Reduced barriers to medications needed to help King County decrease growing number of overdose deaths


Shane Ersland


Better access to medications like buprenorphine, methadone, and naloxone will be key in helping King County officials address the growing number of drug overdose deaths in the area.

Brad Finegood, strategic advisor at the Seattle & King County Public Health Department, gave an update on overdose trends and responses during a King County Board of Health meeting on Thursday. He said the county had over 1,000 deaths related to drug or alcohol poisoning last year.


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“About half of all the overdose deaths were from polysubstance use with a stimulant and opioid,” Finegood said. “These are all actual people, these are community members who have died.”

The county’s overdose data dashboard (which uses King County Medical Examiner’s Office data to compile statistics) also shows that 712 of the county’s overdose deaths in 2022 involved fentanyl. Methamphetamine was the second-leading drug associated with overdose deaths, as it was found to be involved in 528 deaths. 

Finegood said the county’s illicit drug landscape has experienced a change in recent years, largely due to the growing use of fentanyl.

“When we first saw fentanyl coming into our community a number of years ago, it was predominantly in blue pills that were expensive and hard to get,” he said. “Now they run about $1 to $2 a pill. It’s easy to get. Methamphetamine continues to be a significant part of the equation as well.”

The dashboard shows that the county’s American Indian/Alaska Native population has an age-adjusted rate of overdose deaths (a rate that is adjusted to the age distribution of the population) of 293.9 per 100,000 people. This is a continuing trend, as that segment of the population has continued to have the highest rate of overdose deaths in that category since 2014.

“The American Indian/Alaska Native rates are nine times that of our white community,” Finegood said.

The greatest number of overdose deaths occur in Seattle (which also struggles to address lack of housing/homeless concerns), while the number of deaths in south King County continues to rise, Finegood said.

“Homelessness affects it,” he said. “Fentanyl takes away the pain of what’s going on in their lives. It’s about 50 times more powerful than heroin, and is cheap and ubiquitously available to people. It becomes part of what people need due to the significant withdrawals they go through if they don’t use opioids.”

Greater access to different types of housing (particularly low-barrier housing), early intervention strategies, and a variety of treatment options are needed to help the county decrease its number of overdose deaths. Board members asked what city and state leaders can do to help.

“We operate from a deficit-based system with naloxone [access],” Finegood said. “We’re constantly trying to figure out the best place to get it. We don’t ration it, but we have to hedge our bets with it because Narcan is so expensive. People want the nasal one, and it’s so expensive. We’re working with (the Department of Health) on [determining] the true need of Narcan and how to best get it to the community. The other thing we need is more methadone in our community, and more low-barrier methadone access.”

Both methadone and buprenorphine activate opioid receptors to ease withdrawal symptoms and cravings, Finegood said. 

“And people don’t need to take the medications as often as they do with heroin or fentanyl,” he said. “Different people have different recovery journeys. Some people might use buprenorphine as a detox so they can come off it more slowly. It takes a number of people a different number of times of trying medication before they get the right one. We try to make medication access as low-barrier as possible based on state regulations. Some people are able to be stable longer for longer periods of time, but some people cycle in and out [of stability]. It’s important to keep barriers low for people to be able to come in when they want.”