Oregon’s long-standing heroin abuse problem has become worse in recent years. Hospitalizations, deaths, and arrests related to heroin use in Oregon have all increased since 2001. In 2000, heroin overdoses killed 28 Oregonians. In 2015, the number of heroin-related deaths in Oregon rose to 107.
The DEA reports that heroin availability has increased since 2007 in Oregon, especially in areas close to Interstate 5. About one-third of Oregon’s and Idaho’s law enforcement officers reported that heroin was the most significant drug threat in their area.
That’s a troubling change. Heroin use has been a problem in Portland and its surrounding counties since the 1990s. However, as in the rest of the country, people in Oregon’s small towns and rural communities have also started using the drug.
Fortunately, public health policies initiated in Portland can shepherd people struggling with addiction toward treatment. Those policies could serve as a model for public health interventions in the rest of the state.
Heroin use reached crisis levels in Portland in the 1990s. According to the CDC, heroin overdose deaths doubled between 1993 and 1999. Heroin overdose was the most common cause of death among men aged 25 to 54 in Portland in 1999.
Heroin use in the city spiked again in the early 2010s. Visits to Portland’s needle exchanges increased 48 percent between 2008 and 2013. Heroin overdose deaths reached all-time highs in 2011 and 2012. More than 90 Portlanders died from heroin overdose in those years.
Starting around 2010, heroin use began to increase outside of Portland. The counties that surround Interstate 5 have seen dramatic increases in heroin overdose deaths. So have more rural counties, like Deschutes County, including Bend, and Clatsop County, which includes Astoria.
Oregon’s large supply of prescription opioid painkillers is contributing to the crisis. Manual laborers in rural Oregon’s logging, fishing, and farming industries sometimes suffer from chronic pain, and their doctors prescribe opioids at higher rates.
According to Dr. Kristin Miller, the chief medical officer at Siskiyou Community Health — a health network in the logging town of Grants Pass — 1,200 opiate prescriptions are filled for every 1,000 people each year in rural southern Oregon.
Three out of four heroin users in 2016 previously misused prescription opiates.
Portlanders and other Oregonians are working to reduce heroin deaths. The state has expanded use of the opioid-reversal drug naloxone, passed a “Good Samaritan” law to protect people who try to prevent overdoses, and continued running innovative needle-exchange programs.
One of the most important programs is Outside In. The Portland-based nonprofit pioneered naloxone training and distribution in Oregon.
“We do 30 to 40 treatment referrals a month,” said Haven Wheelock, the needle-exchange program coordinator. “We’re constantly trying to get people connected to the services they need.”
Wheelock said that many of Outside In’s clients are referred to the center by a friend.
“One of the things I love the most about the community of drug users is how connected they are and how much they care about each other,” Wheelock said. “Contrary to what people like to think, they really are a compassionate group of humans who want to help connect people to the resources they need.”