On Monday morning, King County Executive Dow Constantine announced a multi-part strategy across five priority areas to address the surge of fentanyl and stop the record overdose deaths in the region. The strategies expand behavioral health treatment, increase access to medications for opioid use disorder, and make overdose prevention tools and resources more widely available.

The rapid rise of synthetic drugs like Fentanyl that now dominate the drug supply has accelerated and worsened people’s substance use disorders, leading to tragic overdoses. The majority (82%) of overdose deaths in 2023 involved fentanyl, illustrating how dangerous and unprecedented the new landscape is across the region. (Public Health — Seattle & King County Overdose Dashboards.)

In 2023, King County served more than 30,000 people through MIDD, provided nearly 1,800 people with substance use disorder (SUD) residential treatment, added 22 walk-in buprenorphine sites and a mobile methadone van, helped more than 13,000 people receive Medications for Opioid Use Disorder (MOUD), distributed 45,000 naloxone kits and over 100,000 fentanyl test strips, and trained hundreds of people on overdose prevention methods. King County’s Emergency Services Patrol responded to more than 22,000 calls and connected more than 6,500 people to shelter and the sobering center.

King County is taking action in 2024 to prevent overdoses, save lives, and clear paths to recovery for all.

The Department of Community and Human Services (DCHS) and Public Health Seattle & King County are working in partnership to implement the following strategies:

Priority 1: Treatment and community-based, recovery-focused care for all

  • Launch a 24/7 Buprenorphine Prescribing Line. As of January 1, 2024, anyone can call 206-289-0287 to talk to a physician and get a prescription for Buprenorphine, a medication to treat opiate use.
  • Enable 40+ existing behavioral health providers to begin providing Buprenorphine induction and ongoing treatment through Medicaid funding.
  • Increase 24/7 youth mobile crisis program by 20 mental health providers and support staff (including family advocates, youth peers and parent partners) to double the capacity of youth mobile crisis teams in the field and increase the 24/7 adult mobile crisis program by more than 30 crisis responders to increase the capacity of adult mobile crisis teams available throughout the day from 17 to 27.
  • Invest in 6 new community navigators for public safety, health care, and community settings, to link people at risk of overdose to treatment and support harm reduction.

Priority 2: Behavioral health beds and facilities

  • Partner with Pioneer Human Services to open a 16-bed residential treatment program for people with co-occurring disorders (mental health and substance use) located in Seattle.
  • Partner with the City of Seattle to site and re-open a 24/7 substance use disorder sobering center that provides an essential health-supervised care setting.
  • Partner with the City of Seattle, Downtown Emergency Service Center (DESC) and University of Washington to open a post-overdose recovery center that provides medical follow-up and behavioral health treatment engagement and initiation following an opioid overdose.

Priority 3: Overdose reversal and fentanyl testing.

  • Expand the number of King County fire departments that provide leave-behind naloxone at sites of overdoses where people are at high risk.
  • Convene a county-wide Overdose Fatality Review process to review overdose fatalities and develop recommendations for policy changes to reduce overdose deaths.
  • Test up to 1,000 drug samples annually, to reduce accidental drug poisonings, through expanding drug checking services in King County-based services.
  • Distribute 45,000 naloxone kits and 100,000 fentanyl test strips, a 15 percent increase from 2023, through a new centralized harm reduction supply center and vending machines.

Priority 4: A robust, diverse behavioral health workforce.

  • Add ~100 new apprentices statewide with half of the opportunities in King County. Apprenticeships range from behavioral health technicians, substance use disorder professionals, and peer counselors.

Priority 5: Reduced disproportionality in overdoses.

  • Distribute $2 million in overdose prevention grants from opioid settlement funds to disproportionately impacted underserved populations. Populations with high overdose rates include Black, Indigenous and communities of color, and people living unsheltered.

Download a shareable one-pager of King County’s actions to stop overdoses.

A recent report, requested by Councilmember Reagan Dunn, commissioned by DCHS, and created by Comagine reviewed service capacity gaps and needs of people with substance use disorders in the region. The report helped inform the five priority areas.

“Fentanyl is a poison that kills three people every day in King County. This is an unprecedented crisis that touches all kinds of people from all walks of life. It will take a collaborative, whole-of-government approach to reverse this surge in overdose deaths and protect future generations from the dangers of fentanyl,” said Councilmember Reagan Dunn. “I thank Executive Constantine for his ongoing partnership on providing more treatment and lifesaving interventions for those who need it. Recovery is always possible, and by working together we can help even more people find that recovery.”

“During the pandemic we led with science, with medical expertise and with facts, and because of that we had some of the best outcomes in the nation despite being the first area hit. We can do it again with this shadow pandemic of substance use disorder and behavioral health crisis. People are hurting and we see it every day on our streets. We know treatment works, and by prioritizing access to treatment, King County is leading with science, expertise, and compassion. The plan outlined today does all of that and will produce tangible results which is why I’m proud to be partnering with the Executive and my fellow councilmembers today,” said Councilmember Teresa Mosqueda. 

These priority actions are funded by existing resources, including MIDD Behavioral Health Sales Tax, Medicaid, commercial insurance, state and federal funds, and the Crisis Care Centers levy upon approval of its implementation plan.

To read more about King County’s response, including information about treatment access and how to support someone with SUD, substance use prevention: key steps to reduce harm and prevent use, or how King County is integrating health care systems to support and care for people with SUDs, check out our other blogs on the DCHS Cultivating Connections blog.

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