‘Fentanyl is all over in our society’: The front line fight against substance abuse and overdoses

SEATTLE — It’s an issue we see across our region: substance abuse wreaking havoc on people’s lives.

Now, we’re giving you a look at the fight on the front lines.

Washington state has spent more than $100 million fighting substance abuse and supporting mental health. But at a time when the opioid epidemic is stronger than ever, the question is: are these efforts making a difference?

Here’s a look at the numbers.

Last year, Snohomish County reported 198 deaths — that’s double what we saw just five years ago.

In Pierce County, overdose deaths quadrupled between 2019 and 2021.

In King County, deaths traced to fentanyl have exploded. We’re seeing numbers seven times what they were just three years ago.

We went straight to the front line of this epidemic to see how some of the programs meant to turn things around are working.

At fire station 20 in Lakewood, Paramedic Matt Heller gives us the lay of the land.

“The reality is that fentanyl is all over in our society, and people are overdosing in the city, in the suburbs. It affects it can affect every family,” explained Heller.

Pierce County Fire and Rescue launched a stay-at-home NARCAN program. Started in May of 2022, the initiative is designed to give anyone the power to save a life when an overdose happens.

“We’re afraid that someone will go to a party, take a pill, and they don’t even know what they’re taking. And then you don’t want that person to just go to sleep in the corner of the room,” said Heller. “That’s how people die from a fentanyl overdose. They stop breathing. NARCAN can stop that.”

From 2019 to 2022, the use of NARCAN in Pierce County nearly doubled. Data shows the county expects the number to triple by 2024.

“It’s the only medicine I carry at the front of the rig,” is the way West Pierce Fire and Rescue Paramedic Adam Catterlin explains how the fentanyl crisis has changed his day-to-day operations.

The Seattle Fire Department’s Health One Unit is fighting the same fight but with different tools.

Health One deploys case workers alongside firefighters to meet the needs of the city’s most vulnerable.

“We are a response and a follow-up service. We provide services for people who are in crisis, in social distress, dealing with chronic or long-term medical issues or who have immediate acute episodic needs,” explained Program Manager Jon Ehrenfeld.

They’re also seeing the impact of the fentanyl and overdose crisis and how it’s stressing every part of our healthcare system.

We’re seeing just a huge spike in the number of overdose responses that we’re attending to, as well as generally people struggling with opioid use disorder, even if they’re not overdosing. It’s cascading down on ambulances, on ERs, on mobile integrated health services such as ours,” explained Ehrenfeld.

Seattle — King County Public Health says the low price and potency of fentanyl make it especially dangerous. In January, Seattle Fire reported responding to a historic number of overdose calls: 5,200 in the past twelve months. A 40% jump in overdoses between 2021 and 2022.

Catterlin sees it all the time, but his job goes far beyond responding to overdose calls.

While riding with paramedics, we were called to an area hotel for a woman suffering from abdominal pain while recovering from surgery.

According to Catterlin, the woman didn’t need paramedics. She needed to be in a facility that could help her with her bandages and pain management.

“That’s a big part of our job. Honestly, we’re working as part counselor, part psychologist, psychotherapist. And a lot of times, it’s just that someone that’s lonely. They don’t know how to solve their own problems,” Catterlin explained.

While shadowing Seattle Fire’s Health One, we went to a call for a man lying on the ground along Third Avenue. He couldn’t stand or walk and was in obvious pain. To protect the man’s identity, we can’t say what exactly was wrong or why he needed treatment. The man declined help from firefighters several times. Health One’s case worker decided it was time for him to seek treatment before things got worse, so Seattle police and an ambulance were called for an involuntary intake and sent him to Harborview Medical Center.

“We saw a very vulnerable person who was not ambulatory and in needing to be evaluated by a doctor, and initially was reluctant to go but medically needed to go. And so we convinced him to go and got him up to the hospital in a compassionate, caring way,” explained Seattle Firefighter Roger Webber.

We asked Webber if this involuntary intake was the best possible outcome.

“Yes. Yes. I would have liked to have taken him sooner, but he was moved with compassion, and he was not in trouble. That is the best result. And I can tell you, my 20-plus years in the fire service, it didn’t always, wasn’t always like that. And so I’m glad we kind of got a new model to work with,” Webber said.

Here’s what we all need to know — paramedics we met with say every household needs to keep NARCAN at home. And talk to kids and family about overdoses and drugs. Middle school is not too young to have this conversation, as kids younger and younger are being exposed to potentially deadly drugs.