Overdose deaths are occurring more frequently than in past years, Thurston County officials told the Board of Health last week, and they are blaming an influx of fentanyl.
The number of overdose deaths reached 153 in 2022, Coroner Gary Warnock told the board. Fentanyl, a synthetic opioid that's 50-100 times strong than morphine, accounted for 114 of those deaths, he said.
"(Fentanyl) is present in numerous drugs — meth, cocaine, ecstasy and counterfeit pills," Warnock said. "It's cheap and it's extremely more addictive. Many users don't know they're purchasing fentanyl, which results in suicide deaths."
Warnock presented a slide that showed 147 confirmed cases in 2022, but he paused to note that number was already outdated.
"That's inaccurate because I just did the updated number and we're at 153," Warnock said. "That's a fluid number that's going to fluctuate because we have pending cases."
In 2021, Warnock counted 51 overdose deaths involving fentanyl, less than half of the 2022 total reported on Tuesday. In 2019, he counted just 10 overdose deaths involving fentanyl.
Citing the outdated 147 total for 2022, Warnock said males between the ages of 18-77 accounted for 109 overdose deaths while females between infancy and 72 accounted for 37 deaths. He clarified that two female infants died last year of fentanyl overdoses.
A 24-year-old person who identified as gender neutral also died, he added.
Fentanyl has affected people of all walks of life, Warnock said, and it has made its way into the Thurston County jail.
Alec Nieland-Herrera, 28, died at Providence St. Peter Hospital in Olympia on Monday, March 13, after suffering an overdose at the county jail on March 9, The Olympian previously reported.
He was one of six people who have experienced suspected fentanyl overdoses in the county jail since March 5, according to the Thurston County Sheriff's Office. Corrections staff revived four of them on-site after administering Narcan, a medicine that reverses overdoses. Another was hospitalized in critical condition on Tuesday.
Undersheriff Dave Pearsall addressed the Board of Health as well. He said two people overdosed in the jail on Tuesday. One was revived after four doses of Narcan, he said, but the one who was hospitalized was given six doses before medics arrived.
Robin Vasquez, a Board of Health member, followed that anecdote by asking why so many doses of Narcan were needed. Health Officer Dimyana Abdelmalek offered her perspective.
"The classic teaching has been one to two doses," Abdelmalek said. "With fentanyl, we are seeing a need for increased doses, just with how potent fentanyl is."
About 2 milligrams of fentanyl can be enough to kill someone, according to the U.S. Drug Enforcement Administration. Counterfeit pills analyzed by the DEA have been found to have anywhere from .02 to 5.1 milligrams per tablet.
The reason it can vary is because fentanyl is often made in foreign clandestine labs and mixed with other illicit drugs, according to the DEA.
Warnock described these labs as "crude" operations that are often set up in Mexico. From there, he said the drugs are smuggled into the United States at the border.
"There's no quality assurance as far as what's in there," Warnock said. "If you take a pill and quarter it out, it's a game of Russian roulette. You take that quarter pill, you may get nothing, (but another) quarter pill is probably loaded with fentanyl."
Fentanyl can come in powdered form or be made to look like other drugs such as Xanax or Percocet, Warnock said. The end result is often difficult to distinguish from authentic drugs, he said.
Prosecuting Attorney Jon Tunheim said he's seen waves of illicit drugs affect the community since the 1990s. However, none of those waves compares to the damage fentanyl is now causing.
"I've never seen anything like this," Tunheim said. "I think this is something that we've really got to focus in on with some significant seriousness."
Tunheim said he believes the community must create more pathways for people experiencing addiction to get help. At the same time, aggressive enforcement action should be taken against those who distribute and sell out of greed, he said.
"It's got to be a holistic approach," Tunheim said. "We got to be working on both sides of this equation. That's my opinion, speaking from my experience."
Lt. Tim Rudloff, commander of the Thurston County Narcotics Task Force, told the board his team seized over 5 pounds of fentanyl and 2.9 pounds of heroin in 2022.
Their seizures have varied significantly over the years even as the influx of drugs seemingly gets worse, Rudloff said. He attributed this to varying levels of funds, staffing and viable confidential informants.
The current task force consists of individuals from the Thurston County Sheriff's Office and Prosecuting Attorney's Office as well as the Washington State Department of Corrections and Homeland Security Investigations.
Rudloff said he hopes to incorporate more members from Olympia, Lacey and Tumwater police departments in the future. However, he cited leadership and staffing concerns at each department as limiting factors.