Wash. county first responders say more resources needed to combat fentanyl

Experts in Yakima County say the number of fentanyl users and the amount of pills consumed are increasing

By Santiago OchoaYakima Herald-Republic

YAKIMA COUNTY, Wash. — Yakima County officials, substance abuse experts and law enforcement all agreed the county needs more resources to handle the fentanyl epidemic during a Friday round table discussion convened by U.S. Sen. Maria Cantwell.

Cantwell spoke in support of the Fentanyl Eradication and Narcotics Deterrence (FEND) Off Fentanyl Act, a bipartisan bill proposed by Republican Sen. Tim Scott of South Carolina. The bill aims to curb drug trafficking in the United States and the money-laundering efforts that fund the criminal organizations responsible for fentanyl production.

"We want a federal response because this problem is just increasing and out of control," Cantwell said to start the conversation. "We need more help. We need people to understand that just one pill can kill people."

She said while the FEND Off Fentanyl Act would be a big step toward diminishing the presence of fentanyl in communities across the U.S., communities need resources to break up drug trafficking operations and to promote the well-being of residents struggling with substance abuse.

Cantwell said the median price of a fentanyl pill in Yakima County has dropped to $1.35. At the same time, the presence of the drug continues to grow, she said, citing a single Yakima County drug seizure last year that turned up more than 120,000 pills laced with fentanyl.

Cassidy Leslie, Triumph Treatment Services' residential clinical director, recalled the first time she met a patient seeking help getting off fentanyl back in 2019. She said the time, that patient was the only one of 140 served that month, less than 1% of all patients, who used fentanyl as their drug of choice.

Earlier this month, Leslie said the number of patients seeking help with their fentanyl addiction accounted for more than half of all patients.

"I recently pulled data just from two weeks in August at our five inpatient treatment facilities," Leslie said. "At an average rate, 55% of our patients are in treatment because of fentanyl use at any given time."

In addition to the number of fentanyl users going up, Leslie said the amount of fentanyl consumed by users has risen too. When she first started treating patients who used the lethal drug, Leslie said they were reporting consuming two to four pills per day. She said that number now sits above 20 or 30 pills per day.

Due to the illicit nature of drug production, the concentration of fentanyl in each pill can vary greatly. This means users don't know if a pill they're taking contains a lethal dose of the drug.

"It's really important to start talking to individuals about the risk of overdose," Leslie said. "Just because maybe you are using so many pills a day your body has become used to that, it doesn't mean your body can tolerate it. All it takes is one pill to take your entire life."

Leslie praised Yakima County for bringing together different subject matter experts to discuss the issue, saying in her experience, that's not the case for other communities.

She said organizations in the field of substance abuse like Triumph and Comprehensive Healthcare should promote more outreach efforts outside of standard 9-5 operating hours.

Other attendees stressed the importance of understanding the strength of chemical dependency and how while it can be overcome, it does not go away.

David Elofson is a retired Yakima County Superior Court judge who oversaw the county's drug court for seven years. There, he worked with defendants who could choose to go into substance abuse treatment and have their charges dropped.

"Most people, addicts and non-addicts, don't understand the power of addiction," Elofson said.

He motioned to Tina Logan, a resident of Thorp in Kittitas County who relapsed in her 40s after 13 years of sobriety and who was present at the discussion.

Both she and Shondra Wells, a Yakima resident, said the stigma around drug use and addiction, paired with the power of addiction itself, led them to hide when they relapsed.

Yakima County Sheriff Robert Udell said Narcan, a drug that can reverse opioid-induced overdoses, is an effective tool in preventing fentanyl-related deaths. He said the county needs more Narcan.

Udell said the first time he heard of Narcan being used to stop an overdose in Yakima, the effectiveness of the medicine was "a big deal."

Now, he said deputies administer Narcan almost daily, to the point where high use, low supply and a tight budget are making it hard for the sheriff's office to keep the medicine stocked.

"We thought we'd have like 300 fentanyl deaths in the county this year. But we're not," Udell said. "Only because we're so good at using Narcan and the deputies are wearing them on their belts. ... We've got to have Narcan available to first responders."

Udell said there have been times when deputies have had to resort to going through programs that offer limited numbers of free doses of Narcan to maintain their supply.

On the law enforcement side of things, Udell said the county needs more money to properly go after the drug-trafficking operations set up in Yakima County that are distributing fentanyl not only to the local community but to towns and cities across the Pacific Northwest.

"The cartel is here in Yakima County. They have sunk down roots," Udell said. "We need the resources to drive them back."

Yakima Fire Department Chief Aaron Markham said firefighters responded to nine overdose calls in the city last week. He said the fire department has also been burning through its stock of Narcan.

Because of the high tolerances users can build, it is common for firefighters to administer two doses of Narcan for one overdose. He added that because of fentanyl's ability to linger in the body, the effects of Narcan, which only lasts about a half hour, go away and users can go back into an overdose.

Markham said the use and potency of fentanyl are so pronounced that he can tell when it's payday for users or when there is a particularly lethal batch of fentanyl going around based on spikes in overdose calls.

"Today is the 25th, so sometime around now or in the next couple of weeks when people have more money in their pocket, the overdoses start to spike," Markham said. "We can tell when a batch of fentanyl coming through the Valley is super strong, we'll just see case after case after case."

Safe Yakima Valley Executive Director Alicia Stromme Tobin said in addition to a stronger focus on treatment, harm prevention and law enforcement, drug use prevention needs to be a priority.

She said putting more resources toward preventing drug use can save money down the line when it comes to expenses related to substance abuse treatment and the use of law enforcement resources.

"Prevention is the one that is invoking group changes and community changes," Tobin said. "On average it costs $263 per individual to raise awareness. Then you start getting into treatment and reentry services, which obviously are needed, but obviously, we want less need for that, you're getting to six to seven million dollars per person."

Ideal Option's lead nurse, Emily Moore, said a shortage of healthcare workers and a lack of facilities to treat patients with substance abuse issues is adding to the difficulty of keeping drugs off the streets and out of people's bodies.

"That's one of our hugest barriers, is being able to get people into treatment," Moore said. "So right now, when we call for a detox bed, they'll call back in two or three hours. Well, an individual is going to become uncomfortable by that point and they're going to do what they know how to do, become comfortable again, which is using substances."

Udell was one of the last people to speak.

"The common theme on all of this is resources," Udell said. "At all different levels. A couple of years ago I was giving a presentation about drug issues and mental health and how they're all linked and I was talking about how expensive it is to truly have a solution. ... We need more beds, and we have to have long-term care and housing. It's going to be expensive."

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