The Multnomah County Health Department is slated to provide smoking supplies to fentanyl and meth users starting this month in an effort to dissuade them from using needles to inject the drugs, which can lead to more potent, fatal doses and the spread of diseases.
The effort will start this month, as first reported by Willamette Week.
People can receive supplies at the Multnomah County Health Department harm reduction clinic and syringe exchange in outer Northeast Portland, said spokesperson Sarah Dean. Outside In, a homeless youth nonprofit, and the Portland Overdose Project also are handing out supplies, separate from the county.
The additional supplies will include glass pipes, tin foil and snorting kits.
“Smoking supplies have already been or are being integrated into harm reduction programs globally,” Dean said. “Research remains clear that distributing harm reduction supplies does not encourage substance use.”
While public health experts agree that more detox beds, substance use recovery and behavioral health services are severely needed to reduce harm and deaths from drugs in Oregon, harm reduction supplies can keep people healthy and alive in the meantime – giving them a chance at recovery once they are ready and once the recovery system is large enough and functional enough to serve them.
As the community waits on promises of more services in Multnomah County, fatal opioid-related overdoses saw a fivefold increase between 2018 and 2022, The Oregonian/OregonLive previously reported, with fentanyl deaths reaching a record-high 209 last year.
The newly available smoking supplies were purchased at the end of the 2022-2023 fiscal year, using $82,835 from the syringe exchange budget that had gone unspent, Dean said.
The rise in popularity of fentanyl, which is more typically smoked or swallowed, over heroin and meth “resulted in the demand for injection supplies drastically decreasing,” she said. “So we used supplies funds that were calculated based on syringes … to purchase smoking supplies.”
Dean said experts don’t know yet if trends will shift back to injecting drugs. What the department purchases in the upcoming fiscal year will be determined by engaging with clients to understand what they need to keep them safe, she said.
The county’s harm reduction budget for the 2024 fiscal year is $3 million, which includes grants from Care Oregon and other sources. The county general fund chips in $613,750.
The Legislature led the way on more harm reduction efforts when lawmakers passed a bill this session to decriminalize the distribution of drug paraphernalia with the intent of expanding harm reduction efforts. The bill was just focused not only on efforts to reach unhoused people on the streets of Portland, but also responding to a large push from student activists wanting to make it legal to provide those life-saving resources to college students as well.
Gov. Tina Kotek still needs to sign the bill.
Across the country, from Los Angeles to Seattle to Boston, health departments are experimenting with the same effort to provide safe smoking tools.
Already health departments, including Multnomah County’s, hand out drug-based harm reduction supplies including fentanyl testing strips, clean needles, biohazard containers, wound care supplies and Narcan, which reverses opioid overdoses. When people visit the centers, they can also receive referrals to medical, mental health, drug treatment and social services, Dean said.
This decision comes after Portland Mayor Ted Wheeler briefly tried to criminalize drug use on city streets. He dropped the effort after Oregon lawmakers strengthened criminal penalties against fentanyl possession and legal experts raised question about the city’s power to regulate public drug usage.
Lawmakers approved House Bill 2645, which makes having more than 1 gram and less than 5 grams of a substance with fentanyl a misdemeanor. The bill also allows prosecutors to charge people based on how many fentanyl pills they’re accused of possessing — not just how much the pills weigh. Possessing between five and 24 pills will be a misdemeanor, which can result in up to a year in jail.
Multnomah County Commissioners Julia Brim-Edwards and Sharon Meieran both told Willamette Week they thought the county should hold off distribution of foil and straws until the commission can discuss it. However, final approval for the purchase of the supplies already came in April during the budget approval process as part of the overall harm reduction supply budget, Dean said.
Portland City Commissioner Rene Gonzalez took to Twitter to express his disappointment.
“Heavy drug use is killing too many, driving crime, deeply damaging livability and devastating our 911 system,” he wrote. “Thoughtful harm reduction may have a place in addressing substance use disorder but handing out tinfoil/straws in a community ravaged by fentanyl is reckless.”
Public health experts said sitting on the sidelines is the true reckless act.
“(Harm reduction) actually allows us to engage with people and connect them to treatment and naloxone,” Dean said. She stressed the importance of using the supplies not just to keep people alive but to make them feel like they have a safe place to turn once they are ready for treatment.
Nicole Hayden reports on homelessness for The Oregonian/OregonLive. She can be reached at nhayden@oregonian.com or on Twitter @Nicole_A_Hayden.
