Rapid access to care – not jail – will help solve Oregon’s overdose crisis 

Recently, a man stood outside the Portland central city library holding a sign that read “please pray for me.” He was on his fourth day of detoxing off of fentanyl. Trying to get sober while cold, alone and living on the streets was becoming increasingly more difficult for him, and he had written the sign as a last plea for some kind of divine intervention.

That intervention came in the form of outreach workers who were on the street that day as part of a pilot project with Measure 110 providers and the Portland Police Bureau’s central city neighborhood response team, the Central NRT Bike Squad. He told them how desperately he wanted to stop using fentanyl, but he felt himself slipping. The team is made up of compassionate recovery peers, people who are also in recovery. Thanks to their quick work, within just a few hours this man was safe indoors, getting basic survival needs met while the outreach team successfully secured a spot for him at a local treatment program. 

They got him connected with medication-assisted treatment to ease symptoms of withdrawal and an emergency shelter bed at a recovery house. 

Here in Oregon, where treatment access is limited, the man’s story has a good end to it. But if Oregon officials ever hope to truly provide hope and recovery to individuals and communities, we can’t count on serendipity alone. 

Our organization, Oregon Health Justice Recovery Alliance, was part of the coalition that opposed passage of House Bill 4002, which recriminalized addiction in Oregon, returned our state to the failed war on drugs, is predicted to lead to disproportionate arrests among Black and brown people and will require additional public defenders who are already in short supply. This bill was crafted by law enforcement for law enforcement and left out important community voices. However, it was clear in the debate on the measure that even the most conservative voices called for treatment, not jail, as voters intended with Measure 110 as the most effective path. 

Let’s hold them to that. 

Under HB 4002, 23 counties have committed to setting up deflection programs so that when police encounter someone using drugs, there is a better option than arresting them. Recriminalization starts on Sept. 1 of this year, but there are no requirements for counties to set up deflection programs by then, and it would be impossible to do so on such a short timeline in most cases.  When these programs are set up, we must ensure that all deflection programs are culturally and linguistically appropriate, emphasizing community-based organizations over law enforcement. 

That’s the model we are using for a pilot project in Portland, where more than 50% of the peer support outreach workers identify as Black, Indigenous or a person of color, and nearly a quarter of them speak Spanish. The project has been going since December, and we have learned some important lessons that counties could use in setting up their deflection programs. 

The most important lesson is that police are not social workers and are not outreach workers, nor do they want to be. In our project, if police are the point of first contact with an individual using drugs publicly, they immediately refer people who are receptive to assistance to a central command center of outreach workers who show up within minutes, then the police back away. 

We have learned that heavy police presence is a detriment to getting people connected to services. 

Lesson two is that contact with peer support specialists – not threat of arrest or jail – is the most important factor in getting people connected to recovery services. Lesson three is that there must be detox and withdrawal management services available immediately for people who are ready to go into detox. Unfortunately, Oregon’s severe lack of these services will severely hinder the success of deflection programs for the foreseeable future. 

When services are available, we get results. In just nine pilot events, providers have successfully connected with 145 individuals. Thanks to providers working together to pool resources and secure beds in advance of each pilot shift, we’ve been able to connect 66 people with same-day services.

If we don’t hold our elected leaders to their “treatment first” approach, the waiting room HB 4002 creates for people struggling with addiction, literally, will be a jail cell. The vast majority of Oregonians believe that addiction is a health care issue — and they’re right. Now all stakeholders working on this issue must come together to turn this collective belief into our shared reality.