At least 231 people in Spokane County died from opioid related overdoses in 2024, according to preliminary death certificate data.
In September alone, there were nearly 250 emergency medical service, or EMS, calls for suspected overdoses, the highest on record for the city.
The average number of EMS calls for suspected overdoses has risen from 51 per month in 2019 to 188 per month in 2024. But the percentage of people receiving naloxone, a livesaving drug that reverses opioid overdoses, before EMS arrives has not increased. It’s remained about the same, hovering around 20% for the past five years but dipping slightly last year to 18%.
In light of this, the mayor’s office proposed an ordinance to Spokane City Council that would establish a Community Health Impact Area in downtown Spokane. It would require retailers selling smoking paraphernalia in the area to buy naloxone, often branded as Narcan, and provide it free of charge to anyone purchasing smoking supplies like pipes, bongs, butane torches or foil. Grocery stores would be exempt from the requirement.
The City Council is scheduled to take a final vote on the ordinance at the 6 pm meeting on Monday, Feb. 3. Council members are also scheduled to vote on a measure that would create an alcohol impact area downtown, in an effort to restrict the hours when retailers can sell alcohol.
The community health proposal is a unique idea without known precedence, says Adam McDaniel, policy adviser to the mayor’s office. Mayor Lisa Brown says the ordinance has two main goals: to discourage the sale of smoking paraphernalia at convenience stores and thereby decrease easy access, or flood downtown with a livesaving drug. Both, Brown says, would be a benefit to the city.
“Convenience stores are facilitating addiction with these supplies, many times not even screening with age requirements,” she says.
Under Washington state law, it’s illegal for retailers to sell drug paraphernalia — that is, supplies used to consume illegal drugs. Outlets that sell pipes and torches market them for legal uses, often labeling them as tobacco-related products. But state code allows cities to make ordinances concerning harm reduction around smoking paraphernalia, according to a report McDaniel gave to the City Council.
Any effort to improve community access to naloxone is in line with recommendations by the Spokane Regional Health District, says Dr. Francisco Velázquez, the district’s health officer. It’s important that naloxone is used as quickly as possible if someone appears to be overdosing on opioids, he says.
Velázquez also says that decreasing access to paraphernalia in order to decrease drug use is a fairly standard public health strategy.
“The most common type of opioid use is smoking,” he says. “Anything we can do to decrease [supplies] will hopefully decrease use overall.”
According to studies collected by the peer-reviewed Harm Reduction Journal, smoking rather than injecting opioids helps reduce the spread of certain diseases. Also, people with access to safe smoking materials were less likely to engage in risky behaviors like sharing pipes.
The health district encourages people not to share anything that goes in the mouth, Velázquez says, since sharing can spread shigella and other bacteria. Also, people may not know what residue is left over in a pipe from the last time it was used. About 80% of overdose deaths in Spokane involve at least two types of drugs.
Still, Brown says her team has looked and hasn’t found evidence that decreasing access to smoking supplies would negatively impact public health.
“Our goal here is harm reduction,” Brown says. “If we get evidence that somehow the lack of access to these supplies is contributing to a problem, we would certainly change course. But at this point, we are trying very hard to make it harder for people to access that paraphernalia, particularly in areas downtown where there is such a concentration of individuals — because that then attracts the people who are supplying the fentanyl and illegal drugs.”
City Council member Michael Cathcart doesn’t always agree with the mayor or liberal-leaning council members like Paul Dillon, Zack Zappone and Council President Betsy Wilkerson who are sponsoring the ordinance. But in this case, the representative for the downtown neighborhood supports the proposal, saying it’s an imperfect but necessary way forward.
“By no means is any of this, say, a strategy to prevent drugs and criminal activity and things of that nature, but we’re so limited in our options that at least it’s a step forward,” Cathcart says. “I hate the idea of putting burdens on businesses, but by the same virtue, these businesses are selling goods that have absolutely no purpose except to destroy.”
Ryan Hwang, owner of P M Jacoy’s in downtown Spokane, sells glass pipes for tobacco use near the front of his store. If the ordinance passes, he isn’t sure yet if he’ll provide naloxone or stop selling pipes. Regardless, he doesn’t think that his business decisions will impact other people’s decisions to smoke or not.
“If people truly want it, they’re gonna get it,” he says, noting that smoking paraphernalia isn’t very hard to find. “It doesn’t matter what the laws are.” ♦
