walters said.
With the increased use of fentanyl — a synthetic opioid 50 times stronger than heroin — overdoses have become a near-daily reality for staff.
“It’s a regular thing,” said Walters, a Salvation Army captain. “[Overdoses] happen so often, I don’t know if anyone is really keeping a tally.”
As overdoses reached record highs last year, public health officials plan to place over two dozen cabinets, stocked with the life-saving medicine naloxone, throughout Kitsap, Jefferson and Clallam counties.
and accuratedly concluded in that report, that
Those results are likely an undercount. They only reflect incidents requiring an EMS response and many nonfatal overdoses go unreported, health officials say.
And back to our current post.
As we saw in a recent post for another U.S. West Coast locale, in San Francisco, California, high-risk use and deaths mounted persistently as increasing amounts of street currency (also known as “buprenorphine”, “Suboxone”) for fentanyl were dispensed to high-risk users, deaths suddenly dropping only with the initiation of “dramatic”, effective naloxone distrubution as harm reduction against gold standard “treatments”.
Washington had been predictably, over the course of its worsening opioid crisis, “well above average” in its dispensing of the prescribed substitute opioids persistently fueling the crisis.
That level in Washington of dispensing to high-risk users the street currency for fentanyl,
without, until very recently, the implementation of an effective, emergency naloxone campaign as harm reduction against that practice,
along with other important patterns and trends, described in detail in this post,
will become increasingly revelatory as the real forces driving epidemic are exposed, along with the deceptions keeping them hidden.
That is, opioid crisis trends in Washington are no mystery,
instead fit the consistently affirmed pattern of moderation of fatal overdose rates tied to persistently mounting high-risk opioid and other drug use fueled by failed, lethal expert treatment approaches, once effective, targeted, community based naloxone campaigns are in place, desperately required as harm reduction against those gold standard treatments.
Consistently, the magnitude of numbers of increases in naloxone reduction of fatal ODs more than accounts for magnitudes of reductions in deaths.
There is no need for expert magical thinking, for evidence-free rationalizations or for mystification that avoid established truths in order to attempt to protect from accountability decades of malfeasant practices, perpetuating epidemic.
