By Danny Westneat
The Seattle Times
SEATTLE — If you walk downtown these days, especially along the complicated stretch of 3rd Avenue around Pike and Pine, you’ll see plenty of drug use going on.
People crouched in doorways with pipes and foil or bent over post-smoke at 90 degrees. All acute signs of the ongoing fentanyl epidemic.
Same with Little Saigon, where the presence of cops pushes the crowds off 12th and Jackson, but often to regather only a block or two south.
Mikel Kowalcyk sees all this too, on her rounds as a street outreach worker. But she also sees, or maybe feels, something new: a shift in direction.
It’s just not as intense as last spring and summer, she says, when the sirens of 15 overdose calls per day kept a constant sense of crisis hanging in the air.
“It’s easing up a bit, that’s how it feels,” the coordinator for REACH told me. “I’m not saying we’re out of it; not even close. But it does feel like we finally hit a peak or a plateau.”
That’s what the data shows. Overdose calls in Seattle have finally gone down, by 13% in the first six months of 2024 versus last year. More recently, the picture looks even better. For the second quarter — April, May and June — overdose calls were down 24% compared to the second quarter of 2023.
In June, Seattle Fire Department medics responded to 253 overdoses. That may sound like a lot. But it was the best month in nearly two years.
Last June there were 386 overdoses. The worst months were all last spring and summer, twice topping 430 — right as the Seattle City Council was divided and stalled over what to do.
“We are definitely down from the peak of last year,” said Jon Ehrenfeld, manager of the department’s mobile health team. “We’ve still got unacceptably high levels of drug abuse. But we feel like we aren’t scrambling from behind quite as much.”
Did something work?
Officials say there’s little doubt that the availability of the overdose treatment Narcan has helped. It’s permeated the culture. At some homeless encampments, I’ve seen makeshift cardboard signs advertising “Narcan available here.”
“We’ve absolutely flooded the streets with Narcan,” Kowalcyk said.
She suspects that when someone gets revived via Narcan administered by friends or onlookers, maybe no one ever calls 911. They still should, but perhaps this explains some of the reduced call volume.
Others said it’s gotten easier to get opioid medications such as methadone or buprenorphine.
Evergreen Treatment has a mobile methadone van in Belltown, and next week is launching a new one in Pioneer Square . In February, the Seattle Fire Department paramedics got permission from the state to give buprenorphine at the scene of an overdose.
The medicines help with cravings and withdrawal symptoms. They aren’t cures. But any day someone addicted to opioids uses one of these is also a day they’re less likely to overdose or die.
Now sober from addictions herself, Kowalcyk said the wider availability of these medication-assisted treatments is a best guess of what’s working.
“I’ve never met anyone yet who has said ‘I just love smoking fentanyl,’” she said. “They all desperately want to get off it. But they struggle so. They’re so addicted.”
It’s also possible the controversial new public drug use ordinance has helped. The mayor’s office says that through mid-June the police had made 355 arrests, with 53 of those booked into jail (only for other crimes, such as illegal gun possession). The vast majority were referred to counselors with the Law Enforcement Assisted Diversion program, LEAD, where 174 had signed up for further visits.
It isn’t known whether this had any effect on fewer overdose calls.
“Unfortunately, you’re probably not going to get a satisfying answer to the question of ‘why?’ ” Ehrenfeld said. “The honest answer is: We don’t know.”
It also could be the fentanyl scourge is simply peaking on its own, as drug epidemics often do.
In the first half of the year, there were roughly a hundred fewer fentanyl deaths countywide, 420 confirmed as of Tuesday, versus 553 in the same six-month period last year. This year’s data is preliminary. The trend might not last, but crucially, fentanyl deaths have now dropped three-quarters in a row.
Washington has been one of the worst states for rising deaths, according to the Centers for Disease Control. With the improving Seattle and King County data, that should soon turn around.
This “shadow epidemic” has been one of Seattle’s worst public health debacles. More Seattleites died of drug overdoses in a single year in 2023 (763) than have died of COVID-19 in the city during the entire four years of that virus’ run (750 total COVID deaths).
Add in the nexus of mental distress, homelessness and crime, and the drug crisis has been a disaster for the city. Most disappointing is that city and state politicians didn’t meet the challenge with anywhere near the needed sense of urgency. They dawdled, riven by ideological differences, for the two years when it was all escalating the fastest.
But that doesn’t change that things finally are trending the right way. Even if no one is quite sure why.
As Ehrenfeld told me: “Last year was a very tough time for this city. What’s starting to work in our favor? We don’t know for certain. But we’ll take it.”
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