Zackary Morris died after overdosing on fentanyl and meth underneath an I-5 overpass near Sodo on April 21. He had been homeless for the past five to six years. He had also been a father to a 6-year-old daughter, a brother who adored his little sister, and a person who would literally take the shoes off his feet to help someone else.
Morris’ younger sister, Alisha Walter, remembers buying her brother sneakers. He didn’t keep them long.
“He was like, ‘Yeah, this guy was walking down the street, and he had absolutely no shoes. And I had mismatched shoes. So I figured that he needed them more,’” Walter said. “He had a very big heart.”
Walter began sobbing at her daughter’s soccer game when her dad called to say that her brother had died.
Morris, 31, is one of 96 homeless people in King County who have died this year, according to the county medical examiner’s monthly report, a number that’s on track to surpass the record of 195 homeless deaths set in 2018. It’s also likely an undercount, as the medical examiner investigates less than a fifth of deaths in the county, and misses anyone who died in a hospital.
King County’s rise in homeless deaths mirrors what’s happening around the country, and health officials point to a few likely reasons, including the nation’s opioid epidemic, barriers to health care created by the pandemic and the increase in encampment removals.
At noon on June 8, the Women in Black gathered on the steps of Seattle City Hall, each holding a poster with a name of someone who died in recent months. Alicia Lopez. Gary Ashe. Fanette Pinkston. Gregory Oakes.
“Part of it is just to recognize them as beloved members of the community, people who matter, people who someone cares about,” said Brigid Hagan, a member of Women in Black who was once homeless.
For many people experiencing homelessness, the deaths have become numbing.
“I’m dealing with it so much, I’m kind of immune to people around me dying,” said Jon Martin, who has been living on the streets of downtown Seattle for two years.
Black men like Martin are disproportionately represented among the deaths. In 2022 so far, 17% of homeless people who died in King County were Black, while they are only 7% of the overall population, and 85% of homeless deaths were men. Native American and Alaska Native people are also disproportionately represented in homeless deaths.
The impact of “blues”
Fentanyl plays a big role in the increase in homeless deaths, according to King County public health officials. The county medical examiner attributed nearly a third of the total deaths in 2022 to fentanyl — 31. In all of 2021, the county attributed 34 deaths among homeless people to fentanyl. The number has increased each year since 2017.
King County’s drug epidemic is not unique. According to provisional data from the Centers for Disease Control and Prevention, a record 107,000 Americans died of overdoses in 2021, a 15% increase compared to the previous record set the year before, also in large part due to fentanyl.
“When it first came on the scene a number of years ago, it was a novelty. They [pills] were expensive,” said Brad Finegood, a strategic adviser for Public Health Seattle & King County. “Now, those counterfeit pills are everywhere.”
Fentanyl can be masked as a prescription opioid pill like oxycodone or Percocet, and is also making its way into other substances like heroin or cocaine. Fentanyl pills are often referred to as “blues,” for their color. “Fetty” is the street name for the more potent fentanyl powder.
Joseph Holstein, 35, who is homeless in Seattle, said he smokes fentanyl because that’s what’s available.
“It’s prevalent, convenient, it’s cheap. And it just is happening. I don’t know how to explain it better than that — it’s happened,” Holstein said. “I don’t know where to get heroin. They’ve made heroin obsolete.”
Fentanyl is 50 to 100 times more powerful than heroin or morphine, making it much more difficult to treat addictions with existing medications.
Robert Earl Montgomery, who lives in an encampment near the Chinatown International District, said he started smoking “blues” after he was shot in the back nine months ago in an accidental gun discharge. He was then unable to work and became homeless.
“I don’t do it to get high. I do it to not feel pain,” Montgomery said. “People who are homeless, most of them do drugs to numb the pain.”
Montgomery said that’s the case whether it’s for physical pain like his or for the emotional pain and shock of having once been housed and losing everything.
Drug overdoses do not need to be fatal.
“Overdose is reversible,” said Finegood of Public Health. “People should not use alone, and people should have naloxone on them.”
Naloxone, also referred to by its brand name, Narcan, is a medication that rapidly reverses an opioid overdose. James Stima, who has been homeless in Seattle and Everett for the past 10 years, said he always carries some, and has used it to save more than 30 people who have overdosed. He said local governments should stock naloxone in places like buses and trains and public restrooms, and people should be aware of overdose symptoms like pale, blue skin, shallow breathing or choking or limpness.
“It’s messed up that there’s been a lot of deaths and stuff with this, but I mean, it’s definitely preventable,” Stima said.
Health care access severed
Homeless death numbers are breaking records around the country for reasons beyond the opioid epidemic, according to Katie League, a National Health Care for the Homeless policy team member.
She said part of the increase is driven by the rise in the number of people experiencing homelessness and the fact that for many of these people, their connection to health care has been severed.
During the pandemic, most of the projects from Health Care for the Homeless, a federally funded program, either shut down or pared back outreach efforts. On top of that, the group’s work has been limited by the staffing crisis that has also hit the larger health care and homelessness services sectors.
League said intensified encampment removals nationwide have added another challenge.
“Access to care is severed,” League said. “There’s disruption in lifesaving treatment and medication. And very often, providers are reporting that they lose complete touch with the person who they had been engaging in that encampment.”
Seattle Mayor Bruce Harrell’s administration has cleared dozens of encampments since he took office in January. The city says it has offered shelter to everyone staying in those encampments, but often, people don’t take the offer because it doesn’t meet their needs, and they move to a different encampment.
On the steps of City Hall, Anitra Freeman, one of the founding members of Women in Black, read the list of homeless people in King County who have died, along with the causes of death.
“So many of the things that I read on these lists are treatable,” Freeman said, “if you have access to health care.”