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'We have a massive problem': Experts say Oregon's opioid epidemic continues

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A recent report from Wallethub finds Oregon has the sixth-worst overall drug problem in the U.S.

It ranks Washington at 19.

The study also says Oregon has the fourth-highest percentage of teenage drug users nationwide.

Researchers say the problem is driven largely by the abuse of opioids, drugs including heroin and many prescription painkillers like Oxycontin.

Federal data says Oregon has the highest rate of seniors hospitalized for opioid-related issues in the country. Washington comes in second on that list.

Oregon also tops a 2013 list of states ranked by the rate of non-medical use of pain relievers. In that study, Washington comes in at number three.

KATU talked with a panel of local experts about the opioid epidemic, which they said isn't going away. They included Mark Kruger, captain of Portland Police Bureau's drugs and vice division, Dan Mark, a recovering heroin addict, Dr. Katrina Hedberg, the state health officer for Oregon Health Authority's public health division and Lydia Bartholow, associate medical director for outpatient substance use disorder services for Central City Concern.

Central City Concern is a nonprofit group serving people in the Portland area impacted by poverty and addiction.

"We have a massive problem," said Kruger, who's been with the police bureau for 23 years. "We're seizing larger quantities of methamphetamine and heroin and cocaine in Portland, Oregon than we have historically ever seized."

Kruger said those drugs are largely coming across the border from Mexico and Central America.

And he said there's a new threat, fentanyl, an incredibly strong, extremely dangerous, synthetic opiate, available online from China.

"Children now can buy fentanyl on the dark web using bitcoins for currency and they can overdose in their own bedrooms on a substance that no one really knew about a couple of years ago," said Kruger. "There are larger and larger quantities of these synthetic opioids, as well as any other drug you wish to name. They're available through the dark web that you can purchase and have delivered right to your home through the U.S. Postal Service."

"Now, we're seeing some overdoses regarding fentanyl," said Bartholow, "so people that are using heroin on the streets are gonna be more likely to have these fatal overdoses."

Researchers say most opioid abusers don't start out with hardcore drugs like fentanyl. They say four in five heroin users begin like Dan Mark did, with prescription painkillers.

"I had some head trauma," Mark said. "I was hurt and I was prescribed painkillers and I was on them for three-and-a-half years at which point they decided to take me off of 'em. I wasn't ready to come off of 'em and ... I doctor shopped and bought 'em on the black market. One day somebody introduced me to heroin."

Mark said heroin was cheaper and easier to get.

"But the problem is is that you get a dependence upon it," Mark explained. "And $30 a day turns into $50 a day turns into more."

Until eventually Mark said he was living under the Burnside Bridge.

"It's a big trap. It's a huge trap." Mark said.

Due in part to new regulations, state data shows the number of prescriptions for opiates is going down.

"But what that means is we have people who are addicted that now are gonna move to heroin," said Bartholow.

When asked how people can get treatment if they can't afford it, she said, "Luckily, right now, with the passage of the ACA (Affordable Care Act) we have very few folks that can't access insurance. In general, for the people we're seeing at Central City Concern, which is, of course, a different population, most of those people can access Medicaid, right, they can have OHP (Oregon Health Plan)."

Bartholow said if the ACA, also known as Obamacare, is overturned and Medicaid is cut back, it would have drastic consequences for many addicts now in or seeking treatment.

And she said there are other challenges.

"For now, treatment options are there but there are not enough treatment beds," Bartholow said. "There's not enough sort of quick access to residential so we need to do some sort of state level shifting to residential facilities for treatment. And then, ultimately, we need payers, private insurance payers, to cover treatment more profoundly. People often will pay for maybe a week-long detox. That's not treatment. That's a detox. So what we need is actually long-term treatment and we need more variance in treatment."

Captain Kruger said a big challenge for law enforcement is staffing.

"In drugs and vice division we've lost about 30 percent of our staffing in the last two years because we've had to redeploy officers back to patrol work given the number of officers we've had retiring," Kruger told the panel.

Mark and Bartholow said treatment should be the focus.

"It's a disease. It's been classified as a disease and we don't throw diabetics in jail and we shouldn't be throwin', you're not gonna get a guy sober in jail," Mark said.

"This is a public health epidemic," Bartholow said, "and we really need to shift funds to treatment."

"For any of that to be effective, it has to be a holistic system where there is accountability," said Kruger. "There's gotta be some level of personal responsibility and accountability with the user."

When the panelists were asked if they had hope about this topic, Kruger said, "Certainly think that we have the capacity to make a very positive impact on this problem and to reduce its effects on society."

"Until we can stop the flow of drugs across the border coming in here," Mark said, "it's going to be a very difficult problem to fix."

"I feel relatively hopeful," said Bartholow, "and I think that comes in reflection to doing clinical work."

And Bartholow said a personal problem may be the source of the epidemic.

"We know that childhood trauma and chaos increases the risk of addiction about 6,000 percent," she said, "so if we're gonna do sort of root cause analysis, we need to be looking at drugs coming across the border, and then also we need to be doing some public health interventions around what they call adverse childhood experiences."

Hedberg told KATU Washington addressed the opioid epidemic earlier on than Oregon.

She said the problem is especially pronounced in rural areas.

"We are seeing very high rates in Southern Oregon and along the coastal counties. They're very high rates of opioid prescribing and overdose," said Hedberg. "In the (Portland) metro area we are also seeing opioid overdose. The metro area has a particular problem with heroin overdoses compared to other parts of the state."

Hedberg said Oregon has recently made some progress.

"The good news is we're starting to see a trend going in the right direction," Hedberg said. "It looks like we've peaked in opioid overdose deaths. Those are starting to decline as well as our hospitalizations and over the past year we've seen a steady, although not huge, decline in the amount of opioids that are being prescribed."

OHA data says the number of overdose deaths statewide peaked about 10 years ago with 220 per year. That dropped to 170 per year around 2015.

“Many people are dying of opioid overdoses. That was not happening 20 years ago," Hedberg said. “We need to figure out ways to address pain in patients other than opioids.”


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