Navigating the Fentanyl Epidemic: Insights from Brad Finegood on Overdose Prevention
Photos by Victor Jones
Brad Finegood recently stopped by The Day With Trae, hosted this week by Besa Gordon, to discuss overdose prevention. Finegood is a strategic advisor for King County and leads the overdose prevention efforts for Public Health, leveraging his extensive experience in the field.
Finegood began by acknowledging the significant changes in recent years, noting the convergence of the pandemic and a shifting drug supply around 2019-2020. He observed a dramatic rise in synthetic drugs, particularly fentanyl.
“In 2015, when I first came to town, there were three fentanyl overdoses in this whole county,” Finegood said. “Last year, there were over 1,000 fentanyl overdoses in this whole county. And so we've seen this huge exponential increase in fentanyl. We've seen it all around the country. And our community, our King County community, our Seattle community, our greater King County community has been tremendously impacted.”
Finegood explained that fentanyl has emerged in various forms and has become increasingly affordable. When fentanyl first appeared in the community around 2019, it was primarily found in counterfeit pills. Individuals seeking pain medication, who could no longer obtain legitimate prescriptions, often unknowingly purchased these counterfeit pills, believing them to be genuine pain medication. These pills contained only 1 to 3% fentanyl and were initially much more expensive and harder to find.
Since 2018-2019, the availability and affordability of fentanyl pills have surged, with prices dropping to less than a dollar. Fentanyl is now ubiquitous, and the drug supply has evolved significantly. In addition to counterfeit pills, fentanyl is now also present in white powder and rock forms. This development is particularly concerning because people who have previously used other drugs like cocaine without severe consequences are now at risk. The fentanyl purity in these powders and rock forms ranges from 15% to 90%, posing a substantial risk to those unaccustomed to fentanyl.
“Somebody who's not used to doing fentanyl, whose body isn't accustomed to it, might experience really bad impacts without knowing,” Finegood said. “That's why it's really important that we think about and use the tools we have, because we have a lot of tools at our disposal.”
Finegood highlighted a couple of key points regarding the impact of fentanyl. Firstly, he noted that many people struggling with fentanyl and experiencing its severe consequences are not young but are older individuals, often in their 40s, 50s, and 60s, who are dealing with chronic health conditions and pain management issues.
"There is a way for people to know and understand if fentanyl is in their supply. People can get access to fentanyl test strips. Through King County, we distributed 30,000 fentanyl test strips in the first quarter of 2024 because we know that people often do not want to be using fentanyl and want to ensure that they are not," Finegood said. "This is made possible through public health initiatives."
By making these tools and resources available, King County aims to mitigate the harmful effects of fentanyl and support the health and safety of its community members.
Finegood explained that the test strips come with instructions and emphasized the importance of following them carefully, as the process can be a bit tricky. Users only need a tiny amount of the substance, so they don't have to worry about wasting it. They dilute the substance in water using a small device provided, then dip the strip in, similar to a litmus test. The results can be read within minutes, just as the instructions indicate. This allows people to quickly determine whether fentanyl is present in their drug supply.
“I think what's really important is that people understand the signs of someone using fentanyl,” Finegood said. “Fentanyl is a potent opioid depressant. It makes you quiet, lethargic, almost like asleep. An overdose looks like someone slipping into a deep sleep. If you notice a loved one or someone in the community appearing to fall into an unnatural deep sleep, it's crucial to check on them. The window to intervene in a fentanyl overdose is very short, so quick action can prevent tragedy.”
When asked about identifying signs of a potential overdose in someone living outdoors, Finegood emphasized the importance of recognizing unusual behaviors, like a person appearing in a front-hunched or slumped position that isn't typical for sleeping. He shared instances where simply asking, "Are you okay?" made a significant difference.
For instance, encountering a person on a bus slumped over with scattered paperwork, Finegood approached and gently checked in. After a couple of attempts to get a response, he tapped the individual's shoulder and ensured they were alright, which they confirmed, expressing gratitude for being checked on. Finegood stressed the importance of carrying Narcan or Naloxone, highlighting their ease of use and safety, urging prompt action and calling emergency services if needed.
"I was here with Converge last year, struggling to find hope amidst rising overdose deaths. Now, from this time last year to 2024, overdose deaths have actually decreased by 8%. I'm proud of this progress because we've successfully distributed extensive treatment options. Effective medications have been pivotal, stabilizing brain function and reinforcing my optimism for the future."
The county has expanded methadone services across various locations, introducing mobile methadone vans to enhance treatment accessibility,” Finegood said. “Buprenorphine, available in oral and injectable long-acting forms, stabilizes brain chemistry effectively. The injectable shot provides protection for up to a month, simplifying medication management for individuals with prolonged fentanyl use. This advancement supports brain stabilization, facilitating progress along the recovery path.
He pointed out that the county has made substantial investments in new low-barrier options. Beginning next year, in collaboration with the University of Washington and the city, a post-overdose center will open. This facility will offer a supportive environment where individuals can recuperate following a non-fatal overdose, receive medication, and engage with peers in a warm setting conducive to recovery. This alternative aims to provide necessary care without hospitalization or legal consequences. Crisis care centers are scheduled to be established across the county in the coming years, further reducing barriers to accessing essential care tailored to individuals' needs.
“I think it's really important to also note how deeply our community is affected,” Finegood said. “You know, there's a recent study showing that nearly half of Americans know someone who's overdosed. So it's not just me; it's almost all of us.”
To learn more about overdose prevention visit kingcounty.gov/overdose.
For more on local art walks in Seattle, tune into Besa on Back2Besa on FOX 13, Thursday at 8:15 am, and with Trae every weekday at 11 a.m. on all Converge Media platforms and The Day With Trae YouTube Channel.
