Health Alert: Increased Number of Opioid Overdose Events Across Washington State

This is a Health Alert from the Washington State Department of Health (DOH) regarding a statewide increase in opioid overdoses in Washington.

Current situation in Washington

Public health partners should be aware that the Washington State Department of Health and our health care partners have noted an increase in opioid overdoses across the State of Washington in recent months. This is apparent in statewide data for both opioid-related Emergency Medical Services (EMS) responses as well as Emergency Department (ED) visits for presumed opioid overdoses. A sustained increase in overdoses began in August of 2024; overdoses have continued to increase through October 31, 2024. This increase in overdoses reverses a downward trend of the number of reported overdoses across Washington that began in July 2023. 

Local public health jurisdictions (LHJs) and Tribal Health Partners should be aware of recent increases in opioid-related overdoses and should work with community and health care partners to inform residents who use drugs or may be around people who use drugs. While we do not yet understand why opioid overdoses are increasing, timely communication with community members who may be at increased risk for overdose is important and may save lives.

Actions Requested

LHJs, Tribal Health, and other community and health care partners should consider the following actions:

  • Inform community members who use drugs and others who may be around people who use drugs of the increase in opioid overdoses. The reason for this increase remains unclear, but one possibility is that we are seeing opioids that are either more potent or combined with adulterants. 
  • Facilitate access to naloxone. Naloxone (sometimes known by the brand name NARCAN®) can help to reverse opioid overdoses. Anyone who may be at risk of an overdose or witnessing an overdose should be provided naloxone and taught how to use it. Naloxone is available over the counter at most pharmacies, it can be prescribed, and it is covered under a statewide standing order. Naloxone is also covered by AppleHealth (Medicaid) and many other health coverage programs. Learn more about naloxone on the Overdose Education and Naloxone Distribution web page.
  • Facilitate access to treatment. Medication treatment of opioid use disorder (MOUD), such as buprenorphine and methadone, reduces both all-cause and overdose-related mortality in people with opioid use disorder. The Washington State Recovery Help Line can be used to help connect people to these services.
  • Encourage harm reduction strategies. People who use drugs should be counseled on the current risk and on harm reduction strategies that can help to reduce overdose risk. Share these harm reduction strategies with people who use drugs. Avoid stigma and judgment in these interactions so people are more receptive to these important strategies:
    • Carry naloxone and ensure that people know where it is kept.
    • Use with someone who can administer naloxone and call 9-1-1 if an overdose occurs.
    • Be aware that Washington’s Good Samaritan Law provides limited protections against drug possession charges when calling 9-1-1 to save a life, even when drugs are at the scene. 
    • Ensure that your phone is charged.
    • Start by using a small amount to test the potency of the drug.
    • If someone is going to use alone, consider utilizing the Never Use Alone hotline (877-696-1996).
    • Naloxone takes about 3 minutes to work. Give a second dose if a person has not responded after 3 minutes. 
    • Because Naloxone can wear off before the opioids in a person’s system does (meaning that even if the person responds, they can go back into overdose), we recommend:
      • Evaluation by health care professionals in an ED after an overdose response.
      • If people do not accept 9-1-1 transport for monitoring, it is important that someone remain with them and have another dose of naloxone on hand.
      • WA DOH has a webpage on Naloxone which includes Overdose Response Instructions in multiple languages. 

Background

Opioid overdose is a serious public health crisis in Washington and across the United States. Opioids are a class of pain-relieving drugs that include oxycodone, morphine, fentanyl, heroin, and other prescription medications and illicit drugs. An overdose occurs when a toxic amount of drug, or a toxic combination of drugs, overwhelms the body. Overdoses can cause serious health effects, including death. Opioids are now the cause of about 75% of the fatal overdoses that occur in the U.S. each year, and more than 90% of opioid overdose deaths are due to fentanyl.

In 2023, there were more than 2,800 opioid-related deaths in Washington state and more than 81,000 opioid-related deaths in the United States. Communities across the state of Washington have been impacted by this epidemic. Access to treatment, which has been demonstrated to reduce mortality by 50%, remains challenging for many Washingtonians. The Washington State Department of Health, Health Care Authority, LHJs, Tribal Health Partners, as well as community groups and health care partners continue to work on ways of addressing this issue.

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