'The demand is greater than the supply': Washington officials grapple over how to combat deadly opioid epidemic

Jan. 24—OLYMPIA — Austin Hoberg's favorite recent memory was a trip to Baskin-Robbins for ice cream with his 6-year-old niece — the type of outing that was unthinkable to him for more than a decade.

A little more than a year ago, Hoberg turned the page on his personal 12-year battle and gave himself another chance at life.

Hoberg, 35, celebrated one year sober from opioids and methamphetamine on Jan. 12. Today, he lives at the B Street Oxford House in Tacoma, a transitional living space for people in recovery.

Oxford Houses are democratically run, self-supporting sober living houses. Hoberg said his house in Tacoma has given him community and autonomy, all at an affordable cost for somebody in early sobriety.

"Everybody at the house runs the house," Hoberg said. "... It can't be just one person who is in a position of power who makes all the rules, if that makes sense. (The house) allows you a lot of freedom to pursue opportunities, whether it's education or getting involved in the community."

The Tacoma man is unique, but his story is not. He is among hundreds of thousands of United States residents in the past two decades who were victimized by pharmaceutical companies that said prescription opioids like Oxycodone did not have addictive properties.

Pharmaceutical giant Johnson & Johnson is one of those companies. On Wednesday, Washington attorney general Bob Ferguson announced the company settled a suit with the state of Washington. Johnson & Jonson will pay the state $150 million for its role in fueling the state's opioid epidemic.

More than $123 million of the settlement will go to state and local efforts to combat the opioid epidemic. Spokane County will get roughly $5.5 million of that money.

Gov. Jay Inslee invited Hoberg to tell his story Wednesday at a government conference focused on combating Washington's devastating opioid epidemic.

Along with the Oxford House, Hoberg said one of the most crucial parts of his recovery journey has been a medication that curbs withdrawal symptoms. Each month, Hoberg goes to a medical clinic and gets a shot of Sublocade, an FDA-approved medication that treats opioid use disorder.

'Everybody had the pills'

Sublocade contains Buprenorphine, the same active ingredient found in Suboxone. Buprenorphine is used in medication-assisted treatment (MAT) to help people reduce or quit their use of heroin or other opiates, such as pain relievers like morphine.

Recovering from opioid use disorder is no small feat. Even with the help of MATs, sober living and mental health supports, it can take years before the human brain stops craving opioids.

"You could be good one minute, and the next minute that is all you think about," Hoberg said. "I can't say the amount of times in the past where I didn't want to do the drug, but I did. The craving was that powerful. To not have those cravings helps tremendously. And that's what Sublocade gives."

Hoberg told The Spokesman-Review that he first tried opioids in the form of Oxycodone pills when he was 22. When supplies of Oxycodone on the streets got scarcer and more expensive, Hoberg turned to heroin. Later, the most common and cheapest opioid on the streets was fentanyl. The last time Hoberg went out and got drugs, that's what he picked up.

In recent years, Washington state has been awarded more than $1.1 billion in court judgments and settlements with opioid manufacturers and distributors. Nearly $35 million of it is headed to the local governments of Spokane County, where the Spokane County Opioid Abatement Council will decide how to spend the cash.

As a manufacturer of opioids, Johnson & Johnson lied to doctors and patients about how addictive its opioid products are, reads the lawsuit filed in King County Superior Court. Despite evidence suggesting otherwise, the pharmaceutical company told the public that there was a very low risk that patients would become addicted to its prescription opioids.

"Johnson & Johnson aggressively marketed its opioids for chronic pain conditions like headaches and lower back pain," Ferguson said at a news conference Wednesday, "despite evidence that opioids were not effective at treating these conditions."

By 2015, Johnson & Johnson was the top United States supplier of the active pharmaceutical ingredient used to make opioids.

"They knew what they were doing; they did it anyway," Ferguson said. "They knew what the harm was; they did it anyway."

When Hoberg first tried opioids, he didn't have a prescription.

"Everybody had the pills," Hoberg said, adding that he likely could have never become addicted to opioids if the streets weren't flooded with Oxycodone that came straight from the mouths of big pharmaceutical companies.

'The demand is greater than the supply'

Washington had the largest increase in drug overdose deaths of any state between 2022 and 2023, according to data from the Centers for Disease Control and Prevention.

In 2022, more than 2,000 people died of opioid-involved overdoses in Washington — more than twice the number in the state who died of the same cause in 2019. Fentanyl was reportedly involved in more than 1,800 of those 2022 deaths.

Washington's Indigenous communities face death rates four times higher than the statewide average. Black Washingtonians are the second-most harmed by the opioid epidemic.

In Spokane County, fentanyl was detected in 72% of all fatal overdoses in 2022, according to the U.S. Drug Enforcement Agency. Opioid overdose deaths affect urban and rural regions of the state.

Fentanyl is a potent synthetic opioid drug approved by the Food and Drug Administration for use as an analgesic (pain relief) and anesthetic. It is 100 times more potent than morphine and 50 times more potent than heroin as an analgesic.

At Wednesday's event, Inslee and other speakers grappled with the challenges of education, harm reduction and prevention surrounding fentanyl.

"The data tells us that the crisis is as bad as it's ever been, and it's continuing to get worse," said Tao Sheng Kwan-Gett, the chief science officer with the Washington Department of Health.

Earlier this year, the governor proposed adding more than $50 million in new funding to combat the opioid epidemic for the 2023 — 2025 biennium budget. The money would be added to a pot of $200 million to be spent on MAT centers, peer support, criminal diversion and other programs.

Recovery advocates and medical professionals are pushing to make Naloxone more widely available around the state, including placing it in all public high schools. In 2022, 36 Washington teens reportedly died from an overdose involving opioids.

Naloxone, also known as Narcan, quickly reverses an opioid overdose, including ones induced by fentanyl, by blocking its sedative effects and restoring normal breathing within a couple of minutes.

Mike Gilman has worked as a juvenile probation officer in Washington for more than 30 years. On Wednesday, he said the state needs to use its public school system to educate children about the dangers of fentanyl and other opioids. Prevention is a part of the response, Gilman added, but it's also important to recognize that progressive substance abuse treatment works.

"Unfortunately, many of our adolescent inpatient chemical dependency centers in Washington have closed, and the absence is glaring," he said. "The demand is greater than the supply."

Research shows medications that treat opioid-use disorder reduce drug-induced deaths by more than 50%.

And three in four people who undergo long-term treatments for substance use disorders achieve long-term abstinence, a peer-reviewed study found.

After Wednesday's conference in Olympia wrapped up, several audience members approached Hoberg to congratulate him on his year of recovery and thank him for sharing his story.

Hoberg plans to start taking classes this year at Tacoma Community College. He wants to become a behavioral health professional and use his lived experience to help others going through what he went through.

"I just found, I guess, a sense of purpose in realizing that anything I want to do in my life is not possible if I'm not sober," he said.

Ellen Dennis' work is funded in part by members of the Spokane community via the Community Journalism and Civic Engagement Fund. This story can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper's managing editor.