Fighting the Opioid Epidemic: One State’s Approach

Chris Baumgartner, Drug Systems Director, Washington State Department of Health

Drug overdose (mostly caused by opioids) now kills more people in Washington than traffic accidents do. Washington had nearly 700 opioid-related overdose deaths in 2016. This national and local trend has been branded a public health emergency and epidemic. While we’ve seen a decline for several years in prescription opioid–related deaths, the state has seen an increase in deaths caused by illegal opioids, primarily heroin.

The state of Washington has been working hard to address this epidemic for several years, and has stepped up activity to meet the complex challenges it presents. In October 2016, Governor Inslee issued an executive order to help bring attention and focus to addressing the epidemic. The order calls on many state agencies and our partners to work together to carry out the Opioid Interagency Working Plan. This plan has four main goals:

  • Prevent opioid misuse and abuse: The key strategy for this goal is to try to improve opioid prescribing practices by using best practices and following new guidelines from both the Washington Agency Medical Directors Group and the Centers for Disease Control and Prevention.
  • Identify and treat opioid use disorder: This goal’s primary focus is to increase access to treatment for those with opioid use disorder. Recent federal funding to the Washington State Department of Social and Health Services is assisting in this work.
  • Prevent deaths from overdose: Distribution of naloxone to those who use heroin or are at risk for overdose is the primary strategy for this goal. The Center for Opioid Safety at the University of Washington’s Alcohol and Drug Abuse Institute coordinates most of this work.
  • Use data to detect opioid misuse/abuse, monitor morbidity and mortality, and evaluate interventions: This goal seeks to improve our ability to monitor the epidemic through morbidity and mortality data we collect, as well as to improve access to and use of the Prescription Monitoring Program.

The Opioid Response Workgroup meets every quarter to continue this work. Subgroups for each goal meet more regularly to work on their strategies and activities. If you are interested in joining this work, or keeping updated on our progress, you can subscribe to get updates and notifications of activities at

A new Results Washington measurement tracks our progress on decreasing opioid overdose. Governor Inslee and his cabinet were given an update on this new measure in October; the video is available on TVW.

During the 2017 legislative session, an opioid bill (ESHB 1427) was passed and signed into law. The new law does several things to help address the opioid epidemic:

  • It streamlines the licensing and citing of opioid treatment programs. The Department of Social and Health Services is implementing this project.
  • It directs the Medical, Dental, and Nursing commissions, the Osteopathic Board, and the Podiatric Board to adopt opioid prescribing rules. These rules will involve potential revisions of the current chronic, non-cancer pain rules, while establishing new rules for acute, subacute and perioperative prescribing of opioids. These rules must be adopted by January 2019.
  • It makes several changes to the Prescription Monitoring Program. It provides new authority to use the system’s data to provide overdose notifications to providers, looks to improve prescribing practices through quality-improvement work, and calls for other changes to make the program more effective. The Department of Health is working on these aspects of the issue as part of our effort to adopt opioid prescribing rules.

As you can see, Washington is hard at work to address the opioid epidemic. We look forward to seeing what comes from the recommendations made by the President’s Commission on Combating Drug Addiction and the Opioid Crisis to assist us and other states in this work. We also look forward to continued work with our partners in this state to carry out the Opioid Interagency Working Plan. 

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Chris Baumgartner is currently involved with the Department of Health’s Unintentional Poisonings Workgroup and the Agency Medical Director’s Opioid Dosing Guideline, and was previously the Prescription Monitoring Program’s director. Throughout his tenure with public health, Mr. Baumgartner has played an active role in a variety of initiatives to promote patient safety and help prevent prescription-drug overdose and misuse.