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Spokane medical examiner says 2024 overdose deaths rose; fentanyl present in most cases
Summary
The county medical examiner briefed commissioners on provisional 2024 overdose data, reporting 346 signed-out overdose deaths for 2024 so far and fentanyl detected in about 78% of accidental overdoses; officials warned that illicitly manufactured fentanyl products are unpredictable and often mixed with other substances.
Dr. Singh, Spokane County medical examiner, briefed the Board of County Commissioners on Feb. 4 with provisional data showing a continued rise in overdose deaths and heavy involvement of illicit fentanyl.
"Using the latest numbers we have for 2024, fentanyl was detected in about 78 percent of of accidental overdoses in 2024," Dr. Singh said, while noting the county has signed out 346 overdose deaths for 2024 as of the briefing and still has additional pending cases. He said overdose cases made up about 30% of the medical examiner's jurisdiction-accepted workload in 2024, up from about 14% in 2019.
Dr. Singh explained the medical examiner's limitations for determining whether fentanyl is pharmaceutically produced or illicitly manufactured: expanded chemical origin testing is expensive and not routinely available to the office. Instead, investigators rely on scene indicators and laboratory testing that together suggest most current deaths involve illicitly manufactured fentanyl products, which often contain variable mixtures including fentanyl analogs, xylazine, other stimulants or cutting agents.
"In the illicitly manufactured market, these products don't have any quality control measures...so we basically have no idea what's in these products," Dr. Singh said. He warned that the irregular composition of street drugs — and chronic medical conditions developed by long-term users — make it impossible to identify a single ‘‘lethal dose’’ for the illicit products.
Dr. Singh and staff showed a geographic heat map indicating downtown ZIP codes (99201, 99204) had higher concentrations of fatal overdoses and said demographic patterns in Spokane largely mirror statewide trends, with most fatal overdoses occurring among people aged roughly 25–65 and a majority among males. He also noted an increase in mixed stimulant-opioid deaths, particularly methamphetamine plus fentanyl combinations.
Ending: Dr. Singh said the data remain provisional and will be finalized as pending cases and additional testing are completed; he said the medical examiner's office is working on a public dashboard and an annual report to make the statistics more accessible.
