UW drug abuse survey shows surge in fentanyl as King County sets record for overdose deaths


Fentanyl use has increased in King County and across the state at an alarming rate, according to a new investigation by researchers at the University of Washington.

Of those surveyed at syringe service sites last fall, 42% said they had used the synthetic opioid in the previous three months, up from 18% in 2019.

And this is a potentially deadly trend.

Fentanyl-related deaths more than doubled in King County last year, reaching 388, according to the Office of the Medical Examiner.

Meanwhile, the county set a 2021 record for total drug and alcohol overdose deaths, with at least 709 (11 more are still listed as pending). The previous record, set in 2020, was 511.

“I’ve been researching drug trends for 20 years, and the growth of fentanyl is the biggest, fastest change we’ve ever seen – and also the deadliest,” said the UW researcher. Caleb Banta-Green in a press release this week.

In an interview on Wednesday, he called the overdose numbers “striking to me as a human being, a Seattle resident, and an epidemiologist.”

Banta-Green is the principal investigator at UW’s Addictions, Drug & Alcohol Institute, which conducts a biennial survey of needle service sites.

Nearly 1,000 people took part in the 2021 survey, conducted in September and October at sites in 20 counties. They included people using drugs for various reasons, at various levels.

Most participants in the 2021 survey who reported using fentanyl said they did so intentionally. It is a change. Previously, most people reported using fentanyl unintentionally mixed with another drug.

Super potent (50-100 times stronger than morphine) and cheap compared to some drugs, illegally manufactured fentanyl pills are often smoked over foil, providing a quick, intense, short-lived high. The drug can take users on an extreme “roller coaster,” with up to a dozen ups and downs each day, Banta-Green said Wednesday. Users may not know how strong the pills are.

Although the UW survey targeted people who inject drugs (people who visit needle service sites), 72% of people who said they had used fentanyl (alone or mixed with other drugs ) said they had smoked the drug, while only 47% said they had injected it.

Most participants reported injecting and smoking drugs. The most cited reason for smoking opioids rather than injecting them was “can’t reach the veins anymore,” followed by “smoking is more social.”

“The majority of people who currently die of overdoses are drug smokers. Yet almost all of our harm reduction services have been directed to people who inject,” Banta-Green said in the press release. UW, calling for adjustments in how programs try to keep users safe and connect them with help.

Survey results and overdose figures are consistent with other indicators.

Seattle police and federal agents seized 650,000 pills last year, 10 times more than in 2020. Narcotics smoked on public transit recently overtook needles and marijuana as a source of complaints King County Subway Bus and Train Drivers. Fentanyl has been part of the picture at intersections recently targeted by Seattle police in the Little Saigon International District and downtown.

This coverage is partially underwritten by Microsoft Philanthropies. The Seattle Times maintains editorial control over this and all of its coverage.


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