State and city officials have declared the end of a 90-day “fentanyl emergency” in Portland, Oregon, and released a report detailing their actions. Overdose deaths reportedly remained steady in the county during this period. Advocates say more services are desperately needed, as they seek to reduce negative impacts of Oregon’s repeal of drug decriminalization.
Oregon Governor Tina Kotek (D) declared the state of emergency in January. On May 3, Gov. Kotek, Portland Mayor Ted Wheeler (D) and Multnomah County chair Jessica Vega Pederson (D) held a press conference to discuss its outcomes. The officials said that during that time, they connected more people with treatment, housing and other services—while also targeting more people who sell drugs.
Vega Pederson reported a total of 80 treatment and detox referrals, 30 housing referrals and 300 shelter referrals during the emergency period. She also reported that government agencies expanded naloxone distribution and peer support, created an overdose map and launched a youth drug prevention campaign.
Officials also discussed building a new intake facility “that accepts referrals from all sources (law enforcement, community organizations, medical professionals, etc.) to match those seeking treatment to the appropriate level of care and supportive services.” Full details of the emergency period are described in a 120-page report.
Law enforcement was a significant component of the emergency actions. In a press release, officials stated that Portland police increased bike patrols in downtown areas on evenings and weekends, and expanded the “Narcotics and Organized Crime” unit to investigate overdose cases and work with the feds on busting drug shipments. Gov. Kotek announced that she is asking Oregon State Police to continue working with Portland police for the next six months.
“The police walks away—and that outreach person starts working to see if the person needs help.”
Tera Hurst, executive director of the Health Justice Recovery Alliance, is concerned that city and state officials are defining harm reduction too narrowly around naloxone distribution, when there are so many other needs. She also questioned why the emergency declaration only happened in 2024, saying it could have applied at least as early as 2020.
The Health Justice Recovery Alliance is a statewide advocacy organization, representing community groups and service providers across Oregon. It was heavily involved in the rollout of Oregon’s historic Measure 110, which decriminalized low-level drug possession and increased funding for treatment and harm reduction. In March, state lawmakers repealed the decriminalization aspect of Measure 110, reinstating low-level drug possession as a misdemeanor.
Hurst said that her organization has been focused on expanding the role of peer support workers in Portland. This has included a pilot program with the Portland Police Bureau, launched in December, to get cops to call on peer workers when they encounter people who use drugs—and curtailing police involvement in those situations.
“We offered to be outreach, so when a person gets cited, the police says, ‘Do you want help? We have someone who can come and talk with you,’” Hurst told Filter. “If the person says yes, they call a phone we’re attached to, and we dispatch two outreach workers to that person within 10 minutes. The police walks away—and that outreach person starts working to see if the person needs help, or connections to withdrawal management, a shower, a bed, shelter…”
The approach has been accepted by law enforcement, Hurst said, because police feel they can leave a situation when “the appropriate person is coming in.”
She added that there’s “a lot of education needed” among police officers, and that this program helps provide some. “Many officers think [fentanyl] is a ‘super heroin,’ as they’ve said to me, which is not the case. It’s important they understand what people are going through on the streets.”
Hurst hopes that this program can be a model to mitigate the harms of law enforcement in other places, turning a potential drug arrest into something else. Portland’s program is set to receive $683,000 in funding from the city, county and state in its first year, enough to buy a van and hire five employees, including four peers, to do this work.
Measure 110’s funding for services remains—committing tax dollars from legal cannabis sales to organizations providing supportive services like treatment, housing and harm reduction—which brings opportunities to help people in need.
“It’s important that we have this outreach, but we need the workers to do more than just put somebody on a waitlist.”
What’s still lacking, however, is immediate, low-barrier treatment and detox services for people who can’t wait. Oregon is far short of meeting demand for treatment and detox beds, as a January report from the state health authority showed. Despite investing $1.5 billion into its behavioral health system, the state would additionally need to spend more than $500 million over five years to create the 3,000 new behavioral health beds needed, without even factoring in the housing units and outpatient facilities required.
“It’s important that we have this outreach, but we need the workers to do more than just put somebody on a waitlist,” Hurst said. “If somebody wants withdrawal management, you need to get them in that spot that day, within the next few hours, or they’re sick and won’t hold out that long. Our main detox center here makes you wait in line at 6 am every morning, and they turn hundreds of people away a month.”
Hurst added that she would like to see Portland open an overdose prevention center (or safe consumption site), to immediately impact overdose death rates.
Regarding the central intake facility discussed by officials, Hurst isn’t sure if it will be helpful without expanded treatment options on the back-end. “What we are desperately in need of is more withdrawal management beds and the followup to those,” she said. “Having a drop-off intake center, if there’s no where to intake them to, it could be problematic. Ultimately, none of this works if we don’t build out the access to care.”
Photograph via Loc’s Public Domain Archive/Public Domain