FORKS — Infamous for its high death rate from heroin overdoses, Clallam County is receiving positive attention for how it fights opioid addiction and its fatal consequences.
When it added drug counseling to its syringe-exchange program last summer, “we were told we were crazy to do that,” said Christina Hurst, public health programs director for the county Health and Human Services Department.
“Now it’s the wave of the future,” she told members of the county Board of Health who met Tuesday in Forks.
“It’s not the Seattles and Tacomas of the world; it’s the smaller communities that have citizen action programs and proactive health departments.
“A lot of people are watching us.”
Public hearing
To that end, the Board of Health set a public hearing Nov. 17 on Health Officer Dr. Christopher Frank’s request to require doctors, first responders and hospitals to report opiate overdoses to county health authorities.
The board also asked Clallam County commissioners for $40,000 to replace injectors of naloxone, which can reverse an overdose long enough to seek complete medical care.
During the reporting period 2012-2014, the state’s death rate from opioid overdoses was 8.4 per 100,000 people.
Jefferson County’s rate was 9.7 per 100,000, while Clallam’s was 14.3 in 2013, according to state Department of Health statistics and to Dr. Jeannette Stehr-Green, a member of the Board of Health.
The board’s first measure would place overdoses — survived or fatal — in the same reportable or notifiable category as communicable diseases like measles and syphilis.
Frank’s purpose for the designation is to gather information on overdoses more quickly and accurately.
The state Department of Health will aid in storing the data, he said.
“The state would like to use Clallam County as a test case for opioids and will give space in its database,” he said.
Hurst said reporting overdoses “will have a trickle-down effect, and other agencies will adopt it across the country.”
A future part of Frank’s campaign would be “a countywide opiate-management plan,” he said, “to reduce the pipeline through judicious prescribing practices.”
Many opioid addicts start taking painkillers like oxycodone with doctors’ prescriptions, become addicted, and switch to heroin because it is cheaper, Frank said.
Beyond abstinence
He also called for public treatment options besides abstinence, which he called “less efficient than medication-supported programs.”
The drug Suboxone,cqfor instance, can help opioid addicts quit their habit without wrenching withdrawal symptoms.
Naloxone may save lives “but that’s the worst-case scenario,” Frank said. “All the other problems are upstream.”
Naloxone, however, remains one of health authorities’ best weapons besides prevention and treatment — and Clallam County is running short of it.
Hurst said the $40,000 additional allocation would replace the 85 Evzio auto-injector kits the county has distributed through its Syringe Services exchange.
Nine of the kits have saved lives, according to Hurst, with Port Angels police saving five more lives with Evzio injectors.
Auto-injectors
Clallam County’s first 100 auto-injectors were donated by their manufacturer.
Replacing them will cost $400 each, although the county may receive a price break through a federal drug clearinghouse.
The auto-injectors come with self-contained recorded insructions and can be administered through clothing into an overdosed person’s thigh.
The injection reverses overdose symptoms for 20 to 90 minutes while medical treatment can begin.
County Administrator Jim Jones has dropped naloxone from his proposed 2016 budget.
Commissioners Bill Peach and Mike Chapman, who also serve on the Board of Health, voted for the request.
Chapman warned that he might vote differently as a commissioner than as a member of the Board of Health.
Chapman, Peach and Commission President Jim McEntire will meet with Jones on Tuesday to discuss budget items. McEntire, also a member of the Board of Health, was excused from last week’s meeting.
Via nose or needle?
At Chapman’s sugestion, the board’s request also will examine less costly naloxone systems such as a nasal spray or a standard syringe that must be filled from a vial.
The Evzio injectors were the county prosecutor’s office choice when it evaluated the various methods for their liability/
The Syringe Service exchange each year assists up to 800 opiate and methamphetamine users who bring used needles to the public health clinic, 111 E. Third St., Port Angeles, and exchange them for new syringes.
Burks said the program has reduced cases of hepatitis B, hepatitis C and HIV, blood-borne pathogens that can be spread by addicts’ sharing syringes.
600 more inquiries
Frank said the Washington Poison Center in Seattle also had received 600 queries about opioid overdoses in 2014 from Clallam County, most of them in addition to people who get aid from first responders or hospitals.
Private groups have joined efforts against heroin. They include the Port Angeles Citizens Action Network — PA CAN — and the Hope After Heroin group of teenagers recovering from addiction.
About a dozen of them, some of their parents and a pair of unaffiliated volunteers policed the Laurel Street stairs and alleys in downtown Port Angeles on Friday afternoon to pick up syringes.
Similar cleanups will start at 12:30 p.m. Thursday along Benson Road south of U.S. Highway 112; at 11 a.m. Friday at Lincoln Park; and at 9 a.m. Nov. 14 along Peabody Creek.
‘We are the leaders’
Hurst, Frank, Burks and others also look forward to a day-long program Dec. 1 at Olympic Medical Center where they will examine Clallam County’s present and future health-improvement programs.
Participants will include members of the University of Washington Alcohol and Drug Abuse Institute, which has conducted summit meetings on opioid addiction.’
“We want at the end of that meeting to have a plan of things that actually can be accomplished, to make an impact on the opioid problem,” Hurst said.
The university’s presence, she said, will be a measure of how Clallam County is being viewed as a pioneer in fighting drug addiction and death.
“We are the leaders,” Hurst said, “in the state of Washington.”
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Reporter James Casey can be reached at 360-452-2345, ext. 5074, or at jcasey@peninsuladailynews.com.
