Opioids

Overview

Opioid use disorder has reached epidemic levels in Washington State and across the country. This public health issue is impacting state and local government, communities, health systems and, most importantly, individuals and families.

In response, Governor Inslee issued Executive Order 16-09 in October 2016, directing state agencies to work with local public health, tribal governments, and other partners to implement an opioid response plan.

The Department of Health and state partners developed the State Opioid Response Plan focused of four priority goals:

  • Prevent opioid misuse and addiction
  • Identify and treat opioid use disorder
  • Prevent deaths from overdose
  • Use data to detect opioid misuse/abuse, monitor illness, injury, and death, and evaluate interventions

The plan was revised July 2018 and is being implemented across the state.


Current Health Status

  • Opioid overdose deaths are the leading cause of accidental death in many parts of our state. In 2016 there were 694 deaths due to opioid overdose in Washington.
  • Preliminary data for 2017 indicate continued decrease in prescription opioid overdoses and increase in synthetic opioid overdoses.
  • According to the 2016 Healthy Youth Survey, 3 percent to 4 percent of Washington youth reported using heroin at least once in their lifetime, and 4 percent to 5 percent used pain medication recreationally in any given month.* 
  • Major Washington cities show the highest numbers of overdose deaths, but rates per total population are higher in some rural counties.
Current Work & Initiatives

The State Interagency Opioid Response Plan provides recommended actions and a 2017 progress report

Efforts supporting the plan include:

The 2017 progress report includes recommended actions.

Additional information and resources may be found on the Department of Health opioids web page.

 

Emerging Issues
  • Synthetic opioids including illicit fentanyl and fentanyl-type drugs have been appearing in other drugs sold as pain pills or heroin, contributing to fentanyl overdose deaths in Washington State.
  • Jail and prison inmates with opioid use disorder often lack access to Medication Assisted Treatment (MAT) and social services while incarcerated.
  • There is a need to transform care for pregnant and new mothers with opioid use disorder, including stigma reeducation.
  • Rising rates of homelessness are creating a crisis in many communities. Trying to address housing and opioid issues is putting great stress on limited resources.
Health Equity Concerns
  • Washington State rates of opioid overdose death vary by race and ethnicity. Data indicate American Indian/Alaska Native rates were highest, Hispanic and Asian populations were lowest. (2011-15)*
  • Those who die from heroin overdose tend to be younger than those who die from prescription opioids.*
  • Low-wage workers in physically demanding jobs may use opioids so they can avoid missing work.*
  • Rural communities are challenged by a shortage of treatment providers and counseling infrastructure.*
  • Access to alternative pain treatments such as physical therapy or acupuncture is limited for some populations. Factors include insurance coverage, sick leave, transportation, and childcare.*

*Sources:

DOH death certificates, includes all intent of drug-related deaths with the additional ICD-10 codes of T40.0, T40.1, T40.2, T40.3, T40.4, or T40.6

DOH Death Certificates, methodology identifies opioid deaths using both ICD-10 codes and the literal text on the death certificate, and excludes intentional deaths due to opioid overdose

HRSA 2016

HRSA 2016

NIH Mar 2017

Key Data and Sources
  • The rate of prescription opioid overdose deaths has declined, while the rate of heroin overdoses has increased.*
  • About 330,000 persons 12 years and older in Washington State are estimated to misuse pain relievers.*
  • Nearly 60 percent of those who inject heroin said they were hooked on prescription opiates before they began using heroin.*
  • 66 percent of drug injectors in Washington reported they would like help stopping or reducing their drug use.*

Sources used:


* Sources:

DOH Death Certificates

National Survey on Drug Use and Health, 2015-2016

2015 Drug Injector Health Survey, University of Washington and Public Health-Seattle & King County

UW Alcohol and Drug Abuse Institute 2015 WA State Syringe Exchange Survey

Recommended Strategies

Strategies for opioids include, but are not limited to:

Resources and tools:


Frameworks and Strategies

Screening Tools

Prescribing Guidelines, Prescription Monitoring

Treatment Recommendations, Overdose Reversal

Trauma Informed Approaches

Strategies for Tribal, Rural, and Homeless Populations

Contact Us

Contact us at P4IPH@doh.wa.gov


* Sources:

DOH 346-083 May 2017

Washington State Department of Health, 2016 Healthy Youth Survey Data Brief

Washington State Department of Health, Opioid-related Deaths in Washington State, 2006–2016, DOH 346-083 May 2017