By Bob Young
The Seattle Times
An “opioid summit” convened by state law-enforcement agencies this week focused largely on reducing the illegal supply of opioids in Washington.
And while armed officers roamed the University of Washington summit and speakers addressed topics such as how to get maximum prison time for dealers, another thread emerged.
Several law officers, and others, spoke about the importance of viewing opioid addiction as a medical condition that should be destigmatized and treated with medications proven to reduce deaths and help people lead functional lives.
“I really believe in medication-assisted treatment,” said King County Prosecuting Attorney Dan Satterberg, who devoted most of his 90-minute talk Friday to advocating a different approach than reducing supply, which has not historically succeeded.
In 2015, 718 Washingtonians died from opioid overdoses, more than from car accidents.
Satterberg noted that most people who are drug-dependent lost connection with a positive focus in life. “The opposite of addiction is not sobriety, it’s connection,” he said. Abstinence and tough-love approaches don’t address the underlying trauma or conditions that lead people to addiction.
“Too many people are clinging to old ideas which are downright dangerous in this field,” he said. Medications such as buprenorphine or Suboxone can alleviate the pangs of drug dependence while not making people feel euphoric or disoriented, he said. That can allow them to work and have relationships and seek treatment for underlying conditions such as depression.
“Nancy Reagan was wrong,” said Seattle Fire Department Capt. Jonathan Larsen, a summit panelist who supervises about 70 paramedics who respond to overdoses. “This is a changed brain,” Larsen said about opioid addiction. “Medication-assisted treatment works. Nothing else works or we wouldn’t have the problem we have now.”
But most people remain unaware that relatively new treatments such as buprenorphine reduce fatal overdoses and support recovery, said Caleb Banta-Green, senior research scientist at the UW’s Alcohol and Drug Abuse Institute.
“In my experience, 99 percent of people don’t understand that,” Banta-Green said.
Meanwhile, local buprenorphine programs are already reaching full capacity, he said, showing the need for expanded access to buprenorphine, methadone and other treatment medications.
Law-enforcement officers can be community leaders, he said, in destigmatizing addiction and building grass-roots support for more treatment facilities.
Steve Redmond, a Seattle police officer, said he works on it every day. Addiction “is a treatable medical condition no different than cancer or multiple sclerosis,” said Redmond, who was on a panel with Larsen and Banta-Green.
He founded a volunteer-run crisis response and referral network, Code 4 Northwest. He also is a board member of Not One More, a community group that aims to destigmatize addictions and support people with them.
The Seattle police and fire departments were represented last year on a Seattle-King County heroin and prescription opiate task force, Larsen noted, and endorsed its recommendations calling for expanded treatment and safe consumption sites.
It’s a positive development that many state first-responders now carry the overdose-reversing drug, naloxone, Banta-Green said.
But he’s concerned naloxone is viewed by too many public-safety officials as the silver bullet, the best they can do to help. “It is a one-hour rescue,” he said, with modest impact.
Naloxone reduces overdose deaths by about 6 percent, he said, while medications such as buprenorphine showed better than a 50 percent reduction in a study of 150,000 people, with the benefit of helping people to be more functional.
“Naloxone is a great gateway drug to a conversation about addiction,” Banta-Green said. “In five years we want to do more than put out a lot of naloxone.”
