A lethal dose of fentanyl, in this image from the U.S. Drug Enforcement Administration.
Courtesy of the U.S. Drug Enforcement Administration
Oregon lawmakers say they’re serious about tackling Oregon’s addiction crisis — from stanching the supply of fentanyl on city streets to reducing Oregonians’ demand for drugs.
That urgent response got off to a slow start Wednesday, as a new joint legislative committee held its first hearing in what leaders say will be a yearslong effort.
“We’re here today because the current state of the drug crisis in Oregon is unacceptable,” said state Senate Majority Leader Kate Lieber, D-Portland, co-chair of the new Joint Committee on Addiction and Community Safety Response. “People don’t feel safe on the streets. Oregonians are not getting the addiction treatment that they need when they need it. We are grappling with cheap deadly fentanyl that has hit our streets in the last three or four years in a big, big way.”
Lieber and her co-chair, Bend Democratic Rep. Jason Kropf, have promised the committee will take a holistic look at addressing the factors that have seen overdoses and public drug use surge in recent years, and which appear to have voters ready to roll back the state’s pioneering drug decriminalization experiment.
For some longtime public health and addiction experts, the conversation is long overdue.
“I haven’t seen this in 19 years,” said Debby Jones, a prevention specialist in Wasco County and member of the state’s Alcohol and Drug Policy Commission. “I can’t thank you enough for coming together and saying we can do something.”
But before they do anything, lawmakers want to learn all about the current state of things. For hours Wednesday, the eight-member committee listened to presentations about Oregon’s current system for preventing and treating drug addiction. The overarching message: Oregon doesn’t have enough treatment beds, detox centers, workers qualified to assist drug users, or pretty much anything else.
“So long as it’s easier to get fentanyl than it is to get the treatment for opioid use disorder, we will continue to see a rise in overdose deaths,” said Kimberly Sue, an assistant professor at Yale Medical School who has worked with drug users and studied effective treatment strategies.
By many measures, Oregon’s outlook is worrisome.
An estimated 19.4% of Oregonians age 12 and up have grappled with substance use disorder in the last year, according to the most recent national survey data, higher than the national rate of 16.5%.
At the same time, the state is among the worst at providing treatment. The survey suggested more than 17% of Oregonians needed but did not receive treatment for addiction in the past year, compared to around 14.5% nationally.
Recently, Oregon has attempted to quantify precisely how many more treatment services it needs in each county. An updated study released earlier this year by the OHSU-PSU School of Public Health found a roughly 50% gap between existing services and what’s needed statewide — with the most pronounced shortfalls in Washington and Clackamas counties.
For example, the study found the state should have roughly 12,600 qualified mental health professionals, but currently has just 879, just 7% of what’s needed. It’s also short 2,000 drug and alcohol counselors and more than 17,700 qualified mental health associates (a position that assists patients with mental health matters but requires less schooling than a mental health professional).
One bit of good news: Oregon no longer ranks as the top state in the nation when it comes to rate of substance use disorder and lack of access to treatment, according to the most recent national survey data. Vermont, New Mexico and others have outpaced the Beaver State on those measures.
Lawmakers heard Wednesday from the Alcohol and Drug Policy Commission, a volunteer group of experts appointed by the governor and tasked with improving the state’s response to addiction. The commission intends to come up with recommendations for lawmakers by the end of the year for how to turn the tide of rising overdose deaths.
But the group is wrestling with how best to measure progress in terms of the Legislature’s mission of curbing drug addiction in Oregon, said director Annaliese Dolph.
“That’s something we are figuring out: What is our measure for success,” Dolph said, adding that other states have focused on deaths related to drug use.
According to the Centers for Disease Control and Prevention, Oregon ranked 34th among states in its rate of drug overdose deaths in 2021. But that rate has more than doubled since 2018, and preliminary data suggests it’s risen higher since the more official figures were released.
Lawmakers also heard from Sue, with Yale Law School, who sketched out what the response to fentanyl has looked like in states like New York and Massachusetts that have grappled with the drug longer than Oregon.
Sue cautioned lawmakers against forced drug treatment, which she said can increase a person’s likelihood of eventually overdosing. She raised the possibility of supervised use centers, which have been rolled out in New York, as one option for curbing public drug use and preventing overdoses. And she emphasized the importance of medication like methadone and buprenorphine in helping wean people off of addiction.
“I would ensure people want to go voluntarily,” she said. “Make sure people have the autonomy to go to treatment.”
Under Measure 110, the 2020 law that decriminalized possession of small amounts of drugs, the decision to seek treatment is voluntary, with no consequences for users who decide to simply ignore tickets for being caught with drugs. A group of wealthy Portlanders has vowed to push a ballot measure next year that would roll back Measure 110, create harsher penalties for dealers, mandate treatment for people caught using drugs, and much more.
How the testimony will inform policy proposals during next year’s legislative session remains to be seen. Both Lieber and Kropf have said all policy options are on the table as they look at ways to address the issue
So far, many of the more prominent proposals are punitive.
In recent weeks, lawmakers have increasingly talked about a bill that would give police the option of stopping people caught using drugs in public — even if the possession of those drugs is not a crime under Oregon law.
That’s an approach that Portland city commissioners have clamored for, as public drug use has become more visible. When Oregonians decriminalized possession of small amounts of drugs with 2020′s Measure 110, cities found themselves hamstrung from stopping people from using in public.
“We’re clearly going to do something about public use,” said state Rep. Rob Nosse, D-Portland, a member of the committee.
Lawmakers are also looking seriously at allowing prosecutors to convict people for dealing drugs more easily, after a recent court ruling that upended three decades of precedent.
The committee plans to meet three more times ahead of the February legislative session. November’s meeting will be focused on the state’s criminal justice approach to tamping down the supply of drugs.
“Oregonians believe that Measure 110 has been a failure,” said Senate Minority Leader Tim Knopp, R-Bend, a committee member. “It is incumbent on us as the Legislature to address this… and I really don’t want to wait another year for a ballot measure.”