Local medical officials report that calls for service to drug overdoses have tripled in recent months in the Sequim area despite a decline in fatal overdoses in Clallam County last year.
Clallam County in 2022 saw 23 confirmed fatal overdoses, with five more pending toxicology results (28 total), according to Clallam County deputy coroner Nathan Millet.
“It can take three to five months for toxicology [reports],” he said, a delay largely due to lack of available laboratory staffing statewide.
“Those five [decedents] will likely be drug overdoses, barring any surprises from toxicology.”
Millet said the overdoses in Clallam seemed to increase during the height of the COVID pandemic: 34 people died in 2021, up from 19 in 2020.
Of Clallam County’s 28 confirmed/pending fatal drug overdoses in 2022, nine were in Port Angeles, nine in unincorporated Clallam County, and five each in Forks and Sequim.
In Washington state, an unofficial total from participating county coroners/medical examiners’ offices, report that from Dec. 1, 2021 to Dec. 31, 2022, there were 2,378 confirmed/suspected fatal overdoses.
The total isn’t firm, says William Barbour, a project manager with King County Medical Examiner’s Office, as many counties — including Clallam — have pending toxicology results, and their staff voluntarily submit totals when time allows.
“The [Washington state Fatal Drug Overdose Surveillance Network Bulletin] represents the best efforts of Washington State’s medical examiner and coroners to provide fatal drug overdose numbers in a much more rapid time frame than is available elsewhere,” Barbour said.
“The numbers in the report are preliminary and certainly an under-representation of the true totals for the state.”
Of the unofficial total recorded through the bulletin, about 54 percent — 1,286 deaths — included polysubstance overdoses (multiple drugs in a person’s system).
Fentanyl, a synthetic opioid that is 50 to 100 time more potent than morphine, was Washington state’s leading drug for overdose deaths in single substance overdoses and polysubstance overdoses, according to the bulletin.
Tripled calls
Clallam County Fire District 3’s medical services officer Kolby Konopaski says the agency’s medics in recent months are now responding to triple the calls for drug overdoses — from about three in a 30-day period to nine every 30 days in the district’s service area from Bagley Creek to Gardiner.
Konopaski caveats the increase saying the agency doesn’t respond to every overdose call as a person may have died already on scene, or someone on scene administered Naloxone — also known by brand name Narcan — to reverse an opioid’s effects.
“The hard part is it’s not typically just fentanyl,” Konopaski said.
“A few years ago, people were overdosing on low-grade heroin, but now fentanyl is the primary thing mixed with something else.”
When responding to an overdose, Konopaski said local medics were starting with smaller doses of the nasal spray Narcan to reverse opioids’ effects, and now it’s taking three-to-four times that dosage to “turn them around” due to the potency of the drugs people are using.
“Narcan is not as effective as before [because fentanyl has become so powerful],” said Sequim deputy police chief Mike Hill.
Sequim officers conduct about 40-50 death investigations a year in the City of Sequim, Hill said, ranging from an elderly person in assisted living to someone dying of natural causes at home to overdoses.
Along with those, they report to about six to 10 overdoses not resulting in death due to a range of drugs such as fentanyl, he said, to provide life-saving measures in most instances until medics arrive.
“For most cases medics will handle the overdose at the scene or the person is transported to a medical facility,” Hill said. “These differ from deaths we investigate.”
Roulette
“[With fentanyl], it’s playing Russian roulette every time you dose,” Clallam County Sheriff Brian King said.
“Everything has shifted,” he said. “Fentanyl is now the drug of choice, as it’s so much cheaper than everything else and highly potent.”
Local first responders say that illegal fentanyl producers have made it more attractive with multi-colored pills, akin to candy, aimed at teens and young adults.
“It’s a bummer for the community,” Konopaski said. “People have seen stuff they can’t unseen.
“On the social side, it’s really depressing. Families are destroyed.”
Some local first responders say they saw a shift in general with local drug use after Washington Supreme Court’s 2021 State v. Blake case (also referred to as “the Blake decision,” made by the Washington Supreme Court), that overturned drug possession crimes in Washington.
Drug use allegedly became more bold in public, some local law enforcement leaders said.
After the ruling, State Bill 5476 made drug possession a misdemeanor on the third offense, and legislators continue to discuss options, such as the proposed SB, 5035 that would make counterfeit substance drug possessions a felony again.
Hill said that prior to the Blake Decision, local first responders heard some drug users feared prosecution so they didn’t seek help via 9-1-1 for a friend/family member’s overdose. He said they don’t want to penalize people for trying to help someone else in that instance, hence state law protections in place (RCW 69.50.315).
It protects a “person acting in good faith who seeks medical assistance for someone experiencing a drug-related overdose [and they] shall not be charged or prosecuted for possession of a controlled substance” and “a person who experiences a drug-related overdose and is in need of medical assistance shall not be charged or prosecuted for possession of a controlled substance.”
“Fatal overdoses can be investigated as a Controlled Substance Homicide or an Unattended Death,” Hill said.
“We will also request [Olympic Peninsula Narcotics Enforcement Team [OPNET]] investigate these types of crimes as well.”
Recently, OPNET officers have made undercover arrests of people allegedly dealing fentanyl, with cases/trials pending.
Treatment
One solution to partially combat the rise in fentanyl use has been treatment at clinics such as Jamestown’s Healing Clinic, a medication-assisted treatment (MAT) clinic, open since July 2022 in Sequim for locals with opioid-use disorder.
While hotly contested including in court appeals, the Peninsula Daily News recently reported that Jamestown S’Klallam Tribe’s Health Services Director Brent Simcosky said they’ve had no complaints from anyone in the community about operations.
Dr. Molly Martin, the clinic’s executive director, said as of the end of January the clinic had 92 active patients receiving services daily, including medicinal treatment and counseling services.
Jamestown Family Clinic also offers MAT services for opioid use disorder to about 100 patients, but only the Healing Clinic offers daily doses of methadone along with some wrap-around services.
Prior to starting treatment, each patient is drug tested and assessed for a treatment plan, Martin said, and more than 90 percent of patients test positive for fentanyl, and close to 80 percent test positive for another substance, typically methamphetamine.
“The challenge is we have good medicines to treat opioid-use disorder, but no FDA-approved medicines for stimulant-use disorder for drugs like methamphetamine,” she said.
“Generally, stimulants and methamphetamine are dangerous, but with opioids, people are more likely to overdose on that.”
Martin said it is no easy task for patients to combat their disorders, but they try to make the clinic a place where patients feel comfortable.
“The way I look at it, every day a patient comes to us, and are getting treatment, they’re safe,” Martin said.
“It’s such a daily commitment, and we’ve got 92 people doing that.”
Martin said all of their patients live in Clallam and Jefferson counties with 85 of their 92 patients from Clallam County and the rest from Jefferson County.
A small percentage of that total is unhoused from one of the two counties, she said, which isn’t uncommon for any clinic.
She said they rarely have people “gone in the wind” from treatment as “most of the time we’re able to figure that information out easily.”
A social services navigator hired as a condition of the clinic opening set by a City of Sequim’s hearing examiner continues to operate out of Peninsula Behavioral Health in conjunction with Sequim Police.
Martin said a majority of the navigator’s engagement hasn’t been people needing MAT services but for other mental health needs.
A nurse case manager, and several counselors help patients in a variety of ways, she said, such as with housing applications, figuring out transportation needs, and managing doctors appointments.
This frees up the social services navigator, so that they can go on calls with police or make follow-up visits, Martin said.
Narcan
Narcan has not been administered at the Healing Clinic to a patient overdosing, Martin said, but they do make sure each person has access to Narcan as part of the intake process.
“We give them a box [of Narcan] if they don’t have some,” she said. “Some patients have ample supply.”
For some local first responders, they’ve increased purchasing of Narcan with Konopaski saying Fire District 3 didn’t want to face any supply chain issues. King said sheriff deputies carry Narcan in their vehicles, and Hill said Sequim Police Department has it stationed in certain areas.
Sequim Police are evaluating if they want to carry it in every squad vehicle, too, he said.
For more about Clallam County’s overdose totals, visit clallamcountywa.gov/478/Coroner-Statistics.
