# Cautious Optimism: Whatcom County Sees Declining Overdose Deaths as Fentanyl Response Plan Unfolds ## Meeting Overview The Whatcom County Council Public Works and Health Committee convened on Tuesday afternoon, January 14, 2025, for their first meeting of the new year in the familiar hybrid format of Council Chambers at the County Courthouse. What should have been a routine organizational meeting became a significant moment of reflection on the county's ongoing battle against the fentanyl crisis, as health officials presented data showing encouraging but tentative signs of progress. Committee Chair Jon Scanlon called the 30-minute meeting to order at 12:55 PM, with fellow members Mark Stremler and Ben Elenbaas present. Also attending were Council Members Barry Buchanan, Tyler Byrd, Todd Donovan, and Kaylee Galloway—an unusually full attendance that Scanlon noted at meeting's end, saying "it is nice when we have everybody here for these conversations" on topics that typically interest the full council. The agenda contained just two items: the annual election of committee chair and a presentation on the county's fentanyl operations plan. What emerged was a nuanced picture of a community grappling with cautious hope amid persistent crisis, and troubling questions about how overdose deaths are classified and counted. ## Leadership Continuity Scanlon quickly dispatched with the committee's organizational business, nominating himself to continue as chair for another year. "I'm interested in continuing. I've enjoyed taking on this role and would like to continue for another year," he said, putting his nomination forward to his colleagues. The vote was unanimous—though Elenbaas added a touch of levity by voting "no" before immediately clarifying, "just so everybody scratches their head, but I fully support you as the chair, Scanlon." With that bit of committee humor out of the way, attention turned to the more substantial presentation on the county's response to the fentanyl epidemic. ## Encouraging Data, Persistent Crisis Kari Holley, a program specialist with Whatcom County Health and Community Services who oversees opioid prevention and overdose response, delivered what she characterized as cautiously optimistic news. The data she presented showed multiple indicators trending downward from the crisis peak in 2023. Emergency department visits related to opioids showed a notable decline through November 2024, with what Holley described as "that steep dip in August" contributing to an overall downward trend. More significantly, suspected overdoses based on EMS dispatch calls had dropped from a peak of 66% of all overdose incidents in 2023 to 58% in 2024—still elevated from the 55% rate in 2022, but moving in the right direction. The most striking statistic was the preliminary count of overdose deaths: 80 through November 2024, compared to 137 in all of 2023. "So far, our deaths here today are 80, which is significantly down from the peak in 2023," Holley reported, though she noted that some cases remain pending final toxicology reports and medical examiner review. Yet Holley was careful to contextualize these improvements. "While from, you know, the height of it in 2023, yes, to 2023 to now it looks like it's headed in a direction that we're cautiously optimistic about, we're still five times higher than we were five years ago," she said. "And so that, you know, our efforts have to be sustained for the long term." This tension between hope and realism defined much of the presentation. The county cannot point to any single intervention that explains the improvement, but Holley suggested the decline reflects sustained investment across multiple strategies recommended by the council in spring 2024. ## Comprehensive Prevention Strategy Holley organized her presentation around what she called the "PETA continuum of care"—prevention, intervention, treatment, and aftercare. The prevention efforts have been particularly robust, anchored by a $150,000 grant from the Washington State Department of Health for opioid prevention and education campaigns. The grant is allowing the county to expand beyond its existing materials housed at whatcomhope.org, which already includes media toolkits with posters, rap cards, videos, fentanyl education materials, information on Good Samaritan laws, and opioid education brochures in Spanish and Russian. "The media toolkit is available to all of our community partners," Holley said, noting presentations to both the MAP group and opioid task force. The new funding will enable translation of materials into additional languages—addressing one of Council Member Todd Donovan's questions about how translation priorities are determined. Holley explained that the county follows federal guidance and demographic data showing which languages are most spoken in the community, with Spanish currently prioritized but other languages to be added as resources allow. Perhaps most importantly, the grant is funding development of new priority messages identified through surveys of community partners. These include emphasizing that "you can't know our can yourself"—meaning people cannot use naloxone on themselves if they overdose—and addressing "the harms of poly drug use" beyond just fentanyl and opioids. "While we're really focused and rightfully so on fentanyl and opioids, we're always mindful that something new could be on the horizon and that methamphetamine, cocaine use, even cannabis use, there's still risk that we don't want to not continue to talk about," Holley explained. The prevention strategy also includes targeted media campaigns across multiple channels—digital, bus advertising, movie theaters—with the ability to reach specific demographics. As Holley put it, "there's certain populations that need to hear this message or that message and so being able to really hone in on what avenue will reach our intended audience." ## Intervention and Treatment Expansion On the intervention side, the county has embedded a substance use professional at the emergency department in collaboration with PeaceHealth, hired an overdose response behavioral health specialist who is now taking referrals from community partners, and partnered on the pending opening of the Dykul Wellness Center at Division Street early this year. The county has also acquired 1,300 additional naloxone kits—100 medication lock bags from the Department of Health grant and 1,200 more from a separate grant. Five additional naloxone kiosks are awaiting placement around the county, with the benefit of being wrapped in both Spanish and English. The Way Station continues operating with an average of 65 clients per day, providing services through Unity Care Northwest. The severe weather shelter has been opening when temperatures meet thresholds, specifically designed with "a lot of intentionality" for working with populations who may have co-occurring substance use and behavioral health disorders. ## Rigorous Evaluation Framework Perhaps the most significant development Holley described was the county's commitment to rigorous evaluation of its fentanyl response efforts. Working with the county's data team, particularly analyst Hunter, they are developing comprehensive metrics to assess whether the substantial time, energy, and resources invested are actually moving the needle. "There's been a lot of time and energy and resources put into the opioid crisis in our community. And we want to make sure that what we're doing is moving the needle or at least having that intended outcome," Holley said. The evaluation will adopt principles of results-based accountability to ensure actions achieve intended outcomes, integrating the PETA model as a framework to assess effectiveness across the continuum of care. The county is examining all 29 operational plan objectives to determine data collection needs, responsible parties, and whether MOUs are needed with outside agencies for data sharing. The timeline is ambitious: finalize the evaluation plan by March 2025, release a first-year monitoring report by July 2025, and complete a full two-year evaluation by July 2026. "Given the urgency of the fentanyl crisis and the scope of this operations plan, the primary focus will be on performance accountability with population indicators monitored to assess broader trends," Holley explained. ## Questions About Data Integrity The presentation took an unexpected turn when Council Member Ben Elenbaas raised pointed questions about data integrity. Speaking from what he described as "a very poor area" with spotty connection, Elenbaas revealed he had received a call suggesting that overdose death numbers might be declining not due to actual improvements, but because deaths were being classified differently. "I was called from somebody and they said, you're going to see data, and that data is going to show that overdose deaths are down. And they wanted to tell me that they felt like someone had been directed to... I'm not going to say falsified the reasons, but if there was any other reason other than overdoses, that is what was listed," Elenbaas said. Initially skeptical—"I kind of thought that they were a little tin foil hatty"—Elenbaas said his perspective changed after personal experience with two recent deaths of people close to him. "Because of my knowledge of the manner in which they died, I... everyone knows it was an overdose, but their paperwork doesn't say that," he revealed. This led to a series of probing questions about whether classification methods had changed between 2023 and 2024 data, and how deaths with multiple potential causes are categorized. Holley acknowledged she could not reliably answer these questions, deferring to the medical examiner's office. Council Member Scanlon asked whether the data reflects only primary cause of death or includes overdose when it's one of multiple factors. Kayla Schott-Bresler from the County Executive's office offered to help council members connect with the medical examiner to address these concerns. The exchange highlighted the complexity of accurately tracking overdose deaths and the importance of data integrity in measuring the effectiveness of public health interventions. As Holley noted, "It's hard. This is a hard one to talk about because any death is too many." ## Financial Complexity and Transparency The presentation also touched on the complex funding landscape surrounding opioid response efforts. When Donovan asked about limitations on opioid settlement funds and budgeting policies, Holley described the situation as "very nuanced and complicated." She referenced "a big document that I am happy to share with all of you on what's allowed and not allowed" regarding opioid settlement fund usage. The county has prioritized spending based on input from the long-standing opioid task force and MAP group, but the funding streams present planning challenges. Particularly concerning is that one of the larger settlements—the Purdue settlement worth $183 million statewide—is currently on hold due to an appeal. "That settlement is on hold," Holley explained. "And one of the things with the dashboard, it will also help identify when those funds are coming in. So even though it sounds like an enormous amount of money, that may trickle in... So that makes it really hard to plan." The state is developing a public-facing data dashboard to provide transparency on opioid settlement fund allocation and spending, which Holley said would help communities "see like what's coming in, what's already been spent, what hasn't been spent and what's your projection so that we don't under fund or over spend some of our programming." ## Looking Forward: Third Spaces for Youth The meeting concluded with discussion of broader prevention strategies, particularly around creating "third spaces" for youth—community spaces outside of home and school where young people can gather safely. This concept emerged from what Scanlon called "the all hands summit" and represents recognition that youth isolation, mental health struggles, and lack of positive social connections contribute to substance use risks. Scanlon mentioned that Chuck (presumably Chuck Robinson, who frequently coordinates community meetings) was organizing a meeting the following day to discuss youth third spaces. He noted that "the city of Bellingham is partnering with the library on having spaces in the library" and invited ideas for additional third spaces across the county. Holley emphasized that both public and county libraries have been strong partners, noting they "are community space. And they are really committed to providing third spaces for our youth." ## Data Transparency and Community Accountability Perhaps most significantly, the meeting highlighted the county's commitment to transparency and data-driven decision making in its fentanyl response. The pending public dashboard for opioid settlement funds, the comprehensive evaluation framework being developed, and officials' willingness to acknowledge both progress and limitations suggest a mature approach to public health crisis management. Yet the questions raised about data classification methods underscore the challenges of measuring success in public health interventions. The gap between community perception and official statistics requires careful attention, particularly when substantial public resources are being deployed based on those statistics. As Holley noted, the county's current data shows they are "cautiously optimistic" while remaining realistic about the scope of the ongoing crisis. With overdose deaths still five times higher than five years ago, the work clearly must continue—but the trend lines offer hope that sustained, comprehensive intervention can begin to turn the tide. ## Closing & What's Ahead The meeting adjourned at 1:25 PM with committee members transitioning immediately to other council business. Scanlon noted that several members needed to attend the Planning and Development Committee meeting at 1:30 PM, though Council Member Elenbaas was delayed by a train crossing. The mood at adjournment was businesslike but positive, with appreciation expressed for the comprehensive presentation and the unusually full attendance. As the county moves forward with its fentanyl operations plan, the next key milestone will be the March 2025 completion of the formal evaluation framework—a critical step toward ensuring that the community's substantial investment in overdose prevention and response continues to show measurable results. The questions raised about data integrity will likely require follow-up discussions with the medical examiner's office, potentially at a future committee meeting or through individual council member inquiries. The upcoming meeting on youth third spaces represents another front in the county's comprehensive approach to substance use prevention, recognizing that addressing the crisis requires both immediate intervention and long-term community building.