Health

Alaska had fewer overdose deaths in 2024 than in the year prior, and state health officials are working on ways to continue to reduce that total in the future.

In all, 339 people died from drug overdoses in 2024 Alaska, a 5% decline from the record high of 357 hit the year before, according to an annual report released by the state Department of Health.

Alaska’s decline was not as dramatic as the nationwide drop in overdose deaths.

Nationally, the 2024 death total was nearly 27% lower than the total for the previous year, continuing a declining trend that followed several years of sharp increases, according to the U.S. Centers for Disease Control and Prevention.

Overdose deaths, as measured in total numbers, peaked in the U.S. in 2021, according to the CDC. As measured by rate per 100,000 people, they peaked in 2022.

It is not yet clear whether Alaska’s decline in fatal overdose rates will catch up to the national rates or even if the state’s decline will last, said Jessica Filley, an epidemiology specialist with the department.

“I think it’s too early to say if this trend is going to continue,” said Filley, speaking on Thursday during a break at the annual Alaska Public Health Association Summit in Anchorage.

If the trend does continue, several factors may be responsible, she said. One of those factors could be the wider use of naloxone, an overdose-reversal medicine, she said.

Distribution of the emergency medicine has increased substantially in recent years, said Tim Easterly, coordinator of a Department of Health program that provides naloxone kits to people who might be treating at-risk Alaskans.

When the program started about eight years ago, it distributed about 8,000 kits annually, Easterly said at the health summit. In the past two years, it has distributed more than 40,000 kits annually, he said. “So this program has grown. And, unfortunately, we continue to see demand, steady around that 40,000 kits per year,” he said.

Naloxone kits are provided to schools around the state under a law enacted in 2024, for example.

Filley, in a presentation at the conference, described some state efforts to try to use a more holistic approach to prevent overdose deaths.

The state’s medical examination process includes an overdose committee that gathers information not just from official documents like toxicology reports, but also from family members, healthcare providers, first responders and other people who can fill in the backstories of overdose victims.

Those reviews reveal life stories that can contain complex and interwoven challenges that preceded the overdoses. Some victims had complex mental or physical health problems that did not get addressed. Some had traumatic experiences in childhood. Housing insecurity and homelessness also emerged as a factor in some cases, she said.

Reviewing each case took hours; the committee reviewed two every quarter, or eight in the past year. Using those reviews, the committee compiled some recommendations for more comprehensive prevention and treatment.

One of the committee’s recommendations, Filley said, is for “more integrated peer support” and more coordination of case management across different settings, including healthcare facilities, treatment facilities, parole operations and interactions with first responders.

Another recommendation is for better education about trauma, including from experiences in childhood that may have long-lasting effects, she said. “We definitely have some cases where there’s evidence that the decedent experienced trauma or adversity in childhood,” she said.

The committee also recommended more education about dangers from substances other than opioids, including alcohol. While opioids have received heightened attention in recent years and are implicated in most fatalities, there are many cases where victims are abusing multiple substances simultaneously.

Statistics from the state’s annual report show that only 35% of overdose deaths between 2020 and 2024 involved a single drug. The most common combination in fatal cases over those years was a blend of synthetic narcotics like fentanyl with psychostimulants, the state report said. Examples of psychostimulants are amphetamines and cocaine.

There were twice as many fatal overdoses among men than among women in 2024, similar to ratios in the four preceding years. By region, Anchorage had the highest rate of fatal overdose per 100,000 people over all years from 2020 to 2024, according to the state report. In 2024, Anchorage had about two thirds of the state’s overdose deaths, even though it has about 40% of the state’s residents.

More than eight years after 19-year-old Kake resident Jade Williams was killed at a party, a man has been sentenced for causing her death. 

On Wednesday, Superior Court Judge Marianna Carpeneti sentenced 33-year-old Isaac Friday to 20 years in prison for manslaughter. Friday has already spent several years in prison since his 2019 arrest. The judge suspended the remaining years of the sentence. 

Instead of serving more time in prison, Friday will be on probation for seven years, and if he violates his probation, he will face the remaining prison time.

Williams was found dead on August 15, 2017 at a party in her family’s house in Kake, according to court documents. Investigators from Juneau didn’t reach the scene until the next afternoon. Williams and Friday, who was 24 years old at the time, had been in a relationship, and the case was tried as a domestic violence case. 

Friday was first indicted in 2019 on four charges: two murder charges, a manslaughter charge, and a criminally negligent homicide charge. As part of a plea deal, Friday pleaded guilty to the manslaughter charge in February 2025. All other charges have since been dropped.

Jeremy Williams, Jade’s father, said at the sentencing hearing that his life hasn’t been the same since his daughter was killed. 

“I had one job — I failed — that was to protect her,” he said. “It eats at me every day.”

Williams said he believes the sentence is just a slap on the wrist, and that his family’s experience throughout the investigation and criminal proceedings has been traumatizing.

“I really don’t know what to make of this,” he said. “It’s been a nightmare”

He said Jade had plans to go to cosmetology school in Washington, and that seeing other kids graduate and go to college makes him feel her loss, even eight years later. 

But Williams said he hopes this sentencing means Jade’s family can begin to move forward. 

“I hope myself, my family, my friends, his family — we could start to heal,” Williams said.

Friday’s defense attorney Eric Hedland said at the hearing he believes it’s possible that his client didn’t kill Williams. He pointed to another man at the party, who Hedland said admitted that he had been in a fight with Jade that night and had injuries consistent with an altercation. Hedland said DNA evidence that came out years after Friday’s indictment pointed to that other man. The state never filed charges against that person in connection with Williams’ death.

“I don’t know what happened. I don’t think anybody does. I don’t think the state does,” he said. “And that troubles me.”

Friday himself took the chance to speak during the sentencing Wednesday, and said he wants to be able to serve his community again. 

“I’m ready to start giving back instead of taking,” he said. “I’m ready to help someone else rather than sitting in a room taking.”

Before delivering the sentence, Carpeneti said she also thinks the facts of the case remain muddled. 

“None of us will ever know with a lot of clarity every event that transpired that evening and all of the harm that was done to different people,” she said.

Carpeneti said she knows the legal system can’t fix the pain Williams’ death has caused.

“There is not a sentence in the world that will restore Mr. Williams, his family, Jade’s friends and the community of Kake,” she said.

But, she said, the court’s responsibility in a plea agreement is to find an outcome that both parties — the state and the defense — will accept. Friday’s sentence, which both parties agreed to, achieves that. 

An Alaska foster youth advocacy organization is suing the state Office of Children’s Services for allegedly failing to provide food and necessities for older youth in their care.

The lawsuit by Facing Foster Care in Alaska claims foster youth placed in shelters or college dormitories don’t receive enough money for food or basic needs like they would if they were in a home placement with a family.

Facing Foster Care director Amanda Metivier said for years, she’s heard complaints from foster youth that they cannot afford to buy enough food or other necessities.

“For a young person in the dorm who needs transportation to a therapy appointment, the state has a duty to cover that cost,” she said. “When the [college] commons close during winter break and there’s no meal plan, we hear from those youth who say, ‘I don’t know how I’m gonna eat during winter break.'”

Alaska foster youth 16 years and older get a small stipend to help with transitioning to adulthood, for things like getting a driver’s license.

But Metivier said the stipend amounts to a small fraction of the more than $1,000 a month that foster families get to provide food and necessities for children in their care. Facing Foster Care has provided gift cards to cover transportation and food outside of meal plans and shelter meals, according to the lawsuit.

The Office of Children’s Services declined an interview for this story, but an official with OCS wrote in an email that they routinely offer food and clothing vouchers, bus passes and other transportation assistance, and that young adults have access to the same funding streams as younger children.

Metivier said her organization’s youth board works with OCS and has brought up the issue multiple times without resolution. She said some other states have better systems to provide stipends to youth living independently as they transition out of foster care.

“As a state, we’ve continued to see a decline in foster homes,” Metivier said. “We’ve continued to see challenges with workforce in the child welfare system, and those things are not going to improve overnight. And these youth have needs right now, and this would be a pretty simple way to solve that, right?”

Facing Foster Care in Alaska filed the lawsuit Jan. 6 in Alaska Superior Court.

Related: Alaska’s foster care system is among the worst in the nation. Can a lawsuit force real reform?

Stomping through stubborn, crunchy January snow, Dr. Jennifer Pierce made her way recently to a new Anchorage Fire Department vehicle. It might look like a simple SUV, but it’s equipped as a new mobile unit that – for the first time – will allow emergency responders to administer buprenorphine on-site, which can help get patients on the road to recovery.

“We want people to see us as a beacon of help,” Pierce said.

Pierce is on a mission: to treat Anchorage residents who overdose and connect them with care afterwards. After being treated for an overdose, many patients don’t agree to further treatment at the hospital or emergency room. Working out of mobile units allows the team to meet those Alaskans where they are.

“We don’t want people to fall through the cracks,” she said.

Narcan, or naloxone, is used to reverse overdoses. But it puts people into immediate and uncomfortable withdrawal. Research shows that in similar mobile programs, offering that second medication, buprenorphine, makes it more likely patients will enter long-term recovery. Even if people don’t continue treatment, Pierce said, the medication can help them make it through a critical window when overdose survivors are at high risk of dying.

“Even if it’s just one life,” she said. “We’re saving lives out there and preventing individuals, maybe from overdosing the next day or overdosing again later and dying.”

Pierce visited successful programs in Texas and Washington state for ideas and best practices to replicate in Alaska.

The Anchorage team can get dispatched by 9-1-1 when someone is experiencing an overdose. During slower parts of their shift, they’ll be able to do treatment outreach with people who are at higher risk of overdose, Pierce said.

Offering patients buprenorphine has several benefits, said Seth Workentine, an addiction medicine specialist in Juneau who consulted for the pilot program there.

Buprenorphine lasts much longer than Narcan, at least 24 hours, protecting people from re-entering overdose. It also reduces withdrawal symptoms, which can push people back to opioid use, Workentine said.

“Withdrawal is an extremely uncomfortable experience hated by almost everyone who’s ever experienced it and is often a barrier to people seeking treatment,” he said. “Now they just feel normal and have a much bigger leg up into entering recovery.”

But buprenorphine is an opioid, and Workentine said he’s heard critics of similar programs argue that it’s just swapping one drug for another. That’s not the case, he said, because buprenorphine is different and, over time, it actually helps reverse the brain changes that happen with addiction.

“So it’s not replacing one for the other, even though they’re in the same category,” Workentine said. “It is actually part of healing you.”

And that, he said, is integral to the recovery process.

Dr. Quigley Peterson, an emergency room physician heading Juneau’s pilot program, said he’s also seen the healing benefits of buprenorphine. He’s confident the pilot will do well partly because he’s seen how helpful the medication can be in a different setting: the emergency room.

“We have something that can help engage people, that’s super safe and it’s cheap, and it works,” Peterson said.

The pilot programs will collect data over the year to see what happens to patients after they’re given buprenorphine for an overdose, Peterson said. His hope is that it reduces emergency room visits and calls for emergency medical care. That would be good for the mental health of emergency responders, too, who get burnt out responding to the same patients over and over, he said.

If you can get patients into long-term care, Peterson said, “you won’t need to see them in the future. You won’t have these recurrent EMS calls.”

If the pilot programs are successful, Peterson’s goal is to inspire similar programs in more communities across Alaska.

Hundreds of health care workers and government officials descended on Anchorage this week for the kickoff of a five-year, $1.3 billion program aimed at reimagining medical care across Alaska.

The money comes from the Rural Health Transformation Program created by President Trump’s signature tax- and spending-cut legislation passed last summer — the same legislation that pares back Medicaid.

The problem the funding seeks to solve is no secret, the state’s former chief medical officer, Dr. Anne Zink, said on a call with reporters and state officials. Zink is working with the state Department of Health on the program, she said.

“We consistently see that people who live in rural areas — Alaska and beyond — have worse health outcomes with increased cost,” she said. “This is an opportunity to rethink the way that care is delivered to make sure, no matter where you live, you have access to quality, timely, effective care.”

States across the country are racing to develop plans to spend the influx of cash. They have until October to obligate the first tranche of cash and another year to spend it.

Alaska is building its version of the program around six goals, from improving maternal health, preventive care and access to healthcare to strengthening the workforce and rethinking how doctors and hospitals charge for care.

That last point — what the state is calling “pay for value” — is a big one. Most medical care is what’s known as “fee for service,” for example, when a patient goes to a doctor and pays the doctor for their time, whether they get healthy or not.

With pay for value, the idea is to pay for results.

But given the fragmented nature of health care in Alaska, where many patients have to travel hundreds of miles from home for care, “the realities of making that transition take time,” said Deputy Health Commissioner Emily Ricci.

“It’s very challenging, and it will look different for every community and every provider and the provider types,” Ricci said.

Another example: Say you have a rash. You go to the doctor. The doctor sends you to the dermatologist, who sends you to the pharmacy for a medicated lotion.

Does your primary care provider know what your dermatologist prescribed? Does your dermatologist know your regular doctor tried that same medication with the hard-to-pronounce name six months ago?

And does anyone know if you eventually get better?

Maybe not. And that’s an issue standing in the way of a transition to value-based care that the state would like to address, Ricci said.

“How can we use this funding to begin now, over the next five years, building out the infrastructure, the concepts, the protocols, the data that providers need in order to kind of make that transition?” Ricci said.

So technology is one focus for the first of what the Department of Health said will be a series of workshops in Anchorage.

The meetings — known as “convenings” — are an effort to get as many stakeholders involved as possible, from cities and tribes to hospitals, medical providers and vendors, Health Commissioner Heidi Hedberg said.

“This funding is really to support what the community and region need,” Hedberg said. “Every community, and every region, needs something different.”

Alaska will receive roughly $273 million per year for five years as part of the $50 billion nationwide program. Hedberg calls it “generational.”

But the elephant in the room, of course, is that the same tax cut legislation that created the program could also push many Alaskans away from the health care system, said Alaska Hospital and Healthcare Association head Jared Kosin.

“I see the bright side and the good things looking ahead,” Kosin said. “I talk about coverage disruptions with these enhanced premium tax credits expiring. We talk about coverage disruptions with the tightening of Medicaid eligibility right around the corner.”

State officials have downplayed the spending law’s impact on Alaskans on Medicaid. But Kosin is worried the changes will push health care costs up, he said, because when people can’t pay, hospitals have no choice but to shift those costs onto those who can.

Kosin said he’s also concerned that the transition to a new administration after Gov. Mike Dunleavy’s term ends in December could throw a wrench in the state’s plans.

State officials, though, say they’re building sustainability into their plans. Ricci, the deputy health commissioner, said that the state Health Department was “acutely aware” of the challenges involved in standing up a program that will span at least two governors’ administrations over half a decade.

“The key to that, I think, is bringing in the communities and the partners and the healthcare entities into the discussion from the beginning and into that structure,” Ricci said.

Put more simply, “this is a project for Alaskans by Alaskans,” said Zink, the state’s former chief medical officer.

“The sustainability will be dependent on Alaskans,” she said.

Alaska Public Media’s Rachel Cassandra contributed reporting.

A national support line for Native survivors of domestic violence and sexual assault has begun work to launch an Alaska-specific service.

Strong Hearts Native Helpline is a Native-led nonprofit that offers 24-hour, seven-day-a-week support for anonymous and confidential calls from people who have experienced domestic violence or sexual assault.

The line is staffed by Native advocates, but Strong Hearts Deputy Executive Officer Rachel Carr-Shunk said there are not yet any Alaska Native people answering phone calls.

That is set to change soon.

“Even though we’re a Native organization and all of our advocates are American Indian, we do recognize that there is a difference for our Alaska Native relatives who experience violence in that context, whether they live in a rural village or they just live in Alaska, which is a different experience,” she said.

Carr-Shunk expects the organization to launch the Alaska-specific line within the next calendar year, after building partnerships in the state.

“When Alaska Native survivors reach out, we want them to trust that they’re going to have someone who understands their experience as an Alaska Native person, or who understands that identity,” she said.

To that end, the organization has hired Anchorage-based Minnie Sneddy, who is originally from Hooper Bay. Sneddy is tasked with explaining Alaska’s regional differences and specific needs to the organization, as well as helping create a database of Alaska resources.

Sneddy has years of experience in behavioral health work and said that her career and life experience have shown her the lack of resources for people who face domestic violence and sexual assault — and how many of those people need mental health support.

“The years I lived in Hooper Bay, and here in Anchorage and Alaska, there’s so many (people) that need help and want help, but they feel like if they do come forward and get help, they get in trouble — not only with their families, but with OCS, Office of Children’s Services,” she said. “I feel like Strong Hearts Native Helpline can help at least allow a person to be heard, because the majority of time, people want to be heard. Everyone just wants to feel seen and be heard.”

Sneddy said she is reaching out to resources that already exist in the state, and Strong Hearts is working with the Alaska Native Women’s Resource Center to build out its state-specific service.

Alaska has the third-highest rate of intimate partner violence against women in the nation, and men kill women in Alaska at a higher rate than anywhere else in the country. In a state where nearly half of women have experienced domestic violence in their lifetimes, Alaska Native women are particularly vulnerable.

“We don’t have a voice, really, in the villages,” Sneddy said, adding that when abuse happens: “There’s no help for an individual. And if a woman decides to do something about it, she’s seen as a bad person.”

The Strong Hearts Native Helpline is available now for Alaskans, even though there are not yet Alaska Native advocates on the other end of the line. A full list of Alaska shelters and victim’s services providers can be found in the state directory at law.alaska.gov.