November 6, 2017

Linda VanDeusen-Price studied the small nasal spray bottle, a sample of a drug called Naloxone, which can save the life of someone overdosing on opioids.

Like many of those gathered recently for the November meeting of East County Caring Communities, VanDeusen-Price had never heard of the drug that health experts credit with slowing the scourge of overdose deaths in Multnomah County.

Dr. Paul Lewis passes around a sample bottle of Naloxone, the drug that can reverse an opioid overdose.

Where death rates continue to rise across the country, in Multnomah County those rates have stabilized in recent years. But addiction — measured by needle exchanges, admissions to emergency rooms, demand for detoxification placements and a squeeze on addiction treatment facilities — continues at an epidemic level.

Public health outreach workers at Multnomah County have worked with health care systems and individual doctors to consider alternatives to — and lower doses of — opioid drugs for pain management, while the county has long invested in drug detox and addiction treatment programs including those offered by Central City Concern and Volunteers for America. It has also offered a needle exchange program for people actively using drugs to protect against transmitting diseases.

Naloxone, also called Narcan, “is very good at waking up people who are unconscious, turning blue, or who are not breathing at all,” Kim Toevs, program manager for Multnomah County Health Department’s HIV, STD, Hepatitis C Program, told those gathered for the meeting. “It’s a tool, not prevention. It’s all the way downstream, right at the point when someone is potentially about to die.”

Toevs' team has trained 270 service providers through 70 organizations and at least 300 active drug users on how to administer Naloxone. The drug has reversed more than 2,000 overdoses, according to data gathered from those who seek refills. Toevs joined Tri-County Health Officer Dr. Paul Lewis and Commissioner Lori Stegmann at Gresham City Hall for a discussion on opioid abuse in eastern communities of Multnomah County.

“This is a public health issue. We have to do something to stem the tide of addiction,” Stegmann told representatives from local government and nonprofits, including Gresham Police, the Reynolds School District, Rosewood Initiative, Human Solutions, New Avenues for Youth and the Multnomah County departments of Health and County Human Services.

Stegmann joined other Oregonians last month for national Prescription Drug Take Back Day, clearing her medicine cabinets of unused prescriptions. As the mother of a socially-active teenage daughter who often has friends come to her house, it felt responsible to make sure she didn’t have any popular or addictive drugs lying around.

Gresham Police Lt. Jeff Miller said kids at local high schools are buying heroin and pills for as little as $5. “Just outside our schools, kids can get, you name it, from alcohol to heroin to marijuana,” he said. “A lot of this is very inexpensive.”

Dr. Lewis said that’s one of the frightening aspects of opioids: street drugs such as black tar heroin are cheap alternative to prescription opioids.

“Think about a latte or a beer. It’s at that price-point,” he said.

About half of the area’s intravenous drug users report their addiction to heroin began with a dependence on costly prescription opioids, for which there is a prescription enough for every man, woman and child in the state. Dependence occurs when anyone takes opioids for a prolonged period.

“Being human makes you susceptible,” Dr. Lewis said. “I’m a pediatrician, and little kids we need to treat with opioids, it can take us weeks to slowly, slowly decrease the dosage.”

VanDeusen-Price, a member of the North Gresham Neighborhood Association, said she knows that story all too well. A family member struggled for years with addiction after being prescribed opioids.

“His primary care doctor just kept adding more meds,” she said. He’s been clean for five years now, but he lost his marriage while he was using.

“It’s a very sad, sad thing,” she said. “He’s doing wonderfully, but that’s not the case for everyone. Not everyone has the support of family and friends.”