Embrace new ideas to triage WA’s fentanyl epidemic

Fentanyl, a drug whose life-threatening high sells in Washington for less than $1 a dose, is on pace to claim more than 1,000 overdose deaths this year in King County alone.

Investments are urgently needed, yes, but so are solutions that will provide triage in a state with the biggest percentage increase of fatal overdoses in the nation — 21%.

On Monday, Gov. Jay Inslee visited an Everett clinic to discuss his intention to spend about $50 million more to help combat the opioid epidemic. Treatment experts, first responders and others contributed ideas . Dr. Michael Sayre, the Seattle Fire Department’s program director, suggested a possible new protocol: What if medics could immediately administer a drug to quell patients’ withdrawal symptoms promptly following their overdoses?

Currently, Sayre said, responders administer naloxone to reverse the opiate’s effects. Yet many don’t stick around for further help.

“Half of the people then refuse further care and walk away,” said Sayre, whose department responds to as many as 20 drug overdose calls each day.

Also administering buprenorphine would quell opiate withdrawal symptoms for a time — an intervention that might make someone more amenable to beginning a treatment program.

But Sayre and others say they need clarity from lawmakers to start a pilot program. Inslee was interested in the idea.

“It may be the only way we can get them to start treatment,” said Caleb Banta-Green, a University of Washington scientist who has been studying opioid use disorder for 28 years.

But he noted that it’s only a start — just as the lifesaving drug naloxone was once far less available to stop overdoses, the use of buprenorphine should become more ubiquitous to help people struggling with opiate addiction to stay away from fentanyl.

“It’s going to take an entire continuum of care,” he said.

Inslee and the Legislature, with help from those at the federal level like Sen. Maria Cantwell — who held roundtables this summer and has worked to pass meaningful legislation on the topic — must continue to be vigilant in finding ideas like Sayre’s and paving their way with tweaks to state law, if necessary, and funding.

It will take all levels of government — and every good idea we have — to end this epidemic.