Up to 80,000 in county may be misusing pills and narcotics
EVERETT — The hush was palpable as health officials and government leaders took in the fact that up to 10 percent of the county may be misusing opioids.
Dr. Mark Beatty, health officer of the Snohomish Health District, had the podium.
The numbers he compiled, by reading patient data case by case and extrapolating the size of the crisis countywide, are staggering.
While treatment has kept more users alive, the number of those using continues to increase.
Between 35,000 and 80,000 people in Snohomish County are estimated to be taking too much of their prescription, using it for the wrong reasons, using an illicit opioid like heroin, or using someone else’s pills.
Between 5,000 and 10,000 people have full blown opioid use disorder that drives users to seek more and more of the drug, Beatty said.
Beatty’s Jan. 8 report laid out the progressive nature of what he explained repeatedly was “not a moral failing” but a disease that causes damaging changes to brain chemistry.
Those with the disorder continue use despite worsening physical and psychological symptoms. And if and when they try to stop, illness and even death can result from the withdrawal.
Assembling the data took a creative approach, because less people are dying from opioid misuse now that Naloxone, a nasal spray that counteracts overdoses, is more widely used.
Deaths have leveled out during the past five years. After 145 opioid-related deaths in 2011, the loss of life continued but numbers dipped, then stabilized. In 2017, 100 deaths were reported. In 2011, more than two-thirds of the deaths were from prescription opioids such as oxycodone and morphine.
But by 2017, deaths from prescription opioids and heroin were split almost evenly, and deaths from ultra-potent synthetic opioids such as fentanyl were rising.
“Following deaths” won’t help assess the burden the disease is causing, Beatty said. He noted that in Snohomish County “we’re actually ahead of the game”
compared to much of the country where deaths are still rising.
So to track use, Beatty turned to a “capture-recapture” data collection protocol used originally to track elusive wildlife, then adapted by the Centers for Disease Control.
The scope of the crisis was extrapolated from 911 calls, data from emergency room and other medical center visits, a syringe exchange study and other sources.
The findingsw: tens of thousands of people are suffering. Knowing how many paves the way to providing proportionate resources, Beatty explained.
Snohomish County isn’t unique. Data shows that between 2012 and 2016, about 12 people per 100,000 died here of opioid overdoses.
Fifteen Washington counties had death rates of 10 or more people per 100,000. In King County, the number was 9 percent, in Skagit, about 11.
The Health District has laid out a few key tasks it considers worthwhile. They include refining the estimate of people who are open to treatment, figuring out how much treatment of any type is available, and whether there is a gap between demand and supply.
The study showed that a person’s interest in treatment varied greatly depending on where the question was asked: Only 23 percent of people transported to a hospital for an overdose said they were interested, but 78 percent of those using a syringe exchange expressed interest when asked.
The results were released at the Jan. 8 Board of Health meeting.
Board chair Adrienne Fraley-Monillas, who is also an Edmonds City Councilwoman, said the board of elected officials needed time to process the findings. “This is quite big and has a whole lot of ramifications.”
The board will identify the next steps at a future meeting.
The Snohomish Health District board meets on the second Tuesday of every month at 3 p.m. in the first-floor auditorium of the district headquarters at 3020 Rucker Ave. in Everett.
The report is online at www.tinyurl.com/SHDopioids
