A 28-year-old Seattle man first got hooked on Xanax in college. Years later, he moved on to fentanyl. Then a string of arrests for impaired driving landed him in legal trouble, and his fourth DUI, a felony, sent him to prison for six months.
Released in June, he relapsed on fentanyl — the same drug that's ensnared his older brother — on his very first night of freedom. Thirty days of inpatient treatment followed, then placement in a clean-and-sober house in White Center.
After a seven-year battle with addiction, he was found unresponsive in his bed Aug. 22, dead from a fentanyl overdose.
"I'm sure there's a million stories like mine," said the man's mother, Andréa, who asked that she and her sons be identified by their middle names to protect their privacy. "He never really could be out in the world and not fall back into it. He definitely didn't want to die."
The death of Andréa's son, Louis, is indicative of a fentanyl epidemic that continues to accelerate across King County and is set to surpass last year's record-breaking death toll. With four months left in 2023, fatalities so far this year from illicit fentanyl stood Thursday at 704, according to data from Public Health — Seattle & King County. That's just eight shy of 2022's total of 712 fentanyl-involved overdose deaths.
Even more concerning is that fentanyl — a synthetic opioid 50 times more potent than heroin and sold for a little as $2 or $3 a pill — has been involved in an even larger proportion of overdose deaths this year, representing 83% of the county's 849 confirmed drug overdose deaths compared to 71% of the 1,001 fatal overdoses in 2022. This year's figure could be even higher, as 60 other deaths are still being investigated as probable or possible overdoses.
In August alone, a 15-year-old girl and 9-year-old boy who died in separate incidents in Kent were among the county's youngest fentanyl overdose victims, according to the King County Medical Examiner's Office.
Fentanyl's reach has even extended behind bars: Michael Fortin, a 42-year-old man incarcerated at the Federal Detention Center in SeaTac, died Aug. 25 of a combination of fentanyl and buprenorphine, a drug used to treat opioid addiction, according to the medical examiner. The prison's associate warden did not return a phone call seeking additional information about Fortin's death.
Nonfatal overdoses are increasing, too. Jon Ehrenfeld, manager of the Seattle Fire Department's mobile health team, told the City Council last month that fire officials are responding to 110 overdoses a week, which amounts to 15 overdoses a day in the city alone. As recently as 2020, Seattle fire officials responded to only about three overdoses per day, The Seattle Times previously reported.
"The volume right now is overwhelming ... it's crushing," Ehrenfeld said. "It's causing a tremendous amount of stress and burnout."
Between January and July, King County's first responders treated more than 4,900 nonfatal opioid overdoses, a nearly 70% increase over the roughly 2,950 they addressed during the same period last year. Though numbers for August have not yet been added to Public Health's online overdose dashboard, it appears certain this year's final statistic will far exceed the 5,835 nonfatal opioid overdoses treated by emergency medical responders in 2022.
Fatal overdoses involving methamphetamine also are on the rise, with the stimulant involved in 454 deaths as of Thursday, compared to 532 for all of 2023.
While the combination of fentanyl and meth was seen in 36% of 2022 overdose deaths, the combination of fentanyl and cocaine was far less common — until last summer. Between July 2022 and this June, approximately 20% of all overdose deaths were attributed to a combination of fentanyl and cocaine, which, like meth, is a stimulant.
"We've heard reports of patients who thought they were taking cocaine prior to experiencing an opioid overdose," Public Health spokesperson Sharon Bogan said in an email. "We continue to work with partners to increase access to tools like fentanyl test strips," which can be used to check whether street drugs have been laced with fentanyl.
Though fentanyl in pill form — known as "blues" — remains the most common vehicle of overdose, Bogan said investigators are increasingly seeing more instances of powdered fentanyl or fentanyl in "rock form" at death scenes.
Meanwhile, a disparity among overdose victims continues to grow. Before 2021, overdose rates among men in King County was roughly double that of women — but that gap has continued to widen, especially for men living unhoused.
The overall number of overdose deaths among people experiencing homelessness more than doubled over the course of 2022, a trend that continued apace in the first six months of this year, according to Bogan.
"Males make up a larger percentage of overdose deaths across all types of housing status, but among people experiencing homelessness, males make up an even greater percentage of overdose fatalities," Bogan said.
While mourning the death of her younger son, an honor student who was one quarter away from graduating from the University of Washington, Andréa remains terrified for his brother, Jacob, who she said is chronically homeless and addicted to fentanyl.
The 31-year-old had kicked a heroin addiction and was sober for five years, Andréa said, but "then he got in a really bad car crash and almost didn't make it."
Jacob underwent seven surgeries and was treated with opioids in the hospital, "then fell back into the streets," his mother said.
She said she's tried for two years to get Jacob into housing, to no avail, despite countless appointments and phone calls.
"My sons have never stopped trying" to overcome addiction, Andréa said, remembering her youngest as funny, wicked smart and charismatic.
She said Louis, who worked while attending UW and is the father of a 3-1/2-year-old boy, was feeling good after his latest stint in rehab and had been optimistic about the future.
Fentanyl, she said, "is as much of a crisis as a hurricane."