Fatal overdoses in Spokane County remain high after years of increasing deaths

Nearly every day for the past two years, someone in Spokane County died from an overdose.

There were 344 overdose deaths in Spokane County in 2025, while there were 346 in 2024. In 2019, when Spokane County overdose deaths began increasing, there were 80.

Though the trend in overdose deaths showed a sharp rise until 2025, there remain uncompleted toxicology reports that could drive last year’s overdose deaths above the levels of 2024.

But the silver lining was a slowing of overdose deaths year over year.

“It is hopeful that the curve is flattening, especially after the continuous increases in fatal overdose deaths we have been seeing these past several years,” Spokane County Medical Examiner Dr. Veena Singh wrote in a Wednesday email answering questions from The Spokesman-Review. “However, the plateau is still a high number, representing so many lost community members.”

Historically, Spokane County lags behind state and national numbers as overdose deaths have increased, decreased and plateaued. Last year, national drug deaths appeared to decline for the first time in years, dropping by 25% from August 2023 to August 2024, according to provisional data from the Centers for Disease Control and Prevention. In other words, this plateau nationally could be a sign of an eventual decrease in overdose fatalities in Spokane County.

Preliminary data from the Washington Department of Health shows that there were 2,100 fatal opioid overdoses in the entire state of Washington in 2025.

“I think it is a good sign that the curve is flattening after years of steady increases; this will hopefully allow treatment and public health initiatives to gain some traction,” Singh wrote. “But the high numbers also do tell a tragic story of loss in our community, that directly and indirectly impacts people across all life circumstances (regardless of age, socioeconomic status, housing status, employment status, etc).”

While final data from Washington or the U.S. is still unavailable for 2025, Singh said if those numbers show a decline, it could mean that Spokane County will experience the same decline in overdose deaths next year.

The ages of people who died of a drug overdose in 2025 ranged from 17 to 75. Men accounted for 81% of the deaths.

The highest number of deaths was among people who were 35 to 46 years old, Singh said during a presentation to the county commissioners. And 62% of the people who overdosed had a home, while 35% were homeless, Singh said. About 96% of overdose deaths in Spokane County were accidental.

Last year, the Spokane Fire Department responded to 1,795 overdose patients and administered the opioid-reversal treatment Narcan 980 times. That’s an average of 150 overdoses and 82 treatments used by the fire department every month in just the city of Spokane.

Around 59% of fatal overdoses happened in either the person’s home or another residence, while 18% occur outside, Singh said. Zip code 99201, which covers downtown Spokane, has the highest concentration of overdoses in the county. Most overdose cases involve several substances, typically a combination of an opioid and a stimulant, which can complicate treatment.

Methamphetamine was the most common drug connected to overdose deaths, which hasn’t happened since 2020. Fentanyl was the second-most common drug related to overdose deaths.

The takeaway from the numbers is that substance use is not a fringe issue, Singh said.

“These numbers show that fatal overdoses are happening across all ages and life circumstances, rather than in a small subset of people,” Singh wrote.