In early February 2018, the Washington State House of Representatives passed two measures aimed at reducing the number of opioid overdose deaths. But Representative Dan Griffey, from the 35th District, thinks that the bills don’t go far enough to address the REAL monster. “It’s nowheroin. It really is.”
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The Heroin Threat in the United States
“The scourge of heroin and opioid addiction is one of the most formidable foes I have ever faced in my entire law enforcement career. It transcends across every social status. The tenacious grasp of opioid addiction will destroy families and an entire generation.” ~ Police Chief Jerry Speziale, Hazelton Township, Pennsylvania Representative Griffey is right. In fact, in their 2017 National Drug Threat Assessment, the Drug Enforcement Administration said, “Heroin poses a serious public health and safety threat to the United States.” Between 2002 and 2016, the number of heroin-related fatal overdoses jumped over 500%. Alarmingly, the Centers for Disease Control and Prevention estimates that the true number of heroin-related overdose deaths is under-reported by as much as 30%. The American Society of Addiction Medicine reports that in 2015, there were almost 600,000 people in this country who had an addictive disorder involving heroin. Pointedly, there are more primary treatment admissions for heroin than for any other illicit drug, despite the fact that there are fewer heroin users than there are users of marijuana, cocaine, methamphetamines, or prescription drugs. To understand how dangerous heroin truly is, look at it this way – there are approximately 10 times as many and prescription painkiller abusers than there are heroin addicts, but there are only about twice as many overdose deaths. 11 out of the 21 DEA Field Divisions rank heroin as the #1 greatest drug threat in their area, while another 6 rank it as the #2 threat. Additionally, 44% of law enforcement agencies responding to the 2017 Drug Threat Survey report that heroin is the top drug menace in their area. It comes as no surprise then, to learn that in 2017, a panel of experts in England came to the conclusion that heroin is the most-addictive substance in the world.
The Heroin Threat in Washington State
“I’ve been counting dead people a long time. Nobody really cared. But it’s so in-your-face now. You see people injecting in public.” ~ Dr. Caleb Banta-Green, Ph.D., the University of Washington’s Alcohol and Drug Abuse Institute To say that there is a heroin is part of the opioid problem in Washington state would be an understatement. It is far more accurate to say that heroin is driving the opioid crisis. According to the ADAI, roughly 85% of all opioid-positive crime lab cases involve heroin. In fact, in ALL drug-positive cases in the state of Washington, heroin is the second-most-appearing drug, behind only methamphetamine. ADAI also tracked opioid trends across Washington State by comparing two different time periods, with some rather alarming results: 2002-2004, the Washington State heroin death rate was 0.65 deaths per 100,000 residents, but by 2014-2016, the rate had ballooned to 4.12. This is an increase of 634%. These factors are why the Seattle Field Division of the DEA reports that heroin is the biggest drug threat in the region.
A County-by-County Comparison Highlights the Heroin Crisis in Washington State
“Opioid abuse is an equal-opportunity killer. It threatens all of our children, all of our families, in every corner of this state, at every economic level.” ~ Washington State Governor Jay Inslee ADAI also tracks heroin trends in each of the 39 individual counties in Washington. When comparing the heroin death rates per 100,000 residents in 2002-2004 versus 2013-2015, we see:
- Adams: Remains at ZERO
- Asotin: ZERO versus 1.51
- Benton: ZERO versus 1.24
- Chelan: ZERO versus .44
- Clallam: ZERO versus 5.95
- Clark: 1.25 versus 2.07 (+66%)
- Columbia: Remains at ZERO
- Cowlitz: 1.04 versus 4.16 (+ 298%)
- Douglas: ZERO versus 1.66
- Ferry: ZERO versus 8.67
- Franklin: ZERO versus 1.91
- Garfield: Remains at ZERO
- Grant: ZERO versus 1.42
- Grays Harbor: 1.44 versus 5.02 (+ 249%)
- Island: .9 versus 2.46 (+ 173%)
- Jefferson: ZERO versus 1.08
- King: .71 versus 5.86 (+ 728%)
- Kitsap: .14 versus 3.22 (+ 2208%)
- Kittitas: .94 versus 1.56 (+ 66%)
- Klickitat: Remains at ZERO
- Lewis: .47 versus 1.31 (+176%)
- Lincoln: ZERO versus 3.12
- Mason: ZERO versus 3.75
- Okanogan: ZERO versus 3.99
- Pacific: ZERO versus 4.73
- Pend Oreille: Remains at ZERO
- Pierce: 1.00 versus 3.85 (+ 385%)
- San Juan: Remains at ZERO
- Skagit: .93 versus 3.31 (+ 254%)
- Skamania: Remains at ZERO
- Snohomish: .31 versus 6.38 (+ 1941%)
- Spokane: .70 versus 3.55 (+ 409%)
- Stevens: ZERO versus 3.03
- Thurston: 1.07 versus 1.49 (+ 40%)
- Wahkiakum: Remains at ZERO
- Walla Walla: Remains at ZERO
- Whatcom: 1.51 versus 4.44 (+ 195%)
- Whitman: Remains at ZERO
- Yakima: .15 versus 2.93 (+ 1904%)
In all, 29 out of 39 Washington counties saw an increase, and none saw a reduction in the rate of overdose deaths involving heroin. The statewide increase was obviously driven by the huge spikes in the three largest counties—King (+ 728%), Pierce (+ 385%), and Snohomish (+ 1941%).
Heroin in Seattle and King County
“Like many places across our nation, Seattle and King County are experiencing an epidemic of heroin and prescription opiate use unlike any we’ve seen before.” ~ Seattle Mayor Ed Murray According to the Heroin and Prescription Opiate Task Force, “heroin and opioid use are at crisis levels” in King County:
- Between 2009 and 2014, the number of heroin overdose deaths in King County have tripled, rising from 49 to 156.
- During that same period, the number of deaths due to prescription opioid painkillers has decreased, dropping from 167 to 97.
- Between 2008 and 2015, the number of drug seizures in King County that test positive for heroin jumped almost sixfold, going from 7% to 40%.
- Since 2000, the percentage of people seeking drug treatment who cite heroin as their primary problem has approximately doubled, and now accounts for 34% of all rehab admissions.
- Significantly, people under the age of 30 are the fastest-growing demographic among people needing opioid detoxification. In 2006. 38% of young adult detox admissions were for opioids, but by 2014, it had climbed to 86%.
There is news that is both encouraging at the same time. Between 2000 and 2015, the number of needles exchanged more than tripled, increasing from just over two million to nearly seven million. While this is encouraging from a harm reduction standpoint, it also starkly illustrates the scope of the heroin problem in King County. The City of Seattle has including funding for a safe injection site on its 2018 budget.
Heroin in Tacoma and Pierce County
“It’s time to treat this as a public health issue instead of a criminal issue.” ~ Pierce County Council member Derek Young In early February 2018, the Pierce County Opioid Summit was held. The meeting included firefighters, police departments, city and county leaders, and even congressmen, all gathered together to discuss the best ways to combat the opioid epidemic. Why was such a summit so necessary? Since 2007, treatment admissions for opioid or heroin addiction in Pierce County climbed by well over 200%. In 2007, there were approximately 75 treatment admissions per 100,000 county residents, but by 2017, the rate had more than doubled, to 175. And according to statistics from the County Health Department, it is climbing steeply. Other statistics about heroin in Pierce County include:
- 60% of first-time opioid admissions are between the ages of 18 and 29
- A 2015 survey of participants in local needle exchange programs found that 74% use heroin.
- Pre-2013, Pierce County saw about 5 new cases of hepatitis C per year. By 2016, the number had climbed to 32.
- 78% of cases were intravenous drug users.
- 56% of cases were between 18 and 35.
Of special relevance, alcohol-or-drug-related deaths in Pierce County are at an all-time high. In 2015, there were 871 AOD deaths in the county. In 2005, there were “only” 472.
The Roots of the Heroin Crisis in Everett and Snohomish County
“The opioid crisis is not new to Snohomish County. Ten years ago when I was serving as the Chief of Stanwood, we were beginning to see the effects heroin and abuse of prescription pills were making on our community…As bad as it was then, I could never have predicted was how much worse it was going to get.” ~ Snohomish County Sheriff Ty Trenary Some people are calling the city of Everett the battleground of the war on heroin in Washington State. They aren’t far off—there are numerous homeless camps in the area littered with used needles and other drug paraphernalia. City officials believe that Big Pharma is to blame. In 2017, Everett filed a lawsuit against Purdue Pharmaceutical, the manufacturer of OxyContin. Among other claims, Everett alleges that the drug giant “knowingly, recklessly, and/or negligently” supplied the highly-addictive painkiller to “suspicious” doctors and drug stores. It also alleges that Purdue monitored the illicit distribution of OxyContin, was aware that high volumes of pills were being trafficked, and refused to share this information with local law enforcement. It is estimated that over one million illicit OxyContin pills reached the black market because of Purdue’s inaction. This in turn contributed to the heroin problem, because 80% of heroin addicts start out by misusing prescription painkillers, primarily because of easier availability and a much lower cost. 94% of surveyed heroin users say that physician-prescribed opioids are “far more expensive and harder to obtain”.
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Snohomish County—Ground Zero for Washington’s Heroin Problem
“What’s unique with heroin is that we’re not seeing it decline. We see heroin is continuing to rise…” ~ Cammy Hart-Anderson, Division Manager for Snohomish County Chemical Dependency, Mental Health, and Veterans Services How bad is the heroin epidemic in Snohomish County? Supplies of needle cleanup kits—hand sanitizer, puncture-resistant gloves, protective eye gear, and sharps containers—ran out in just two days and are now on back order. Other heroin statistics:
- Although it has only 10% of the state population, the county accounts for 18% of all heroin-related deaths.
- 2011-2013, 1 out of every 5 fatal heroin overdoses in Washington State happened in Snohomish County.
- In 2013, two-thirds of the county’s overdose deaths were due to heroin or prescription opioids.
- Homeless camps, squatters, and other “nuisance properties” are hotbeds of heroin use. There are over 200 such places in Snohomish County.
- Heroin addiction is closely tied to crime. During one two-year period, May 2013 to May 2015, county burglary rates shot up 80%.
- The County Jail’s medical housing unit is over-filled to over 200% capacity, with 90% of the patients receiving care for heroin or opioid withdrawal.
- Since the County Sheriff’s Office began using naloxone, more than 100 lives have been saved.
What Can Local Communities Do to Fight the Heroin Crisis in Washington State?
“There is not one single solution that will solve the opioid epidemic. It’s going to take all the community partners, public health, law enforcement.” ~ Heather Thomas, Snohomish County Health District A number of applicable ideas came up during the Pierce County Opioid Summit, including:
- Prevention of improper opioid painkiller prescribing;
- Increased access to Medication-Assisted Treatment
- Better access to naloxone
- Referrals to treatment for overdose survivors
- Enhanced educational outreach and awareness campaigns
- Coordination between jail release and outside support systems
- Clean needle exchanges
- Affordable housing
“We accept many health insurance plans. You can get your life back in order with our outpatient program today!”
What Can Individuals Do to Combat Washington State’s Heroin Problem?
There are several actions anyone can take to fight heroin abuse:
- Properly dispose of all unused, unwanted, or expired medications—especially opioids.
- Familiarize yourself with local resources—community agencies, task forces, advocacy groups, etc.
- Report homeless encampments and other nuisance properties.
- Report any suspected drug activity.
- If you have a friend or family member abusing heroin, prescription pain medications, or any other drug, try to get them into a heroin treatment program.
- Learn how to recognize the signs of a heroin overdose.
- Train how to properly administer Narcan/naloxone.
By any measure, heroin abuse in Washington State has become an unprecedented public health crisis that will take cooperation and coordinated efforts from EVERYONE—healthcare professionals, law enforcement agencies, elected officials, community groups, and even individual citizens—if the tide is to turn and lives are to be saved.