After people are arrested and brought to the Snohomish County Jail, they’re escorted through a set of double-secure doors. Then they are taken to a pat down wall where deputies check for drugs or other contraband. In some cases, they end up being strip searched in a small space with a curtain just off to the side.

“At which point then they get screened by our medical staff, and our nursing staff comes back and they have a series of questions, they check vitals, they look to see for drug usage,” said Sgt. Dan Young, noting that if they are “cleared to book” medical staff runs urine tests on all incoming inmates to see what, if any, drugs they’re on.

Over one recent morning in the booking room, a woman was brought in fidgeting, screaming and crying. Officers suspected she was on meth.

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“What you see here is a female who is not very cooperative, ” Sgt. Young said. “Before the nurse can evaluate her, she has to be searched; make sure there are no weapons or other contraband on her person. Some new bookings, in just a matter of minutes, we get through the process. There are other times when we’ve spent 20-30 minutes trying to deal with them.”

It’s just one scene from a seven-day effort to count overdoses across Snohomish County — from jails to emergency rooms. Multiple agencies took part, attempting to provide a snapshot of the opioid crisis.

Overdoses are common in the county. During a one-week period in June, 321 of the 399 new bookings at the jail were placed on 72-hour withdrawal watches, most for opiates or a combination of meth and opiates, alcohol, or another drug.

The three-day detox watch takes place in the jail’s medical and detox facilities. The Snohomish County facility is one of the first in the state to provide inmates with Suboxone, a drug that treats addiction medically. That’s where they meet Nurse Julie Farris, one of the lead nurses at the jail’s med unit, where’s she’s worked since 2005.

“As far as drugs and alcohol, it was primarily alcohol,” Farris said. “And as the years have gone by, we’ve had more and more methamphetamines, and the introduction of heroin, and then we had the Oxycontin problem that happened. It exploded. The Oxycontin company changed their formula … and then the heroin really took over.”

Treating addiction at Snohomish County Jail

Inmates dealing with addiction often have a range of other medical problems.

“The abscesses … the chronological aging that occurs because our population is getting older,” Farris said. “The heroin is continuing and accelerating their aging process.”

“We need to find out if the females are pregnant, because sometimes we have people who don’t know they are pregnant when they get here, because of their lifestyle, and they are not … taking care of birth control,” she said. “That has big ramifications if they are pregnant and heroin addicted because now we have two patients.”

About 90 percent of the women who are pregnant at the jail end up having opiates in their system.

Farris admits not everyone who goes through the jail’s detox stays clean — she ends up seeing them again — but she hopes at some point she’s the right person at the right time to make the difference and get that person on a better path. And she’s passionate about the cause.

“Life motivates me,” Farris said. “And the youth motivate me. And that is what the heroin is taking away; the youth from us. Heroin is taking our children. If we lose our children, what future do we have? So I’m going to continue doing what we do.”

The Snohomish jail’s med unit is often well above capacity, so the jail doesn’t always accept people showing signs of drug use who are arrested for smaller crimes like shoplifting. Those folks end up back on the outside.

Addiction in the ER

Eric Korsmeyer is a registered nurse who tracks overdoses for the county. He often encounters addicts at the ER. When someone shows up with withdrawal symptoms or survives overdose, he asks them some questions, whether they want help, and what they can do to help them get services they need.

He sees an average of seven overdoses a week. He has a new tool to help people dealing with opiate addiction — a Suboxone program at the ER.

“Somebody is in active withdrawal and they are seeking help getting started on Suboxone, we would refer them to a Suboxone clinic, but by they time they actually physically got in there, they couldn’t withstand the withdrawal so they end up using again,” Korsmeyer said.

Korsmeyer also helped identify a recent trend the county is now warning drug users about, with nearly a half dozen overdoses in the past 2-3 weeks linked to fake “Perc 30s.” They’re popular among drug users who think they’re buying legit 30 milligram Oxycodone pills. They’re actually bogus pills made with synthetic fentanyl, which is much more deadly than the real deal.

While some drug users who overdose survive, others end up at the Medical Examiner’s office which has seen 49 confirmed overdoes this year and is awaiting toxicology results to confirm more than two dozen others. In 2017, there were 129 fatal overdoses – the highest number in the county in four years.