Re-Bar’s dance floor, the scene of many a fun, sweaty night, hosted a more subdued event one Tuesday evening earlier this year.
Sitting in a half-circle of chairs, eight workers from Re-Bar and other Seattle establishments were at the venerable South Lake Union club to learn how to administer a medication that can temporarily halt an opioid overdose and potentially save someone’s life.
Opioid overdoses aren’t a widespread problem in Seattle’s nightclubs, said program creator Scott Plusquellec, the city of Seattle‘s nightlife business advocate. But he wanted to take preventive action as Seattle and King County battle an opioid crisis. “This is an epidemic that will continue to grow and be problematic,” he said.
The issue has been compounded recently by the emergence of fentanyl, a powerful synthetic narcotic many times more potent than heroin. The drug, used by health-care professionals to treat severe pain, is also turning up in heroin and other drugs bought on the street.
Last year, 62 people died in King County from fentanyl-related overdoses. That number could change as final toxicology reports from the end of the year come in. But already, it’s almost double the 33 deaths here involving the synthetic opioid in 2017.
Plusquellec, along with public-health officials from the city and county, hopes to help stem this tide by distributing kits of naloxone nasal spray, also known as Narcan, to bars and nightclubs and training workers on how to use them.
He told the small group assembled at Re-Bar that all nightclub employees, from the bouncer to the bartender, could be in a position to save a life.
“If somebody is going past your club who is having problems, you can help them,” Plusquellec told the group. “This is really about keeping you safe, keeping your staff safe and keeping your patrons safe.”
Dane Wilson, who bought Re-Bar in 2014, has spent much of his career in Seattle’s nightlife scene. He has lost friends to overdoses through the years, and he says he believes in the importance of having his staff trained for the worst. After a 2016 shooting at an Orlando nightclub killed 49 people and wounded 53, Wilson started providing CPR training for his employees and other nightlife workers from around the city.
“Having employees, owners and artists trained helps,” Wilson said. “This is part of our due diligence.”
Re-Bar’s naloxone kit hasn’t been used, Wilson said.
Seattle and King County’s joint public-health department helped with training and funding for the kits, which come two to a box and were purchased at cost for $90 each from Kelley-Ross Pharmacy. The pilot program cost $2,000 and included 10 Seattle clubs.
Plusquellec pitched the naloxone program to the Seattle mayor’s office after learning about a similar effort in British Columbia. That province-wide program, run through B.C.’s Center for Disease Control, gives a naloxone kit to whoever wants one. To date, 128,000 kits have been distributed, and at least a quarter of those have been used to reverse an overdose, said Dr. Jane Buxton, who leads the center’s harm-reduction efforts.
“They are being used,” Buxton said. “They are essential, they are a tool to be used.”
Since introducing the take-home naloxone program in 2012, the provincial government has expanded it, offering free kits at 1,500 sites throughout British Columbia. Five separate health authorities provide training.
Public-health officials in British Columbia have largely shifted to a harm-reduction approach, implementing policies and interventions meant to minimize the negative consequences of drug and alcohol use. Disseminating naloxone is part of that larger effort, as is educating people about treatments that could include buprenorphine, a narcotic that removes a person’s physical craving for opioids without getting them high.
“We have to have all manner of ways to treat people, no matter where they are in their substance-use journey,” Buxton said.
King County is also adopting a harm-reduction approach. The more resources that get to drug users and those trying to help, the better, said Joe Tinsley, a health manager at Public Health – Seattle & King County.
Tinsley, who works at the needle exchange in Belltown and helped with the nightclub training sessions, hopes naloxone can be distributed more widely to places like public libraries.
“Our main target for Narcan training are the folks using opioids,” Tinsley said. “We have done training with other community-based organizations and outreach workers. Family members have been trained. Those are the folks we want to make sure they have the knowledge and the training.”
Some bar and club owners haven’t heard of the program or are worried participating might encourage the use of heroin and/or fentanyl in their businesses, said Wilson, the Re-Bar owner. Plusquellec said he hasn’t heard those concerns and that the people he speaks with want to be prepared in case the worst happens inside or outside their businesses.
The program would need a second round of funding before it could be expanded from its pilot stage.