As drug deaths rise in Portland, calls grow for safe consumption sites

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On the same night several people were asking the city to create what are known as safe consumption sites, the Portland Police Department announced five people had died from drug overdoses in the first 10 days of November.

The deaths were part of a growing trend, notably from opioid use. Between 2008 and 2019, there were 373 overdose deaths in the city, and 2019 alone accounted for a 25 percent leap from 2018.

“The tragic impacts of substance use disorders are all too real,” Portland Police Chief Frank Clark said in a press release. “For those fighting that fight, we stand ready to help you on your path to recovery. We can make referrals and connect you with resources right here in our city. For those trafficking or bringing illicit drugs into our community, I can assure you that you are on our radar and our officers will be diligently working to hold you accountable for any such actions.”

Although officials at Portland’s Public Health Division don’t have a stance on safe drug consumption sites, they do see the need for greater public action around the increased number of overdose deaths in the city. (Portland Phoenix/Colin Ellis)

Zoe Brokos, the program coordinator for the Substance Use Prevention and Harm Reduction Services department in the city’s Public Health Division, said the state projects a continued high number of overdose deaths.

“We can focus on the numbers, but these are all lives that have been lost and lives that contributed in many ways to our community,” Brokos said.

Brokos said the coronavirus pandemic has played a role; it’s harder for people to connect with others, and they sometimes turn to substances instead.

“We have also seen an alarming rise in people who were on a path to recovery struggle and relapse and not feel able to connect to those supports they used to connect to,” Brokos said.

In addition, she said, there are fewer resources available than before the pandemic, and for people who have recently been released or will soon be released from prison, there aren’t recovery centers available.

Brokos said fentanyl, a synthetic opioid up to 100 times stronger than morphine, is increasingly the drug found on the street. It is often cut into other opioids, such as heroin.“It’s changing rapidly, and it’s hard to look at a substance and know if there is fentanyl in it or not,” she said.

She also said there has been a rise in non-opioid drugs testing positive for fentanyl, which is an added complication in trying to keep the drug-using community safe – especially if people don’t know they are using fentanyl and don’t have naloxone or Narcan available to reverse a possible overdose.

She said Chicago and other cities have been testing substances people are using on the streets to ensure there is no fentanyl.

“By us providing this kind of pragmatic approach to substance use, we’re able to help keep people connected and work with them to connect in other areas of the community as well,” Brokos said.

Safe consumption

At a Nov. 10 City Council Health and Human Services Committee meeting, several people advocated for safe consumption sites, which so far have not been authorized anywhere in the U.S.

These spaces allow individuals to use pre-obtained drugs under the guidance of trained personnel. Vancouver, British Columbia, was the first North American city to launch such a site, which proponents say can significantly reduce the number of overdose deaths, and eventually help individuals stop using drugs.

Dr. Kinna Thakarar, a physician who spoke during the meeting, later said consumption sites in Canada, Europe, and Australia have saved lives and also saved their cities millions of dollars.

“These facilities provide clients safe injection techniques,” she said. “They provide vaccines, STD screenings, and treatment. They’re not just providing needles.”

Thakarar said safe consumption sites, such as the ones in Vancouver and Toronto, not only teach safer practices for drug users but can dramatically reduce costs associated with hospital stays and treatment for diseases like HIV.

Thakarar, who specializes in infectious disease, said she had the chance to visit a site in Toronto where there was community buy-in.

“It speaks volumes to people understanding harm reduction and what it’s all about,” she said. “At the end of the day, we want to save someone’s life.”

Another speaker was Kari Morissette, director of the Church of Safe Injection, which was founded by Jesse Harvey, a recovery advocate who died of a possible overdose earlier this year at 28.

“I lost two of my community members to overdoses tonight,” she told the committee.

Morissette, who said that she is HIV-positive and worked as a prostitute during the time she was homeless and struggling with addiction, said safe consumption sites could help the city by reducing the cost of emergency response services.

Thakarar said there are three main factors standing in the way of safe consumption sites becoming common in the United States: legal barriers, public opinion, and funding. She said legality with these sites is often complicated. For example, such a site was permitted in Philadelphia but ultimately snarled in legal battles.

She said these sites also need public support.

“The key is educating people that these sites are public health interventions that can reduce mortality and infection,” Thakarar said. “They can reduce public injecting. I think just trying to show people that this is really a public health intervention.”

Funding is also a barrier, she said, because these sites require startup capital and fees to operate. However, she said the money saved over time will more than exceed those costs.

Overall, Thakarar said there must be a greater recognition that substance use disorders are chronic medical conditions that should be approached as such.

“These sites are a way to prevent bad things from happening to people,” she said. “We just want to keep people alive, and these sites have proven to do that.”

Other steps

Although safe injection sites aren’t something on the city’s immediate horizon, Brokos said Portland has taken several steps to help reduce the number of overdoses.

For example, she said, the city has been doing overdose prevention training with naloxone since 2015, and Portland is the state distributor for York and Cumberland counties for the over-the-counter overdose reversal drug.

Naloxone, also known as Narcan, is an over-the-counter drug that everyone can be encouraged to carry and trained to use.

“It’s a great way to educate yourself and learn more about issues going on in your community,” Brokos said. “It does affect everyone; it does affect a community on a broader level. Carrying naloxone and having that training to recognize an overdose can be really valuable for people.”

Until then, however, overdoses and drug-related incidents will continue to rise. In addition to the deaths this month, a city clerk found almost eight grams of fentanyl and methamphetamine on the floor of Portland City Hall. It is suspected the person who dropped it was there to register their car on Nov. 6.

On Nov. 9, police stopped a vehicle at the Big Apple Gas Station on Park Avenue. The owner was arrested on a warrant. While being arrested, police said she tried to destroy drugs that police had missed during a pat-down search. She allegedly had more than 12 grams of powder that was a combination of fentanyl and methamphetamine.

That same day, police stopped a car at the corner of Cumberland Avenue and Wilmot Street, where a police dog found 18 grams of methamphetamine, 23 grams of fentanyl and crack cocaine, and 32 Xanax pills were seized.

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