Earlier this year, Oregon lawmakers passed a bill to implement new criminal penalties for drug possession and end the state’s three-year experiment with drug decriminalization. The legislation also allows law enforcement in counties that have opted into the program to deflect drug users away from the criminal justice system and into treatment as a way to avoid charges. In Multnomah County, 127 deflections have been initiated since the program started in September. Portland Police Commander Brian Hughes and Heather Mirasol, Director of the Behavioral Health Division for Multnomah County, join us to talk about what the deflection program looks like so far.
Note: The following transcript was transcribed digitally and validated for accuracy, readability and formatting by an OPB volunteer.
Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. Earlier this year, Oregon lawmakers created new criminal penalties for drug possession, ending the state’s historic three-year experiment with drug decriminalization. The legislation also allows counties to opt into programs that let police officers deflect drug users away from the criminal justice system and into treatment as a way to avoid charges. In Multnomah County, about 130 deflections have been initiated since the program started in September. We’re gonna get an update now on how the program has been going.
Heather Mirasol is the director of Multnomah County’s Behavioral Health Division. Brian Hughes is the commander of the Portland Police Bureau’s Central Precinct. They both join me now. It’s great to have both of you on Think Out Loud.
Heather Mirasol: Thanks for having me.
Brian Hughes: Thank you.
Miller: Brian Hughes, first. What does it take for a police officer on patrol – walking around, driving around, biking around – to decide to enforce this new possession law?
Hughes: Well, decide to enforce – we have this new tool that is made available to us. And Chief Bob Day’s direction for the members of the Portland Police Bureau is that, when we are out in the community and come across somebody that is found to be in possession of drugs, that we make an effort to get that person over to what’s now called The Pathway Center, which is the physical manifestation of the deflection program.
Miller: The physical one, because when recriminalization started, the deflection center was not physically up and running yet, but the deflection process was. Is that what you’re getting at?
Hughes: That’s correct.
Miller: How might an officer decide that somebody is in possession of a controlled substance?
Hughes: So, for your listeners, the most common way that fentanyl is used – and fentanyl is one of our most problematic drugs at the moment – is typically through tin foil. So it’s ground up, put on tin foil, burned and then usually kind of smoked through a straw. And officers are familiar with that. As they go about their daily patrols, when they see that, they can now engage that person for what’s now been recriminalized – it’s now a crime, a misdemeanor crime, in the state of Oregon.
Miller: When you say engage, what does that conversation actually sound like?
Hughes: Now that it’s been recriminalized, the officers have the authority and the ability to identify who these people are that they come across, to ask for ID, conduct an investigation, if you will. And through the investigation, they’ll be able to determine a number of things: is the person found to be in possession of larger quantities, maybe they are dealing the drugs, maybe the person has weapons, maybe the person has a warrant for their arrest. So through that investigation, if they determine that there are other charges present or if the person has a warrant for their arrest, that would not make them eligible to go to the deflection program.
Miller: Any other charges or are there certain low level charges that don’t make it so somebody’s not eligible for deflection? Or is it any other charge besides possession of a controlled substance?
Hughes: Yes, so the way it’s currently set up, any other charges besides possession of a controlled substance, then we would take the jail option there.
Miller: OK, but if it’s pure possession of a controlled substance, a low level, a user amount, what does the officer say?
Hughes: For a situation like that, and nowadays with The Pathway Center open, the officer, with no other charges, can take that person into custody. So they would be handcuffed, because technically, now, per House Bill 4002, that’s a misdemeanor crime and we can’t arrest. They give the person the option to either go to the deflection center and maybe find some solutions on how to get out of the situation they’re in, or opt to go to jail. The majority of people we come across that just have drugs alone, choose to go over to the deflection center, and that’s how that happens.
Miller: And it’s a police officer who then takes the person, drives them to the deflection center in inner Southeast Portland?
Hughes: That’s correct.
Miller: Heather, what happens when someone arrives there?
Mirasol: There’s a direct pass from law enforcement to a care plan team. We have peer support specialists, so someone with lived experience, and a healthcare team that will sit down with the individual and do an individual care plan – talk about what resources are available for them to stabilize, access, recovery resources, treatment, some basic needs, other stabilizing stabilization resources.
Miller: Are they in handcuffs for this initial conversation? At what point do those come off?
Mirasol: Maybe Commander Hughes can ...
Hughes: Yeah, they are handcuffed. When we get out of the car, they’re brought into the the center in handcuffs. Then once inside the center, that’s when the treatment phase begins. We have what we call a warm handoff with staff at the deflection center, take the handcuffs off. And at that point, the deflection begins and the law enforcement presence ceases.
Miller: So, as you were saying, the beginning, it seems like a general “Where is this person? What do they need? Where are they in their life?” I mean, it’s kind of “What’s going on?”
Mirasol: Yeah, and we’re creating a supportive environment. So, as Commander Hughes mentioned, they’re not in handcuffs. We’re sitting with them to create a plan, to just really offer them opportunity to engage. So these are folks that might be under the influence. They’re oftentimes experiencing homelessness, so they’re coming in out of the elements. We can provide them with an opportunity for a shower, some food, protection from the elements. Then really kind of get them to a place of being able to engage in that care planning process, and really just talk about what’s available and what they might be willing to have incorporated in their care plan. Then, from there, they have 30 days to engage one of the referrals that’s made from their care plan.
Miller: This is the requirement, that within 30 days they have to access one of the referrals?
Mirasol: Correct.
Miller: And what happens if they don’t do that?
Mirasol: They become ineligible after that 30-day period. So 30 days following, if they are arrested or have a law enforcement encounter for the same offense, they could face arrest.
Miller: Do you have good numbers yet? It’s only been three months, but in terms of the percentage of people who enter into the deflection program, who do follow through within 30 days and seek out some version of treatment?
Mirasol: We actually really understand the interest in that, like we’re eager to get that information out. And as you mentioned, we’re just over 90 days into a process that really takes 60 days to validate, right? Because an individual has 30 days to engage, and then we have 30 days to get the information from the service providers as to whether or not they followed through on the referral and their care plan. So really, we need 60 days to know whether or not a deflection was successful.
With us being just over 90 days in, we really only have some maybe a little bit of information on the first 30 days since the law changed and then recognizing the CCPC, the Coordinated Care Pathway Center, opened on October 14. So we’re eager to get that information out. I think we have to be really responsible with the data that we release. Our aim is to have a quarterly report in mid-February, where we feel like we’d have enough time and engagement to really share information that might contribute to a better sense of how successful the program is and any changes that might be needed.
Miller: This deflection center, it’s not itself a big new treatment center, right? I mean, it’s more like a place where people can go for a short period of time to be connected, in the future, to other services. Is that a fair way to put it?
Mirasol: Yeah, so you’re connected with essentially a care coordination team. And really, the pivotal piece is a person with lived experience, so that peer engagement. We’re experiencing workforce shortage, service shortage, and I think the community knows that well. With that said, there are services. So we want folks to know there’s services and there’s opportunity to engage. But that peer connection is also really crucial in establishing a relationship that provides hope, accountability, shared experience, so that people can walk through and into their recovery journey with that support of somebody who has a similar experience or has been through it, has faced the same barriers.
Miller: Is that someone they’re gonna have an ongoing relationship with, or they’ll see that peer that one day and and maybe never again?
Mirasol: It depends. I would say, peer engagement in substance use disorder treatment – oh gosh, it’s such a powerful … it’s best practice, right? What I would say is, that connection through the Coordinated Care Pathway Center is that preliminary engagement. If somebody follows through on a referral, it’s possible that they might connect to another peer through that service referral. But it provides that initial connection with someone, so that there’s that additional opportunity when the individual might be ready to engage, to ask questions, to figure out what to do with this care plan. Because it may not be in that moment. It may require some time for them to be ready to follow through.
Miller: Commander Hughes, what parts of the current system would you most like to tweak?
Hughes: Well, the Pathway Center is great. We’ve been very well received over there. They offer great customer service to us. Where, I think, we could improve upon is getting people there. So, for me, as the commander of Central Precinct, having a limited amount of patrol officers, our primary work product during the day, if you will, would be answering calls for service from the public. So 911 calls, and we triage all of our calls for service. I would like to be able to go out right now, and take 100 people off of our streets and bring them over to the Pathway Center to give them a shot at sobriety, as opposed to jail. But I don’t have the resources to do that. So I think if I would tweak something, it would be – and we’re in talks with Multnomah County on this – to expand transport to the Pathway Center.
Miller: Meaning, what, like a car or a van would show up on some street corner where the police officer and the person who was arrested [are] … instead of a police officer then driving to the deflection center, some other people would take the person there?
Hughes: That would be helpful, yeah, and free up the officer for 911 calls and other things. I think that would be helpful. And not only just when an officer is there, but maybe engage with the community. We call them, I think, friendly contacts or something like that, but people with lived experience can be in these vans and meet people where they’re at, encourage them to come over to the Pathway Center, and see what a life of sobriety looks like.
Miller: What would it take to actually do that from the county’s perspective? The first question I have is just about funding. I mean, where, where might that funding come from?
Mirasol: I mean, I think there’s a lot that we don’t know, right? So we’ve sat down in these discussions of how do we open the pathway? Currently, the discussion is just around whether or not we engage, expand out to other public safety partners and/or first responders, so that we can serve more. The transportation issue is one that Multnomah County has been in discussions with, with our system partners to try to navigate and answer all of those questions. So, funding is certainly a question mark, as well as just how to operationalize that process.
Miller: Brian Hughes, you said that you wish you could just take 100 people right now who are struggling with substance use disorder and take them to the deflection center. I mean, I imagine that was just sort of a number, not exactly tied to real numbers in the street. But does that give us a sense of the scale of the problem still and the scale of what every piece of the deflection program can actually do right now? Is there way more drug use and drug possession on the streets of Portland right now than you’re able to respond to?
Hughes: Absolutely, Dave. And I can refer you back to Multnomah County’s Health Department. A quick check online will show you that in 2018 and 2019, there were two fentanyl overdose deaths per month. And in 2023, that number rose to nearly 36 deaths a month – way too high. I would say that anything we can do to bring that number down is worthwhile.
Miller: I should say, though, that I was actually looking at that dashboard today. It’s a little bit hard, we’re still, we’re not done with 2024, and when you look at it, you can see that not everything from the medical examiner’s office has been finalized. But it does seem that over the course of 2024, there has been a drop in overdose deaths in Multnomah County compared to the year before. And that would be the late follow-on from what we saw in other parts of the country. In 2023, there were actually significant drops in overdose deaths outside of the West Coast. Maybe it’s finally happening here, and we’ll know that when this data is no longer preliminary.
Heather Mirasol, does it seem like something is changing on the street – separate from the enforcement that we’re talking about – that conditions are slowly improving?
Mirasol: Yeah, there’s been a lot of effort around this. I mean, I think, as we mentioned, similar to Portland Police Bureau’s capacity strain in facing this flooding of fentanyl and methamphetamine into the region, we have capacity strain on our workforce, our ability to meet the need with services. But yeah, there’s a lot of effort. I think there’s a lot of effort in harm reduction, there’s a lot of effort in community awareness. There are services available. We are connecting people to services. We’re also engaging more at that intersection between homelessness and behavioral health. The county just provided some SHS funds towards 250 recovery stabilization in transitional housing beds, launching this year. So we’re really trying to put all available resources into addressing something that’s grown exponentially in recent years.
Miller: Where does a sobering center stand right now?
Mirasol: In the spring, we’re gonna add 13 sobering beds with some medical support to the Coordinated Care Pathway Center. And then we have a long-term … we’re in the process, we’re running parallel. We’re running concurrently at establishing a long-term facility that’ll include sobering withdrawal management and really open the door to serve more than just individuals who are eligible for deflection, to really meet that need.
Miller: Brian Hughes, what’s your best understanding of how a sobering center and a deflection center would interact with each other? I mean, in the scenarios you were describing before, you said that that it’s possible that the person that your officers would take in handcuffs to the deflection center, that they’re not sober at that moment, that that they’ve just smoked some fentanyl and now they’re on their way to the deflection center. In the future, would they be taken perhaps to the sobering center first and then to the deflection center? I’m a little confused how everything’s gonna interact with each other.
Hughes: So the problem is real. I mean, when you asked earlier about the use of drugs on our streets, I think that’s one of the number one complaints I have as a commander of Central Precinct. I have Downtown Portland, Goose Hollow, Old Town Chinatown, and a lot of businesses are down there trying to to come back and we are seeing that. But one of the top concerns are people under the influence of drugs. So a sobering center, at least my perception of that, would be giving somebody a chance to sober up a little bit. And we had that model before with alcohol, but that was when alcohol was more prevalent. Now, they’re having to design it a little differently for fentanyl. But give somebody a chance basically to sober up, have the fentanyl out of their system, to make good choices and hopefully accept some of the programs being offered.
Miller: Heather Mirasol, before the deflection center opened, there had been a lot of local community concerns about the siting of it, what it would mean in this particular neighborhood, in close-in southeast. What have you heard from nearby residents or business owners since it’s opened?
Mirasol: We’ve ventured to be good neighbors from the very start of this process. We’ve been up against really short timelines, with the legislative change that was passed through the legislature in April, for a September 1 start date. We have really focused on the intent of a good neighbor process and that’s really for the community’s safety. So we’ve put a lot of resources and support into that. We’re providing security. Our providers are doing neighborhood engagement and there’s been no increase in loitering, camping or criminal activity in the area surrounding the Coordinated Care Pathway Center. We really have to recognize that stigma is a real barrier to recovery, so recognizing the concerns. We’re also not seeing any major changes and we are engaging with the community around us.
Miller: Do you agree, at this point, with the central premise of decriminalization, that, for a lot of people with substance use disorder, only the threat of criminal prosecution will get them into meaningful treatment? I mean, that, in a sense, is the argument lawmakers made in response to a lot of community outcry and that’s why we are where we are right now. Do you think this is good policy?
Mirasol: I think we always have to balance supportive encouragement with supportive accountability. People engage in recovery when they’re ready and there’s certainly accountability measures that serve as motivators. What I would say is, from the recovery perspective, we just have to provide every opportunity because for someone who is in recovery, I think they know the moment that it happened, right? So the readiness may not be today, it may not be tomorrow, or two weeks from now, or a year from now. But if we’re available – and this is really a key opportunity with that law enforcement engagement, when somebody’s stopped for the misdemeanor offense – to actually make a direct connection with somebody who can be there on the ready when the person’s ready to engage. Really, that’s our approach: how do we open the pathway, so that that access to recovery is available when the individuals that we have the opportunity to serve are ready to be served.
Miller: If you were in charge of a pot of money that could only be used for some version of recovery services, where would you put it right now in Multnomah County? Where do you see the biggest specific gap?
Mirasol: Oh goodness, you’re giving me that.
Miller: This is a theoretical pot of money, but I’m wondering what you think the biggest gap is?
Mirasol: It’s hard to center on any one thing, to be honest with you, Dave, because of where we are in behavioral services. We have capacity gaps at all levels of care, and so we really need to do a lot of upstream prevention. We need to engage in that intersection between homelessness and behavioral health, so that when people enter into the recovery journey or they engage in treatment, they have somewhere safe and comfortable to land. Treatment demands a lot of people. Even when your basic needs are met, it’s hard.
So, for me, it’s a combination of recovery housing, engaging more in withdrawal management, and getting people into residential care and other services that maybe they can access if they also have housing. So it’s really all of the things.
Miller: Heather Mirasol and Brian Hughes, thanks very much.
Mirasol: Thank you.
Hughes: Thanks for having me, Dave.
Miller: Heather Mirasol is the director of Multnomah County’s Behavioral Health Division. Brian Hughes is the acting commander of the Portland Police Bureau’s Central Precinct. They joined us to talk about the first three months of drug recriminalization and deflection in Multnomah County.
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