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Drugs burnt in a spoon.

While overdose deaths in Yakima County have held steady for several years, heroin was a factor in nearly 1 in 5 of those deaths last year.

While small, that’s a dramatic increase from the previous six years in which only one heroin-related death was recorded in the county.

Of the 26 overdose deaths last year, five involved heroin, according to the Yakima County Coroner’s Office. A wide range of legal and illegal drugs accounted for the other deaths.

The jump in deaths is partly due to efforts by the medical community here and across the nation to make it more challenging and expensive to get prescription opioids, said Dr. Ed Bilsky, Pacific Northwest University provost, chief academic officer and opioid expert.

“What has happened is the cost for the prescription opioids has gone up and there’s not as much in the system,” he said. “At the same time, heroin became more pure and the overall cost went down, too.”

Many people became addicted to prescription opioids when they were most often prescribed by doctors between 1990 and 2010. But in many cases, those prescriptions are no longer being written as doctors pursue other potential non-addictive remedies. That’s prompted some people to switch to heroin or other “designer drugs” with the same effects as opioids.

These increasingly common designer drugs, such as fentanyl, a synthetic opioid painkiller 50 to 100 times more powerful than morphine, don’t appear to have caught on in Yakima just yet, but have been spreading nationwide.

Yakima has opioid-related death rates on par with other Eastern Washington counties, which typically see fewer deaths than the west side of the state.

But when it comes to the rate of people undergoing publicly funded treatment for opioid addiction, Yakima is about on-par with much more populated counties, such as King, Pierce and Thurston, according to a report from the University of Washington’s Alcohol and Drug Abuse Institute.

Yakima saw from 90 to 180 people per 100,000 admitted to public treatment facilities between 2011 and 2013.

While heroin deaths rose last year in Yakima County, it’s mostly because other opioids — which have been present in more than half of drug overdoses since 2010 — have fallen.

“The bottom line is opioid addiction is the overall driver of deaths. People will use whatever opioid they can get. It’s just that which one they’re buying is changing a bit,” said Caleb Banta-Green, principal research scientist at the UW Alcohol and Drug Abuse Institute.

Opioid addiction has become so prevalent, President Donald Trump vowed earlier this month to officially declare it a “national emergency.”

That action could bring together schools, doctors, public health workers and others to help fight the problem. Any fix will require more after-school and education programs for students and for medical professionals to work with patients on pain treatments that don’t require prescriptions, Bilsky said.

At this point, it’s unclear if the call for action will succeed.

“I do know lot of people I talk to in this community have been impacted (by opioids),” Bilsky said. “They have a friend (who’s addicted) or they know somebody who has a friend, and we just have to do better.”

Information from The Seattle Times was used in this report.