Fentanyl is straining Oregon's public health system
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Illustration: Victoria Ellis/Axios
Recent surges in fentanyl-related overdoses have drawn renewed attention to the drug epidemic in Portland.
- Axios spoke with Oregon Health Authority's John McIlveen, the state's opioid treatment authority, about the strain the crisis has placed on public health infrastructure.
Why it matters: Illicitly manufactured fentanyl, a synthetic opioid, has fueled a significant increase in overdoses since 2019, per OHA data.
What they're saying: "The overdose net is getting wider," McIlveen said. "People are overdosing and, at the very minimum, developing severe dependence much faster than they used to."
- Fentanyl is 50 times more potent than heroin, a lot cheaper to buy and manufacture, and 100 times stronger than morphine, according to the Centers for Disease Control and Prevention.
The big picture: Fentanyl has created a "perfect storm" for Oregon's public health infrastructure, McIlveen added, due to its low cost and widespread availability. Overdoses are now trending younger and affecting those who are "opioid naive" — first-time users.
- The explosion in fentanyl use has placed extreme pressure on already overextended, under-resourced public systems like emergency medical technicians, withdrawal assistance programs and medication-assisted treatment (MAT) centers.
- "The need is outpacing our ability to match that," McIlveen said.
For example, many of the publicly funded withdrawal management services in Portland, like Hooper Detoxification Stabilization Center, are at capacity. Many Portlanders, most of them homeless, show up for care but are turned away due to lack of beds.
- "We do need more medication-assisted treatment providers," McIlveen said. "These are systemic issues that come from historical lack of investment."
- Central City Concern, a nonprofit serving people experiencing homelessness in Portland, is currently without nearly a dozen drug and alcohol counselors. Because of that, the organization estimates it's unable to serve over 400 people who would be seeking outpatient treatment.
What's next: McIlveen pointed to some "bright spots" in the region's response to the fentanyl crisis.
- In February, the Grand Ronde Tribe opened its second Great Circle opioid treatment clinic in SE Portland, in addition to its Salem location. Native Americans are one of the most vulnerable populations to overdose deaths.
- A bill in the Oregon Legislature aims to fund drug treatment and behavioral health programs for those incarcerated within the Oregon Department of Corrections. Formerly incarcerated people with histories of addiction have some of the highest rates of overdose nationwide.
Meanwhile, OHA is building out its Opioid Treatment Program, aimed at delivering counseling and medical services to those experiencing addiction and coordinating care plans with more service providers.
The bottom line: "We can't, and maybe shouldn't, do it all by ourselves," McIlveen said. "We need partners, key stakeholders and people that are doing this work in the communities that are being impacted."