What Happens When You Treat The Addiction Crisis Like A Natural Disaster : Shots - Health News A rural county in Washington declared the opioid epidemic a life-threatening emergency. It uses a multiagency coordination group straight out of FEMA's playbook to respond to the crisis.

A Rural Community Decided To Treat Its Opioid Problem Like A Natural Disaster

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Rural Americans say drug abuse and addiction, including opioid addiction, are the most urgent health problems facing their communities. That's according to a new poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. Now one county in western Washington is taking a unique approach to tackle the problem. Anna Boiko-Weyrauch of Finding Fixes podcast reports how that works.

ANNA BOIKO-WEYRAUCH, BYLINE: Back when Ty Trenary was the police chief of Stanwood, Wash., population 7,000 people, he thought rural communities like his were immune from the opioid crisis until, one day, a mother walked through his door.

TY TRENARY: And basically said, chief, you have a heroin problem in your community. And I remember thinking, well, that's not possible. This is Stanwood. And heroin is in big cities, you know, with homeless populations. It's not in rural America.

BOIKO-WEYRAUCH: For decades, heroin was a big city problem but no longer. In the recent NPR poll, about half of rural Americans said the opioid problem in their communities has worsened in the last five years. Now Trenary agrees. A few years ago, he was elected sheriff of Snohomish County. He toured the jail and saw this.

TRENARY: Very, very sick, very, very sick people because detoxing from heroin is like having the worst possible stomach virus you can have. People are proned out. They're, you know, they're just suffering.

BOIKO-WEYRAUCH: The county jail had become a de facto detox center. At any given time, around half the inmates were withdrawing from heroin. It was a dangerous and expensive situation.

TRENARY: It took becoming the sheriff to see the impacts inside the jail with heroin abuse, to see the impacts on the community across the entire county for me to realize that we had to change a lot about what we were doing.

BOIKO-WEYRAUCH: So they did. Last year, Snohomish County - where Stanwood is located - declared the opioid epidemic a life-threatening emergency. Now they're responding to the opioid epidemic as if it were a natural disaster, the same way they'd mobilize to respond to a landslide or flu pandemic. Snohomish County is the first county in the country to treat it this way.


UNIDENTIFIED PERSON #1: State patrol also advised the road is flooded. Lines are down.

BOIKO-WEYRAUCH: The idea grew out of their experience with another tremendous disaster in the county.


UNIDENTIFIED PERSON #1: This is a major slide here.

BOIKO-WEYRAUCH: In 2014, the town of Oso, Wash., experienced one of the deadliest landslides in American history. Forty-three people died. Shari Ireton is the sheriff's director of communications. She took reporters to see the landslide. And she ended up learning something, too.

SHARI IRETON: It was amazing to see Black Hawk helicopters flying with our helicopter and a fixed wing over the top of that and all in coordination with each other, all with the same objective, which is life safety.

BOIKO-WEYRAUCH: Coordination, life safety. What if they used that system of everyone working together across government agencies to tackle the opioid epidemic? County leaders took the idea and ran with it.


BOIKO-WEYRAUCH: Now their response to the opioid epidemic is run out of a special emergency operation center, a lot like during the Oso landslide. Every two weeks, representatives from across local government meet - people in charge of everything from fire trucks to the dump. The technical name for this group is the Multi-Agency Coordination group or MAC group. It comes straight out of FEMA's emergency response playbook.

UNIDENTIFIED PERSON #2: Six ten is completed.

BOIKO-WEYRAUCH: They talk through PowerPoint slides.

UNIDENTIFIED PERSON #3: I think 7.5 is kind of...

BOIKO-WEYRAUCH: The numbers refer to items on their to-do list. There are seven big goals, like reduce opioid misuse and reduce damage to the community. Each goal is broken down into smaller pieces, like distributing needle cleanup kits and a project to train school teachers to recognize trauma and addiction. This to-do list is over 100 items long.

IRETON: Some of these goals are really long term. I mean, they're going to take years, decades.

BOIKO-WEYRAUCH: Ireton is also the spokesperson for this group. She says, the key is to be realistic.

IRETON: So if you set an objective for yourself to just end the opioid epidemic, you're probably never going to be successful in either - in any of our lifetimes. By breaking it down, it's like eating an elephant. You just can eat one piece at a time - breaking it down into a piece that you can actually digest.

BOIKO-WEYRAUCH: They make transportation easier for people in drug treatment. They train family members and others in the community on steps to reduce overdoses with medicine. And they actually send teams of police officers and social workers to help addicted homeless people.



BOIKO-WEYRAUCH: In Marysville, Wash., rain drips through a cedar forest next to a strip mall. Officer Mike Buell cracks jokes with some illegal campers.

MIKE BUELL: (Laughter) Hi, Crystal. I'm Mike.

BOIKO-WEYRAUCH: The woods throughout this county are the sight of homeless encampments with piles of spent syringes and trash. Buell's job isn't to arrest the campers but help them get drug treatment and housing.

BUELL: We're your transport. We're basically your Uber. We'll get you to and from your appointments.

BOIKO-WEYRAUCH: The new approach is paying off. The teams have helped hundreds find housing and drug treatment. That's just one item in the county's plan. And problems with opioids are far from solved here. So Snohomish County will keep working on their large and small goals - one bite at a time. For NPR News, I'm Anna Boiko-Weyrauch.

GARCIA-NAVARRO: This story was reported by Finding Fixes, a podcast about solutions to the opioid epidemic.

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