Numbing the pain: Opioid crisis on the Olympic Peninsula

Vicki Lowe, a Sequim City Councilmember and citizen of the Jamestown Tribe, was taking notes on intergenerational trauma at a conference when it hit her.

“I'm like, ‘Oh my gosh, this explains so much. This explains so-and-so and that person,’” she said. “And then I went, ‘Oh my God, this explains me.’”

Intergenerational trauma is one reason the opioid crisis looms large in the small towns and rural areas of the Olympic Peninsula, where Lowe lives, two and a half hours west of Seattle.

Opioids numb that trauma, Lowe said.

"When I was 13, I started drinking," she said. "I realized when I was drunk, there was something that I didn't feel anymore. I feel like that's what happens with opioids."

This area in Washington’s northwest corner encompasses the towns of Port Angeles, Forks and Sequim, and is home to several Native tribes. Opioid use disorder disproportionately affects Native Americans, in large part because of intergenerational trauma.

I

n the mid-2010s, communities on the peninsula launched a cascade of programs to get things under control. They were just starting to slow the death rate when, in early 2021, fentanyl arrived, and overdoses shot up.

Last year, they tried a new approach: a healing clinic. Despite fierce resistance, the Jamestown Tribe opened the clinic last July.

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Lowe, the Sequim council member, tells the story of her friend, someone so close she was there when her baby daughter was born.

When that baby daughter was 15 years old, “she got in a car accident and hurt her back, and got addicted to opioids, and then just didn’t live to see 21,” Lowe said. “There’s so many of those stories. If we could have had a program like we have now for her, she would probably still be here.”

“The design of this clinic was done to be big and open and beautiful,” said Molly Martin, the clinic's medical director. “We want patients to feel welcomed here, and also to feel like this is a place where they can come and be safe.”

Most come here for a daily dose of methadone, medicine that blocks opioid receptors to keep people from experiencing withdrawal after they stop taking fentanyl or another opioid.

Patients might spend hours here, not just getting methadone, but also dental care, primary care, and mental health counseling. The clinic also provides door-to-door transportation and child care.

So far, there are about 100 patients.

“The average age of our patients is mid-30s,” said Martin, who’s also a nurse practitioner with a doctorate in nursing practice. “Most have had opioid use disorder for over 10 years. And most of our patients have lived on the Olympic Peninsula for the majority of their life.”

On the Olympic Peninsula, as elsewhere, the opioid epidemic started with prescription drugs — but those pills were prescribed at higher rates on the peninsula than elsewhere in Washington, partly because of work-related injuries from fishing and logging.

Other factors that contributed to the crisis were poverty, lack of affordable housing, and intergenerational trauma.

Despite the magnitude of people struggling with addiction, the Jamestown Healing Clinic almost didn’t get built — it faced tough opposition from a group called “Save Our Sequim,” many of whose leaders were not from Sequim. In fact, the group’s chair has never lived in Sequim.

The group held protests and tried to challenge the project in court — but was found to not have standing.

“They didn't want the people who would be served anywhere near them, even though they're already here, obviously,” Lowe said. “They didn't trust the tribe to do a good job. Because you know, that assumption of incompetence is part of racism.”

The chair of Save Our Seqium, Jodi Wilke, gave a different reason for opposing the clinic. She is also a nurse and the chair of the Jefferson County Republican Party.

She said they worried about Sequim’s sizable retirement community — that people with a history of substance use might commit crimes against vulnerable, elderly Sequim residents.

“In big cities or downtown Seattle … it’s not safe,” Wilke said. “The people that are living in Sequim do not want to see the degradation of our quaint small town, rural retirement and family-oriented community.”

Wilke also said there were already plenty of treatment options in the area, and that the Healing Center was too big for a small town.

Save Our Sequim participants “are 100 percent willing to support and try to help addicts that are part of the community,” Wilke said, “but they’re not so willing and supportive of the idea that we should invite people from all over the peninsula and even from Seattle, or wherever, to come on out.”

None of the clinic’s patients come from as far away as Seattle.

The tribe pushed ahead and opened the clinic in July.

“Has there been an increase of problems like we were concerned about? I don’t know; I can’t answer that,” Wilke said. “I haven’t looked into it at all.”

“What happened to Seattle took decades,” she added. “It’s not going to happen overnight, that’s for sure.”

Molly Martin, the clinic director, said the protests have died down, but the opposition made some of the patients more nervous about getting treatment.

“There were a lot of signs in people’s yards,” Martin said. “Our patients saw that. And I still see the ripple effects [on] people — it’s like they have another invisible hurdle to overcome coming to see us.”

Some of Martin’s patients don’t want the clinic’s transportation vans to pick them up at their homes, because their neighbors had “Save Our Sequim” signs. Others don’t want to tell people they’re on methadone, or that they’re being treated at the Jamestown Healing Clinic.

Learning the skills to be able to navigate social situations in the community sober is a big part of the recovery process.

The clinic has been open for a little less than a year, which is long enough to have had a dramatic impact on the people who come here.

Some of them had lost everything — jobs, homes, marriages, children. Now, they’re turning things around: applying for part-time jobs, finding housing, repairing their relationships with their families, and working to regain custody of their kids.

Martin said a huge challenge for her patients is figuring out how to reinvent themselves in a small town, where you constantly run into people you know and people who might tempt you back into using.

Despite individual successes, Martin said, a year is not long enough for the clinic to have had a noticeable impact on the scale of the epidemic in the community.

“While we’re treating people, the fentanyl crisis is surging around us,” she said. “Unfortunately, we’re likely going to have many new patients for a long time to come.”