Pill disaster: Peninsula counties among tops in state per capita opiate deaths

A state Department of Health study found Clallam County to have the highest per capita rate of opiate-related deaths from 2008 to 2010, while neighboring Jefferson County ranked No. 8.

According to the study, Clallam County had 25 deaths attributed to opiate-based painkillers — methadone, Hydrocodone, Vicodin, Percocet and others — or street heroin from 2008 to 2010.

Jefferson County had seven opiate-related deaths during that span, according to the study.

The Clallam County death rate was 11.7 per 100,000 people, and the Jefferson County death rate was 7.9 per 100,000.

King County had the most deaths in the state with 324 deaths but a per capita death rate of 5.6 per 100,000, placing it 16th in the state.

An earlier study by the Department of Health found Clallam County had 42 opiate-related deaths from 2007 to 2009 — again ranking No. 1 in the state — for a death rate of 17.6 per 100,000.

Dr. Tom Locke, public health officer for Clallam and Jefferson counties, said the North Olympic Peninsula is one of two clusters in Western Washington where opiate drug use is particularity high.

The other is Pacific County.

“We’ve long known that we have high rates of illicit opiate use,” Locke said.

“We don’t have hard data, but there is anecdotal evidence of increasing heroin use on the Peninsula.

“The most disturbing thing are the fatalities that are associated with it. This has been a statewide phenomenon.”

Clallam County Drug Court Coordinator Preston Kayes said more and more young people are using methadone, a highly addictive, readily available synthetic opioid used to treat pain and withdrawal symptoms of heroin addicts.

“It’s frightening,” Kayes said.

In Jefferson County, there were 12 opiate-related deaths from 2007 to 2009, the study found.

“Parenthetically, prescription drug abuse is a major problem for most areas of the state, and the rural counties are at a special disadvantage because of a lack of resources to help patients and providers help ameliorate the problem,” said Roger Rosenblatt, a professor and vice chairman of family medicine at the University of Washington School of Medicine, in an email.

Rosenblatt said his colleague, Mary Catlin, was recently on the North Olympic Peninsula to work on a project called Rural Opioid Addiction Management, or ROAM.

The goal is to curb overdoses from prescription opiates by increasing the availability of treatment in rural areas.

“Clallam County partners, including the hospital, health department, tribal clinics, and clinicians have been active on this issue,” Catlin wrote in an email.

“They have instituted drug take-back programs to make sure drugs in medicine cabinets don’t find their way to ‘pharma’ parties of teenagers,” he continued.

“Hospitals and clinicians have participated in more education about safe compassionate use of opioids for persons with chronic pain,” he said.

“Emergency rooms have instituted policies to communicate with primary care providers before they give opioids to patients with chronic pain.”

The state this month launched a prescription drug monitoring database to cut down on cases in which a person gets pills from multiple pharmacies.

Project ROAM is trying to address the 1,899 opiate- and opioid-related deaths that occurred in Washington state from 2007 to 2009, Catlin said.

A third study — by the University of Washington Alcohol and Drug Abuse Institute — that compared figures from 2000 to 2009 found that Clallam County had 16 opiate-involved deaths in 2009 compared with five in 2000.

Jefferson County had three opiate-involved deaths in 2009 compared with none in 2000.

Statewide, there were 722 opiate-related deaths in 2009, or more than double the 344 opiate-involved deaths in 2000, the UW study found.

“This is an alarming trend,” Locke said.

“It’s one that we have been seeing build up for some time.”

Kayes, who works closely with chemically dependant misdemeanor offenders to help them get sober and avoid further legal trouble, said opiate addiction spiked about two years ago.

Clallam County Sheriff’s Office Chief Criminal Deputy Ron Cameron, who heads the Olympic Peninsula Narcotics Enforcement Team, said detectives also have noticed a spike in the use of heroin and opiate-based painkillers in the past few years.

“And this is a statewide issue,” he said.

Cameron cautioned that not all opiate-related deaths are reported.

But he does not dispute the general findings of the studies: that more people are using —and dying from — opiates, either prescription pills or street heroin.

“I look at the numbers they’re citing, and I don’t think it’s very far off,” Cameron said.

“There is an issue.

“There is a clear, physical addition involved in it.”

The recent Department of Heath study found that Clallam County had 148 hospital admissions for prescription opiates in 2010 compared with five in 1999.

In Jefferson County, there were 10 opiate-related hospitalizations in 2010 compared with two in 1999.

Statewide hospitalizations were 4,898 in 2010, and 318 in 1999.

Locke said there are two main factors behind the Peninsula’s high rate of opiate use.

“No. 1 is income,” he said.

“We see higher rates of abuse and overdose in areas of the state with lower per capita income.

“No. 2, I think, is availability.”

“From a public health perspective, it’s a real and pressing issue,” Locke added.

“Opiate addiction and intravenous drug use is associated with a wide range of problems: infectious disease transmission and high death rates.”

Of all the opiates and opioids, Locke said the most lethal is methadone because it is relatively cheap and can build up in a person’s system.

“Methadone is a powerfully addicting drug,” Kayes added.

“And the withdrawal from methadone, as in my experience in inpatient treatment, is it’s more difficult to get off methadone than it is to get off heroin.”

Health officials took notice a few years ago when opiate-related deaths exceeded vehicle deaths in King County, Locke said.

“One of the tragedies of it is that it’s completely preventable,” Locke said.

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Reporter Rob Ollikainen can be reached at 360-417-3537 or at [email protected]

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