The grim reason fentanyl deaths are falling in King County

Fatal fentanyl overdoses may have reached a peak in Washington state, according to preliminary data. But that's not all good news.

At the end of 2023, the quarterly death toll statewide was down 9% after rising nearly every quarter since 2019. While synthetic opioid fatalities are still rising in some parts of the state, the rate in King County has fallen since July 2023, when nearly four people died each day, on average, from overdoses involving fentanyl.

Caleb Banta-Green, a research professor at the University of Washington School of Medicine, said the change seems primarily due to so many Seattle-area fentanyl users having already died.

"There are only so many people who are using a drug, and when it has that high of a lethality rate, it will eventually — in a really horrific way — start to self-extinguish itself like a forest fire," Banta-Green said. "So, it's literally burning out the fuel. The horrible thing in this instance is the fuel is people."

Banta-Green said that grim curve has also been observed on the East Coast where fentanyl took hold earlier.

"I hope we continue to have a decline, but I hope that the future decline isn't because people are dying, but because they're accessing the really wonderful life-saving interventions that we're really making great strides to make more widely available," he said.

That includes replacement drugs like buprenorphine and methadone, which help reduce opioid intake levels, and lower users' risk of fatal overdose.